Maggie McKay (Host): Welcome to Putting Your Health First. I'm your host, Maggie McKay. Joining us is Michelle Rogers, System Director of Health First Home Care, private duty and home companions, to discuss care in the home setting. Thank you so much for being here today, Michelle.

Michelle Rogers, MHA: Thanks Maggie. It's great to be here.

Host: So to begin, would you please introduce yourself and tell us a little bit about your role at Health First?

Michelle Rogers, MHA: I would love to. First of all, I just want to say that home care is my passion. I am again, Michelle Rogers, System Director for Home Care, private duty home companions, and have been with Health First for over 26 years. But I've also been in the home health industry for over 35 years, so of course that means I was 12 when I started. Right? The other thing I like to share with folks is that I am also currently serving as the President of the Board of Directors for the Home Care Association of Florida. So that means I have the pleasure of representing all home health agencies throughout the state of Florida and helping to be their voice in Tallahassee.

Host: Wow, that is a lot. Many families don't know the difference between home care and private duty, which can make decisions really tough. So how would you explain these two options to someone just starting to explore care for a loved one?

Michelle Rogers, MHA: That's a great question, and particularly because all of the services are provided in the home setting. We get asked that a lot. Aging at home with Michelle Rogers MHAconfidence Understanding your care options.So home care is what we'll refer to typically as skilled medical care. It's nursing, physical therapy, maybe wound care, and it usually occurs after a hospital stay or some type of acute care setting such as a nursing home, and those services need to be ordered by a physician and are often covered by Medicare insurance.

Now, private duty, the other segment, is really non-medical support, so that would be your help with bathing, dressing, meal preparation, companionship, and that's usually paid out of pocket or maybe by a long-term care policy if some of our patients planned ahead. So it's really more about choosing specific days of care and hours you'd like someone in your home and has a little more flexibility than the home health setting.

Host: Well, let's get into the specifics. What kinds of services can families expect with home care and how do those compare to private duty?

Michelle Rogers, MHA: So the types of services they can expect would be physical therapy, medical social workers, occupational therapy, registered nurses, also, aid services for some of the bathing; that's with your home care. And to qualify for those services, a patient needs to be considered home bound. Now, what is home bound?

That means it's really difficult for that particular patient to leave their home. Not that they can't leave their home, but they probably are going to need a walker or a wheelchair or somebody to assist them to get out so they can go to their doctor's visits. But basically at this particular time, they're kind of stuck at home.

And that's where we come in to help. We help manage those new diagnosis such as congestive heart failure, COPD, maybe new diabetic care or a lot of post-surgical services. And then on the private duty side, they don't require a doctor's order. And that includes the personal care such as bathing, dressing, but they can do like housekeeping chores, transportation, and just general companionship. You know, we had one patient recovering from surgery who was able stay at home with his 10-year-old dog Barney. And our caregiver was not only there to help with the patient's recovery, but as you can imagine, this pet is very important.

And so we fed Barney. We took Barney for a walk every day, and just that kind of extension of the family and the services and what's important to our patients really makes that difference at home.

Host: That is so nice. Caregivers play such a vital role in the quality of care provided. Who provides care in each service? Are there differences in the training or the qualifications of the caregivers?

Michelle Rogers, MHA: Yes, and you know, we are only as good as who we send out into the homes, right? We can be great in the office. But if we don't have wonderful representation out there in the home setting, we are not doing our job. So that is the heart of what we do. It's provided by the professionals, like nurses and therapy that we talked about earlier.

Private duty caregivers are often home health aides and they're trained in personal care and safety, and we do ongoing supervisory visits. Constant in-service trainings, as well as ongoing competency checks and annual training. And at Health First, I feel we go above and beyond to ensure that safe care at home.

Because our clinicians are bonded and insured, they undergo national background checks and level two fingerprinting through the state of Florida, they receive vaccinations, drug testing, which rarely happens in other private duty agencies and health screening. So these are a lot of the steps that many of our competitors don't take, and this helps give the families truly a peace of mind.

Host: Well, choosing the right care depends a lot on a person's unique health needs I would imagine. What kinds of situations or health needs make someone a good fit for home care versus private duty?

Michelle Rogers, MHA: It is very specific based on what they are looking for. So home care is great for someone that is recovering from surgery, maybe managing a chronic condition. Those skilled professionals provide what we'll call short-term intermittent visits under a physician's supervision to restore a patient back to their optimal health.

And sometimes optimal is in the eyes of the beholder, right? So maybe we have a patient who just wants to be able to walk to the mailbox again because of whatever happened they're not able to do that. Or maybe having some breathing difficulty. But then you have others who want to get back out on the golf course or the tennis court. So, back to their optimal state of health.

Private duty is ideal for those who need help with daily tasks or companionship. They can choose as little as like a couple hours a day or all the way up to continuous care around the clock. So really we are looking to mold those days, hours, and services based on what that family's looking for, especially if they have family members who still work or live outta town and can't be there for them. As a matter of fact, we've had some clients we've cared for for years on the private duty side. We really, truly become an extension of their family. And, we're getting ready to go on a cruise with one of our patients.

She doesn't have any family available. She does need a little bit of help with her personal care. So we have a lucky home health aide who's going to get to take a cruise. So it's exciting to be able to do that. The holidays are a great time for us to take people shopping. They don't want anybody to see the gifts, and so if they can't get outta the house by themselves, we take them to the store, we wrap gifts. It's just really a lot of those daily chores and tasks that sometimes, our patients can't do any longer.

Host: So some families might benefit from a combination of both services. Is it possible to use both services at once? And how do they work together to create a seamless care experience?

Michelle Rogers, MHA: Absolutely they can use both and it's really quite common. For example, a patient might receive wound care from a nurse while private duty aid helps with bathing and meals. So we're going to coordinate these services to ensure that they compliment each other and create a seamless experience. One family told us how their father was able to stay home comfortably surrounded again by, you know, it always comes back to the pet, the dog who never left his side.

And, now

with Epic and MyChart, the customers can receive seamless coordination of those services between all types of departments at Health First, from the hospital to the physician to then home care. We're able to see each other's records and really provide that seamless care.

Host: How does Health First personalize care for each patient's unique needs, whether it's medical, emotional, or maybe day-to-day support?

Michelle Rogers, MHA: So to provide that individualized care, we start with an assessment and we create a care plan that is going to reflect that patient's medical needs, their preferences, their lifestyle. It's very personal when you're invited into someone's home, and we are a guest and we know that whenever we are caring for someone at their home setting, we collaborate with a patient, their family, the physician.

I mean, we're down to asking, okay, which day should we take the trash out? What day do you like to do laundry? Are there certain, things that you do that we can help with? And as we create that care plan, we even match the caregivers based on personality and some of those traits. If someone likes a particular caregiver, maybe they talk a lot and they want to chatter or they like their silence. So they would prefer someone who is fairly quiet, but they help build that trust. One of our other patients. She used to be a florist and so they ended up planting flowers together. So that was kind of their thing that bonded them together and really made her want to keep that particular caregiver.

So we really, in that care plan, are looking for not only personality traits, but also medically what is going to restore them back to their health.

Maggie McKay (Host): I love that. I love that. The flower planting, how cool and all the dogs that can stay with their owners because of the help. So flexibility is often a top concern for families who are balancing care with daily life. How flexible are these services in terms of scheduling and choosing the right kind of help?

Michelle Rogers, MHA: They are quite flexible and particularly because there's never a contract involved. So when you have services from either our home health side or our private duty side, we actually just sign a consent. A consent that we can come into your home and that we can provide services, but you are not obligated to any length of time or a contact.

So you can choose just a few hours a day or up to 24 hours, seven days a week, depending on how much care you need, and you can change it. So maybe the first week you come from home, from the hospital, you require more care. But then as you start feeling better, you would like to cut back on that care.

We're certainly flexible in that respect, and depending on whether you're a morning person, an evening person, or just a caregiver who's exhausted and want to get some sleep, we could come and spend the night. So really allows that family flexibility depending on what their specific needs are for the care plan.

Host: And Michelle families often have a lot of questions when considering in-home care. What are some of the most common questions or concerns you hear from families?

Michelle Rogers, MHA: They do have a lot of questions, and once again, because it is the environment of their own home, safety comes first. They want to know that they're hiring the right person, that they're hiring trustworthy people. One of the suggestions I would make is that they do hire a licensed home health agency. Even if it's not us, I would ask that they do their due diligence, hire through the state of Florida, which is one of the licensed home health agencies, instead of using independent contractors.

There are many agencies who provide independent contractors that do the same services we've discussed here today, but it does put a little bit of risk on the client's side. For example, if an independent contractor gets injured in their home, that homeowner is responsible. Or if something gets broken or stolen in the home, they have no recourse.

It's really between them and the caregiver that's been assigned all the way, even down to filing taxes believe it or not, if they have someone in their home, they need to file taxes for that person and money exchanges hands in the home, which just is not as safe as I believe the setup of some of the other licensed professional agencies.

So at Health First, name, you know, and trust. We cover their workers' compensation if they're injured. If something were to get broken, we are responsible and because our associates are insured and bonded, lastly, we file all those payroll taxes for our clinicians and we can keep track of that and provide an end of year statement for their tax write-offs too.

That's one of the main ones, feeling safe at home. But a couple of the other questions. How quickly can services start? We can get out there a lot of times on the private duty side, we can get out there within same day. With the Medicare side, just because there are more regulations and paperwork involved, it's usually 24 hours or up to 48 hours. And then that question that we talked about before, is insurance going to cover this? Who's going to pay for it? Medicare pays for home health and then for private duty, a lot of times it is out of pocket and or long-term care insurance.

Host: That's great that you offer all those services because I'm thinking, when you are ill or older or whatever the reason you need someone in home, the last thing you want to worry about is all those other things. So that's amazing. You cover it all. So, to wrap it up, what advice would you give to families who are just beginning to explore in-home care and how can Health First help them take the next step with confidence?

Michelle Rogers, MHA: So I always suggest that they start with a conversation. Talk to your loved ones, your doctor, or reach out directly to us. There is no charge if you would like for us to come and meet in your home and just discuss what opportunities are available, when you're ready to pull that trigger. You want to make informed decisions and know what your loved one's wishes are, to explore those options earlier, you're gonna be more prepared. You don't want to wait until you have an emergent situation and then try to figure it out. We even have a pre-registration program where you can set up all of the necessary paperwork and sign documents ahead of time so that if the primary caregiver ends up in the hospital or something happens, you just call and we come.

Oh, we had a husband he was a primary caretaker for his wife with dementia, and he was so worried with no family in town. If he was taken to the hospital because he had some cardiac issues, who was going to care for his wife of 52 years. We set everything in motion and then unfortunately, he did suffer a heart attack and called his neighbor, had him come over and we were there within the hour.

Everything was all set up. We cared for his wife until he was discharged back home. And then we cared for both of them for a little while until he started feeling better. So that's really the difference we want to make in people's lives. Have those conversations early. We would love to become an extension of your family when family can't be there.

And having been in this community for over 26 years, we are highly respected and have a lot of staff who've been here those whole 26 years and have worked continuously with us. So we would be glad to be in involved in those conversations to help you plan for the future.

Host: That's great to know. Thank you so much for sharing your expertise. This has been really informative and helpful, so we appreciate you.

Michelle Rogers, MHA: Maggie, thank you so much for having me today. It's been a pleasure.

Host: Absolutely. Again, that's Michelle Rogers. If you or someone you love is exploring in-home care, we are here to help our home care and private duty teams provide compassionate, personalized support tailored to your needs. For private duty, call 321-459-1804. PRIVATE duty, again, that's  321-459-1804. Or for home care call 321-434-5909.  321-434-5909.

If you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you, I'm Maggie McKay. Thanks for listening to Putting Your Health First.