OVERVIEW
Countrycarers is a nursing agency which provides professional and compassionate nursing and personal care for people in their own homes, from long and short term nursing care, to companion care for tea and company; daily, weekly or monthly nanny minding for children, teenagers, and young adults; domestic housekeeping services including washing, ironing, changing bed linen, bedmaking, and general maintenance cleaning of a home or unit; and handyman and garderner services for minor maintenance and repairs around the home.
Long term, short term or respite care is available 24 hours a day in Newcastle, Sydney, Wollongong, the Illawarra, the South Coast, the Southern Highlands and Canberra.
Under the supervision of a Registered Nurse, we design individual care plans for our clients that reflect our commitment to providing the best possible caring techniques in the comfort and safety of familiar surroundings.
Countrycarers philosophy is based strongly on patient-centred care, which means that the needs and patterns of the patient's daily life is what the care revolves around. Patient confusion caused by constantly changing staff is minimised by our policy of a small, 3-member team working closely with a single patient.
Nursing requirements are supervised and monitored by a qualified Registered Nurse. An onsite supervisor who is a member of the care team supervises each care team. The Housekeeping Manager monitors housekeeping, and household budgeting and expenses are looked after by Countrycarers Client Services Manager.
RESPITE AND CARE RECOVERY
Thanks to the availability of our own in-house Clinical Psychologist, we have been successful in designing and implementing respite, or care and recovery programs, for a variety of patients.
The programs are developed by our Psychologist, in conjunction with our Nursing Manager, and a supervising GP or Specialist. They are administered by our own appropriately qualified nursing staff.
They are usually live-in programs, but live-out programs conducted in the patient's own home have also been completed.
Programs to date have included personal and family difficulties posed by addiction, palliative care, autism, physical and mental disabilities, dementia, and include relationship counselling.
Countrycarers has available a reasonably wide range of accommodation options that are very suitable for patient care from $70 a day up to whatever accommodation level is desired. This enables patients to get away from any environment that may be a part or contributing cause to a problem, and yet be completely supported and cared for on a 24 hour 7 days a week basis. It also provides an opportunity for respite for family or carers.
Contact us for the details of a program that may suit your own family situation.
We are just a phone call away, so please call us now to see if we may be of assistance, or to inquire about any queries or concerns you may have. Our Priority Call number is 1300 852 998, or call our mobile on 0438 418 053. If you prefer to fax use (02) 4443-5669. To e-mail us, click the link above or use the form on our Contact Us page.
Our services include the following:
- 24 hour live-in or out aged care nursing, 1 to 7 days a week
- Long term or short term respite care, 2 hours to 24 hours, or longer as required
- Palliative care
- Dementia care, diabetes management, diet and nutrition, dietary and weight loss plans and meal preparation
- Assessment and ohs plans, care plans and coordination with all services, medication, daily observations, personal hygiene, continence management
- Skin, oral and dental care, exercise and leisure programs, massage therapy, physiotherapy, injections
- Transport and escort, liaison with other services including doctors, government services, chemist, hairdresser, podiatrist and advocacy and advice
- Household management, shopping, meal preparation and service, light housework, laundry, ironing, assistance with all forms of daily activities of living
- Domestic cleans, moving cleans
HOME NURSING OR NURSING HOME
We are very often asked about the difference in costs and results. The answer on results is easy, the answer for costs more complex.
Only home nursing care can provide one on one nursing for any patient in the familiar environment of their own home. No hospital or nursing home can ever do this. The result of home care (according to Scandinavian research) is a much happier patient with a usually longer life span and substantially improved quality of life.
Institutional nursing usually has a staff to patient ratio of between 1 nurse to 12 patients , up to as high as 1 nurse to 90 patients. A supervising RN will typically have 45 to 120 patients to supervise. One on one care for 24 hours 7 days a week is an impossible dream in institutions. It is one reason why our Federal and State governments are trying to move to a model of care in the home after decades of supporting and resourcing institutional care.
Hospitals and nursing homes have a very necessary role to play in our community. They are not always the best or only option. The problems of nursing homes were well covered in the recent ABC Four Corners documentary (2.6.09). They are systemic.
COSTS OF CARE
As to the difference in costs, home nursing usually costs more than institutional nursing, but it is often a difficult sum to determine.
There are a lot of variables - personal or family financial structure, available legal and tax advice, the accommodation bonds charged by nursing homes, the status of the patient, the accommodation required, and the normal weekly charges for services charged by nursing homes are but a few.
Just one example is accommodation bonds. Countrycarers have dealt with clients who have paid or have been asked to pay from $160,000 to $2.4 million in accommodation bonds, with very complex retention clauses. That buys a lot of home nursing.
We are nurses, not tax experts or advisors, but there are available a number of available offsets to income to help with the cost of home nursing which is carried out under the direction of a GP, by legally qualified nurses and health professionals.
These include:
• 20% of fees paid over $1550 per annum (ATO)
• Part payment of care by Federal or State Governments and providors
• Part payment by some medical insurers
There is no single source that can advise on all these and several more possibilities. It is of vital importance to deal with a well qualified tax or financial professional, and to get a ruling from the ATO.
THE LONG GOODBYE
Patients with dementia are not easy to nurse. The physical, emotional and mental load increases as the disease progresses. At Countrycarers, we have a policy of no more than 3 days by any one nurse caring for a dementia patient. It is for the nurse's protection.
Traditionally, the nursing of family members fell to daughters, aunts or grandmothers. That might have been OK (but probably wasn't) when the average life expectancy was 50 to 60 years. It is now 82, and dementia is primarily a disease of advanced age. The numbers of patients is rapidly multiplying. It was perhaps okay when traditional life was far less diverse, movement was very restricted, and horizons were focussed on only what could be seen.
Almost no person in Australia lives that way. Life is long, complex, stressful, uncertain and insecure. The work that men and women do nowadays is intense, skilled, interdependent, and constantly under pressure.
Many people nurse their own family at home. It is done out of love, and is a great expression of the human spirit. It is not necessarily the best thing for the patient, or the carer. The following are the fairly standard problems of caring for a dementia patient.
There are usually 5 stages, and each one can vary in length and severity dependent on the progress of the disease, and the care of the patient.
The disease is terminal. There is as yet no known cause or cure. There are drugs available to relieve symptoms. Research into identifying the cause and finding a cure is very promising. The first is part of stem cell research which may bring about a cure in 10 years time, and involves making new brain cells grow.
The second is research into an already existing drug used in the treatment of rheumatoid arthritis, which seems to be giving good results in slowing or stopping the progress of the disease. That could be available in about 5 years (2015).
The disease takes the form of a plaque which coats connections between the cells of a brain, and destroys them. A hole is left where the brain matter used to be. At the end of term, the brain from a patient with advanced dementia can resemble a cheese, shrunken and with lots of holes.
Symptoms usually start with unusual forgetfulness. As the functions of the brain are affected and lost, so the physical and emotional well being of the patient slowly disintegrates.
Loss of short term and then long term memory takes away the memory of that life. Control of bladder and bowel functions are lost. Disturbed sleep patterns, delusions and hallucinations occur. The ability to maintain personal hygiene goes, and patient dehydration and malnutrition must be carefully watched as they can quickly escalate to problems requiring hospitalisation and intensive care. Urinary tract infections, constipation and pressure sores can also develop unnoticed and quickly, and must be promptly treated. Patients commonly walk for hours, and take any opportunity to wander away. People in their 80's and 90's will climb out of first floor windows, and head off down to the nearest habitation in their pyjamas or without.
The inability to dress, and the compulsion to remove all clothing is also common, irrespective of the temperature or weather. Minor infections like colds, flu, coughs must be identified and treated to prevent a rapid onset of pneumonia. TIA's (little strokes), strokes, heart attacks and heart malfunctions must also be quickly identified and dealt with. Unattended and unwatched, falls are common, and accidents such a broken femur, or hand or foot can have very serious consequences. Medication schedules and monitoring must be continuously observed, managed and all changes promptly passed on to the CMO. Daily observations pick up changes or trends.
Of course there is much more, but this is surely enough to dissuade most people from taking on caring at home without professional staff, professional expertise and respite care.
There is one extraordinary thing that also occurs. The former person of the patient does completely disappear, and is no longer observable. In spite of this absence, or perhaps because of it, another entity exists in the body - perhaps a person, or soul, or spirit, that is sentient, knows that help is available, and has a form of life no matter how narrow or small the focus becomes.
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