Colorado's Voyage interviews Bill Dahlquist of Home Instead Senior Care an In Home Care provider.
Tom "Bill I want to discuss this is a hot issue. Nowadays it's the baby boomers who are getting old at this point time and there's not enough adequate services out there and you're kind of fulfilling a niche because you want to keep the senior in home as long as possible. So tell us about your business and how do you do to help fill this void"?
Bill "Be happy to. So at home instead we provide non-medical services to help seniors to stay safe in their own homes and the services include things like companionship, meal preparation, laundry, light housekeeping, but today even includes dementia care as well as hands on personal care. These services are in some ways considered gap services. They're not provided by nursing or skilled home health and often times they're not otherwise available to families unless they use a resource like Home Instead. So we're able to help seniors stay safe in their own homes for as little as three hours at a time to as much as 24 hours a day seven days a week here in Denver".
Tom "So tell us about the employees that you hire and how many do you have. Also, do you offer more than one employee to go out to the customer if there are different needs for that particular senior".
Bill "Well every situation is different. And so the needs of our clients often times are different and we at Home Instead have an army of caregivers to provide these important services. How do we select these individuals is really important to the peace of mind of families who call Home Instead. So you're having someone come into your home it's a very personal matter. You want to make sure that you have a company like Home Instead who are very proud of our screening process. We require six references. We have obviously a pre-employment background check as well as a pre-employment drug test along with two interviews but we also do random drug tests and we do annual background checks and motor vehicle record checks so we understand how important it is for our seniors to have the best caregivers possible. And that's why we take such extraordinary measures in the industry to make sure that our caregivers are the absolute best they there".
Tom "I know you sometimes hear those stories where somebody is being taken care of but they're also being neglected or are actually being ripped off by some of these caretakers out there. So I can see why you do an extensive background check for your employees. So it's when somebody is at that point to get yours service what procedure do they have to do in order for that to happen. Do you go out to the home to interview the family or how does all that work".
Bill "Most often what we find is that people call us in crisis. There's been an event that's happened with their loved one and that event has led to the need for more help in the home. And so we'll get calls where care is needed right away and the typical process is a family member will call Home Instead and we will take down some information initially over the phone, then we will set up an opportunity to visit the family with the Home Instead team member. That team member would gather even more information and provide a plan of care for that family going forward. How many days a week does the family need or want care and what care do they want those days of the week and hours of the day. So that's done at an initial meeting and then after that we would come out at Home Instead introduce the caregiver or caregivers to that family prior to starting the service so that everybody's on the same page as well".
Tom "So when you make that initial interview and you go out to the senior have you ever seen a case where you couldn't handle and recommend a different service to go in and help them out".
Bill "Yes we will recommend other services and like I said at Home Instead, what we offer is non-medical home care and we believe is that we do it better than any other home care that you see in the city and state of Colorado. So there are other services that fall along the continuum skilled home health. So they might have P.T. or OT, speech therapy, they might have a nurse come out typically these services are Per diem or per visit kind of thing that aren't extensive or long visits. But certainly that there is hospice of a part of the care continuum and there are situations where hospice is appropriate fit. So what's important about Home Instead and what we really focus on is that we're a resource first. If its home care and non-medical that they need we're certainly ready willing and able to provide that. But there is variety of other services that we're in a situation where either we pull it in or we have a family who is in need of the services or before the service starts, we're reaching out to our friends if they need care continuum hospice, home health, skilled nursing and say hey we've got a client who might need your services or we're not able to provide service but maybe you are. So we're working hand in hand with our partners in this long term care continuum".
Tom "So basically you can probably go out to the home multiple times during the day so that if the customer needs breakfast you handle the breakfast, then leave and then come back and do some light housekeeping and get them lunch and various other things right".
Bill "You're exactly right. Most families will have us come three to five hours a day or some might need three to five days a week. And if you're referring to a split shift scenario where they might have us come out in the morning and then come back again in the afternoon we offer that as well. And that's becoming more and more popular”.
Tom "So for a person that has their parents at home and you're handling the situation they have a sense of security that you're going out there and checking up on them and I'm sure they probably have a lifeline and various other things that if something goes wrong they can get that information fairly quickly in their hands and take necessary measures right".
Bill "You're absolutely right. So we have family members obviously who have jobs and families of their own and they have a loved one who needs a home care, Home Instead is able to come in and provide the care with the quality assurance visits to make sure that the care is provided the way the family wants it provided. And also communicate effectively with the daughter or son whose working or who has responsibilities outside in addition I should say to that loved one. So it’s really relieving for that family caregiver who until Home Instead was lifting, if not all the weight most of the weight of care giving and doing it quietly without much help. At Home Instead we're able to come in and provide the care, communicate the care to the family and in the case of an emergency obviously we're able to alert family of a change in their client's condition and bring in family for that”.
Tom "I know the resources have gotten so much better over the years and in my case when my mom started to fail I was basically the one that handled all the responsibilities of taking care of her and that was in the early 2000's and now we're seeing all these agencies such as yours popping up to alleviate some of those crisis that somebody will be facing in the future for their aging parents. Now tell us what has changed and what has helped you and that caretaker to help keep their loved ones in the home”.
Bill "Well first of all I want to thank you for bringing attention to this service so many families come to us and say I didn't know and if I had known that Home Instead was available my life would be much easier or would have been much easier. You're bringing attention to this service I think will help families who like you are primary caregivers and in going it alone. With regard to the change, there's a lot of change with regard to certainly the need for the services growing exponentially day by day week by week. We have been providing the service since 1997 in Denver. We have an eleven hundred offices throughout the world. We're the world's leading provider of non-medical services providing more home care to more seniors and more places than any other home care agency. We're all independently owned and operated of course as I've told you before myself and my wife own two Home Instead in south Denver. And we've seen the evolution since 1997 when we first started serving seniors in Denver. Technology is much more a part of the home care solution for families. We have the technology now that we didn't have then. Now today families can log on to our technology look at the schedule whether they're in the East Coast or West Coast which we see a lot of that in Denver Colorado. So they're much more able to check on Mom's schedules and see who's coming today and what time they're coming. We also have resources that you mentioned like life line, we use Philips as we are the preferred provider for so to all of our clients you can receive discounts and waivers of certain fees for my Life Line. And then finally medicine is really an important component of people staying safe in their own homes. So what you see is this confluence of medication. Some of it contradicts or conflicts with each other that makes for a situation where a client might not have stability and might fall and so at Home Instead we bring resources and solutions regarding medication management. Really revolutionary stuff that helps keeps that client's medication straight. So they're not taking multiple medications. They're not mixing medications. And so there's a host of resources that are not the least of which is our education here at Home Instead. It's about not only being a resource but provide an education to a family caregiver. So we have education on dementia care, which we've never had before its world class care training on dementia care. I think it's second to none. Families can come to our office sit in our classroom, the very classroom our caregivers sit in and learn about behavior management and learn about encouraging engagement. All these are really important tools and make a huge difference in the life of the senior who's living with dementia. So we have education in these technologies and these additional resources outside of our primary service home care that really make a difference for family caregivers and clients".
Tom "It amazes me what I had to go through when I was dealing with that situation and I had my stress elevated to an all time high. It just took so much out of me and drained all the energy out of me, but I just felt like I needed to do it myself I don't know why. But then after a while of doing it I found it became too much I did eventually have help coming in on a day to day basis. Soon after the help I felt guilty on why I couldn't handle it myself. Also, I didn't want to rely on putting my troubles onto an agency so I don't know what it was, but do you feel there are many people like me were they have a difficult time going to you and say hey I need help”.
Bill "Oh absolutely and the burden of being a family caregiver. You try not tot think of it as a burden, you feel as it is a promise to your parents and you're going to make sure your doing everything you can to make sure they're happy and they're safe. And certainly there are a lot of family caregivers out there. I'll just tell you one quick story, we have a daughter whose mother needed care. The mother's husband had passed away recently over the holidays and the mother was resistant. Didn't want care but needed it and it wasn't until the daughter said “if you don't do it for yourself do it for me”. And A light bulb went off in the mom's mind because she herself was resistant to care, the caregiver the daughter was grappling with this idea as a daughter I should be doing this but maybe I don't have enough time in the day to do everything on my plate. The mother hearing that from her daughter said “OK I'll do it”. And ever since had home care and has been able and their mother's to stay in her own home and the daughter relationships is better than ever. But the resistance or the guilt that family caregivers feel is real and I hope your story and those that have heard it understand that. That happiness and guilt while it's understandable it's also OK to ask for help and I hope your listeners ask for help whether from Home Instead senior care or the countless other resources of the community. But meet with somebody and talk. One of the things that we do nowadays than what we didn't do 20 years ago or 30 years ago when you and I were a little bit younger. Now we use technology more ever. So the one of the good things of technology is we have for example caregiversstress.com. So if you're a family caregiver is listening to this program and you're struggling with this guilt that we all suffer from and you say gosh darn it I don't know should I or shouldn't I have some help, go on a caregiverstress.com that you can take a five minute test. There are 10 or so questions it will tell you your level of stress as a family caregiver, and we need affirmation don't we. If it says hey listen your stress is way out of whack. Here are some solutions, not the least of which is Home Instead, but there are some other community solutions out there. Start looking towards church or some outlet to find a way to alleviate that stress. And at the end of the day we want a healthy happy family caregiver. People who can continue to be sons and daughters that their mothers and fathers need and want, but not at the expense of their own health".
Tom "I found that out where I lost trust with people because it was just one of those things that I've seen so much of bad advice and it gave me that mistrust. When I was going to different agencies and then listening to their advice I just kept on thinking that their advice just didn't seem like it was touching me where I wanted to get their help. I think a lot of people feel that way and it takes a lot of work where they've got to talk to somebody that they feel comfortable with. And so with your agency they can actually come in and talk to your employees and get a personal interview. They also are probably like to see a couple of different employees that they feel most comfortable with and trusting of them coming into their home and taking care of their loved one".
Bill "Absolutely, I mean at the end of the day that person and its family members have to be comfortable. And so whatever it takes to get them to that point if it's not today they want service but they might want to down the road that's fine. Some of them are at a different stage in their whole kind of evolution of guilt and responsibility and what do as a caregiver. So we understand and I want to go back to something earlier that you had asked or made mention that you had a bad experience at a time when you were going through as a family caregiver. Some legitimate reasons why some mistrust had built up due to your experiences. I understand that you're not alone that I came from a background as a prosecutor. My job was to prosecute among crimes against persons, crimes against the elderly. I saw that firsthand where there were experiences that families had with neighbors, friends, people they trusted that didn't go well. And of course, human nature is that you've had a bad experience and that that wall goes up you say no more I'm not going to go down that road again. So I understand as a prosecutor having done the work seeing it firsthand knowing that family's experience and that part of the drive that led me to where I am today. I left everything I knew, my friends, my family, my home, my job, my career to come to Colorado in 1999 just to take over Home Instead Senior Care and it's been my mission to provide you peace of mind to families and to do it with that a bit of a prosecutor hat on that make sure that we ask the difficult questions when we're screening caregivers and we do all we can to make sure families are safe".
Tom "And this is what the show's all about for Colorado's Voyage just to get to know the business owners and get trusting of the people within the community. I don't think there's an outlet out there where people can actually go to and find out about these different businesses and situations that you come across in your life and there's so much out there it's like where do you go for that resources. You got you search engines but that's just a information from who knows.. They just throw out a bunch of words and there's no personalization in that. So from step 1 to step two to step three I don't think a lot of people really know what needs to be done and how the caretaking progresses from step to step.. And then once one step arrives you don't know where to go to Step 2. And it's a procedure from what I've learned so when step one happened what to do and I said OK I'll take that responsibility on myself, but I could have had help with that step one. and then step two was here, there was another procedure that I was not prepared for and I had to go into that next role and it was OK my mom is having difficulty walking, she can't cut a toenail and she's having difficulty bathing. So does your agency offer help with bathing, transfers and cutting toe nails".
Bill "Well actually. In terms of bathing, hands on dressing, hands on incontinence care, transfers and baby assistance, we do all that day. You mentioned some of the other areas, but there's a there's a lot of services at Home Instead that provides and the vast majority of them are really important to helping families stay safe in their own homes. The challenge really and it's our personal campaign is to have conversations earlier rather than later, before a crisis happens and families begin to scramble to make decisions. We call this program the community education program called 40/70 talk and other articles referring to the 40/70, You'll find a variety of resources, but in essence it says “assess if you're 40 years old and your parents are in their 70s plus begin now”. They may be getting out, they may be driving, they may be going to restaurants and movies and caring for the grand kids. But begin now assessing the situation on a variety of subjects including what is mom and dad want do in terms of living arrangements, what do they want to do with regard to their finances, what do they want to do with regard to driving. These are all very personal subjects, but you and I as family caregivers were thrust into that. Generally, because of some crisis that we don't necessarily get the opportunity to do things as smoothly as maybe your mom or dad would like us to do simply because we're reactive versus proactively. Know a game plan. So 40/70 talk has about a four or five topics that are really important. It will help your reader begin the conversation. I say in the 40's when your parents are in their 70's but really you get the idea. Adult children talking to adult parents about four or five topics. And then there's a real neat tool an acronym act "A" stands for assess the situation, so for driving you assess your mom or dad on how they're doing. You consider options so maybe there are other alternatives to mom or dad driving. And then finally you have a conversation or talk about those things with your parents. The beauty of it is today versus 1995-1999 all those talking points about those really important subjects including home care are out there for families all they have to do is search. We talk about search engines and the kind of impersonal nature of what you gather but at 47/70 talk or caregiverstress.com these are resources for your readers that will help prepare them for that point in time where they themselves are family caregiver and then begin looking for resources and then know what mom or dad really wants. So I'd encourage your readers check those sites out.
Tom "And it's a difficult subject nobody really wants to talk about this because we hate seeing parents age and getting to that point where they need that care”.
Bill "You're exactly right. I mean it is hard on the child and not to mention of course a parent, but I've heard time and again that the difficulty of Family Caregivers struggling with this concept that mom or dad who's done everything that's been accomplished and been really a strong person in their life, then now is in need of help. So that's difficult".
Tom "Tell us about the future, since it's 2017 and things have really changed over the last 10 years. What do you see going on with the next 10 years for your agency and the ability for people to stay in their home and if not in their home what other options would they have available. For example, when my mom needed full time care there was only one option and that was a nursing home and I dreaded it, I did not like the care or the facility, I heard of boarding homes, but before I can get her in one she died before. So can you talk about that".
Bill "Well there are fantastic nursing homes and there are some that are working towards that. With options I think boarding homes will be increasingly popular. It has a home based living condition with only 5-6 residents. And we've all heard the phrase, it's gotten a little bit old by now, but the tsunami the numbers of baby boomers who are aging and becoming 65. We're all understanding that’s the reality of the demographic shift. I see that there will be a growing need for providers for not so much home care agencies but the direct care worker and so that will be an increasingly difficult person to find and hire. We're doing a fantastic job here at Home Instead and the resources of finding these individuals. It's it takes a special person and we might have a hundred applicants and we might only hire eight of those. Our standards are very high, but there's a great need for caregivers. So I see a great need for caregivers. Of course a licensed industry that's the highest on Oversight and Government agencies. In Colorado 2008 they licensed all home care agencies and dividing them up into A and B license agencies. That has been the norm for the last six or seven years now".
Home Instead Senior Care has many locations. Bill Dahlquist is located at 2095 S Pontiac Way Denver CO 80224. Ph #303-389-5700. Web site which is www.homeinstead.com.