Care Delivery

Care Delivery

Dementia and Memory Care

Service Offering Playbook

Care Delivery



Once you have signed a client on for care, it is important that you understand how to now deliver high quality care to that client. There are a number of factors to take into consideration when it comes to care delivery including having a detailed care plan, training caregivers effectively, and receiving payment for services provided. In this section, we will go into detail on these topics to help you understand how to provide high quality care to dementia and memory care clients.

Care Planning

Care plans are created out of the in-home assessment after you’ve had the opportunity to speak with the client and/or family members and see the status of their home environment. Building a care plan for a dementia patient involves considering a range of factors to ensure their unique needs are met.

At Qualicare, each and every care plan is personalized to the client’s needs to ensure the brand experience is of the highest quality and that clients are taken care of – not only will this ensure clients get the care needed but it will also help with receiving word of mouth recommendations from clients and/or family members who are impressed with the services you provide.

Effective Care Plans
In order to design an effective care plan for a client with dementia or cognitive impairment, it’s important to incorporate the following elements. These are included in the care plan documents that can be found on QCentral.

o Stage and Type of Dementia - Different types and stages of dementia present different symptoms and challenges. Understanding the specifics of the client’s diagnosis is essential to crafting an effective care plan.

o Physical Health - Consider the client’s overall physical health and any chronic conditions that may impact the care plan. This includes mobility issues, dietary needs, and medication schedules.

o Mental and Emotional Health - Assess the client’s emotional state and any mental health conditions that need managing. Depression and anxiety are common in dementia patients.

o Activities of Daily Living (ADLs) - Identify the client’s ability to carry out daily living activities (like bathing, dressing, and eating), and determine where assistance is needed.

o Behavioral Symptoms - Determine if the client experiences behavioral symptoms like agitation, aggression, wandering, or sleep disturbances. Strategies should be put in place to manage these behaviors and ensure safety.

o Communication Skills - Assess the client’s current communication abilities. Tailor interaction techniques accordingly and plan for potential future communication difficulties.

o Social Interaction - Socialization is important for cognitive health. Incorporate opportunities for social interaction into the care plan, whether with family, friends, or community groups.

o Home Environment - The client’s living environment should be safe and dementia- friendly. This might involve modifications to reduce fall risks, secure dangerous items, or accommodate mobility aids.

o Cognitive Stimulation and Activities - Engage the client in activities they enjoy, which can help maintain cognitive function. This could include music, art, puzzles, or gardening.

o Caregiver Support - Caregivers also need support. If family members are involved in care, ensure they have the necessary resources and respite to prevent caregiver burnout.

o End-of-Life Care - If the client is in the later stages of dementia, consider end-of-life care preferences. Discuss these plans with the client (if they're capable of making such decisions) and their family. Be aware that those in the later stages of dementia may not be able to make these decisions but could be present for a discussion with other family members.

The care plan should be flexible, as the needs of a dementia patient are likely to change over time. Regular assessments should be performed to ensure the care plan remains appropriate and effective. Training your caregivers to notice any changes that may need to be made to the care plan is also a helpful way of determining if a new assessment must be completed as a client’s dementia progresses.

Training Staff

Having a detailed and effective care plan is going to ensure your staff are clear on what a client needs in order to be effectively cared for during their time at the home. As a business owner, you want to ensure that your caregivers are also trained in providing care for clients with dementia as it does require specialized training to be most effective. Being able to adequately explain how your caregivers are trained is going to help the client and family members feel comfortable with having caregivers come into the home to provide care.

There are a number of resources you can look at and use when it comes to training caregivers. As an example, training platforms such as Relias have multiple courses related to caring for a client with dementia and memory impairments. Good training will include the following items:

o Understanding Dementia - Caregivers need a solid understanding of dementia, its causes, symptoms, and progression. This includes knowledge of different types of dementia, such as Alzheimer's disease, vascular dementia, and Lewy body dementia.
o Communication Skills - Dementia often affects a person's ability to communicate. Caregivers need to learn techniques for effective communication with dementia clients, such as using simple sentences, maintaining eye contact, and using non-verbal cues.
o Behavior Management - Dementia can cause a range of behavioral issues, including confusion, agitation, aggression, wandering, and sundowning. Caregivers need training on how to manage these behaviors in a calm and respectful way.
o Safety Precautions - Caregivers should be trained on how to make the home environment safe for a person with dementia. This includes removing tripping hazards, securing dangerous items, and potentially using safety devices to prevent wandering.
o Personal Care Techniques - Dementia clients often need help with personal care tasks such as bathing, dressing, and toileting. Caregivers need to know how to assist with these tasks while respecting the person's dignity and independence.
o Activities and Engagement - Keeping dementia clients active and engaged can improve their quality of life and slow cognitive decline. Caregivers should be trained on how to engage clients in appropriate activities, such as music, puzzles, or reminiscing.
o Nutrition and Hydration - Proper nutrition and hydration are critical for dementia clients. Caregivers need to know how to prepare nutritious meals, encourage regular eating, and monitor hydration levels.
o Medication Management - Many dementia clients take multiple medications. Caregivers need to understand how to manage and administer these medications, and be aware of potential side effects (note – this is only applicable if your agency is able to administer medications)
o Stress Management and Self-Care - Providing care for a person with dementia can be stressful. Caregivers should be trained on how to manage stress, take care of their own mental and physical health, and seek support when needed.
o End-of-Life Care - As dementia progresses, caregivers may need to provide end-of-life care. Training on topics like pain management, comfort care, and emotional support can be beneficial.

Regular and ongoing training and support for caregivers is crucial, as the needs of dementia clients can change over time. Providing care to people with dementia can also be draining. It’s important to allow your staff who are caring for clients with advanced dementia or who have more challenging expressions some respite with clients with fewer needs to prevent burn out/turnover of staff.

Have open communication with your caregivers on what they feel they may need support or training in. By doing this your caregivers will feel they have the tools and resources necessary to provide high quality care to persons with dementia.

Beginning Services

Starting in-home care services for a new client with dementia requires careful planning and sensitivity to the client's needs. It is a transition for a client to have someone coming into their home and this can create nervousness, anxiety, and fear for the client and their family. Having a strong process in place to alleviate these feelings will provide a stronger brand experience for everyone involved. Here are some of the best practices related to beginning service for a new client with dementia:

1. Involve the Family - Work closely with the family or other close support persons to gather detailed information about the client's lifestyle, preferences, routines, and medical history.
2. Gradual Introduction - Start with short visits to allow the client to become comfortable with the caregiver. Gradually increase the duration of care as the client becomes more accustomed to the caregiver's presence.
3. Consistent Caregivers - Try to maintain consistency with caregivers, as changing caregivers often can be confusing and stressful for individuals with dementia.
4. Clear Communication - Ensure clear communication about the roles and responsibilities of caregivers. Make sure the client and their family understand what to expect.
5. Reference the Care Plan – The care plan has been developed to be focused on the client’s needs. Ensure the care plan is being referenced regularly to address a client’s medical needs, personal preferences, daily routines, cognitive challenges, and social and emotional needs.
6. Establish a Routine - People with dementia often do well with a predictable routine. Establish a daily schedule for meals, medication, activities, and rest.
7. Prepare for Changes - Dementia is a progressive disease, so the care plan must be flexible and adapt to changing needs over time. Regularly assess the client's condition and adjust the care plan as necessary.
8. Address Emotional Needs - The transition to in-home care can be emotionally challenging for both the client and their family. Provide emotional support and reassurance throughout the process.
9. Be Patient – Caring for a client with dementia can be very challenging, particularly as their disease progresses. Be patient with the challenges that come up and coach your caregivers to have patience. This can help both the client and the family members to remain calm during a very emotionally trying time.

Putting focus on the steps above helps to provide a client and their family members with a brand experience that exemplifies the 360 Approach. Not only are you and your caregivers ensuring high quality care is being delivered for the client but you are also focused on ensuring the family receives what they need for their peace of mind.

Invoicing Services

As with any service you provide in your business, you do need to have a system and process in place for payment of care provided. Knowing this process, and communicating it clearly to the client and/or family member paying for the service, is vital to ensuring smooth collection of outstanding amounts and prevents you from having a growing pile of unpaid invoices. However, invoicing for in-home care services, especially for clients with dementia, requires a clear, compassionate, and ethical approach. Here are some best practices to consider:

o Transparency and Clarity - Clearly itemize all the services provided and their respective costs in the invoice. Use simple, non-technical language as much as possible.

o Frequency of Invoicing - Determine a consistent billing cycle (weekly, bi-weekly, monthly) that suits the client or their family's needs. Consistency will help them anticipate when invoices are coming and plan accordingly.

o Format - Make sure the invoice is easy to read. Use a larger font size if necessary. If the client has a designated family member or power of attorney handling their financial affairs, be sure to include them in the invoicing process.

o Due Date - Clearly mention the due date for payment. A grace period before late charges apply can be helpful for family members managing multiple responsibilities.

o Mode of Payment – As much as possible, aim to have a payment that is collected automatically, such as a credit card. The expectation can be set that the invoice will be sent with enough time for the family to review before the payment will be automatically billed. Having automatic payment helps you to avoid having to chase payments, which can become increasingly more difficult as your business grows.

o Communication - Send the invoice to the person responsible for payments, which may not be the client if they have advanced dementia. Email is best but be prepared to send via mail, based on the recipient's preference.

o Invoice Review - Offer to review the invoice with the client or their family. This could be over the phone or in a meeting, offering them a chance to ask questions and better understand the charges.

o Confidentiality - Ensure the client's financial and personal information is kept confidential, respecting privacy regulations and guidelines.

o Disputes - Have a process in place to handle disputes or questions about the invoice. Be prepared to provide supporting documentation or explanations if necessary.

Always remember that patience and empathy are crucial when dealing with dementia patients and their families, who may be under stress due to the illness and the associated costs. It is obviously important that you are paid for the services provided so combining patience and empathy with clear expectations and communication will lead to fewer missed payments and AR in your business.

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