I need a high-quality, well-regarded home health care service to help my
84-year old mother who lives in Skokie, Illinois (outside Chicago). 
She recently developed mobility problems and has a good deal of pain
from spinal stenosis and related problems.  I am looking for a service
that will assess what she needs in terms of nursing care and household
help and will provide what is needed--something similar to the
Visiting Nurse Service of New York.

Hello!

Thank you for choosing Google Answers.  

I commenced my search by investigating the Visiting Nurse Service of
New York, in an effort to understand the type of service that they
offered, as well as why you would want your mother's service in Skokie
to be comparable.

I see that the basic gist of the Visiting Nurse Service in New York is this:
Our At Home Where I Belong program provides: 

*Comprehensive, competitively-priced services to seniors and their
families who are able to afford them privately

*A customized plan of care

*A "core" personal-care team that typically includes a nurse care
manager, a supervisory RN, administrative supervisor and a home health
aide
(source: http://www.vnsny.org/s_athome.html)

I see that the RN manager visits your mother in her home and performs
the needs assessment, ultimately creating a customized care plan.

Depending on your mother?s needs, here are some of the services they
are able to provide:
?	Care management
?	Skilled nursing care
?	Home health aides to help with such day-to-day activities as
bathing, dressing, meal planning and preparation, laundry, shopping,
and housekeeping
?	Physical, occupational, and speech therapy
?	Assistance with accessing entitlements and other benefits 
?	Money management 
?	Help with scheduling doctor and other appointments 
?	Transportation to and from doctors appointments (with an escort when necessary) 
?	Assurance that prescribed medication is being taken properly 
?	Arrangements for home health care medical equipment and supplies 
(source: http://www.vnsny.org/s_athome.html)

All for one monthly fee.  Perfect.  Now that we are clear as to the
type of services provided by this prototype, it?s on to find the right
care for your mom in Skokie.

Because you stipulated in your request that she suffers from a good
deal of pain due to Spinal Stenosis, I thought that it would be a good
idea to immediately contact the Spinal Cord Injury Association of
Illinois.  Not because what your mother is suffering is a result of an
injury, per-se, but I was certain that they would be familiar with
reputable services that are at the VERY least sensitive to your
mother?s needs as a patient with Spinal Stenosis.

The people there were VERY helpful, and actually were able to direct
me to a place on the Web on which they have listed precisely what you
seek!

You can find that information right here:
http://www.sci-illinois.org/Pages/factsheets/pca.htm

However, not all of these agencies are created equally?and not all of
them have characteristics that match the Visiting Nurse Service of New
York.

Here is a WONDERFUL explanation of the fundamental differences between
the types oh home care provided:

?	home health agencies:
More than 20,000 home health agencies exist in the US today. Some home
health care agencies are Medicare-certified (which means they have met
federal minimum requirements). Home health agencies may offer a wide
range of services, including physician care, or may just offer a few
services, such as basic nursing care. Most home health agencies
assemble a care team for the patient based on his or her needs.
Because home health agencies are responsible for their personnel, they
assume liability for all care. Home health agencies are usually
available 24 hours a day, seven days a week.
?	homemaker and home care aide agencies:
Homemaker and home care aide agencies provide patients with the
day-to-day care in the home, such as cooking meals, bathing, and
dressing the patient, cleaning the house, and providing companionship.
Some agencies are licensed, depending on state requirements.
?	pharmaceutical and infusion therapy companies:
Pharmaceutical and infusion therapy companies provide patients with
drugs, equipment, and training to administer drugs and feedings in the
home. Sometimes a pharmaceutical and infusion therapy company is also
a Medicare-certified home health agency.
?	durable medical equipment and supply dealers:
Like pharmaceutical and infusion therapy companies, durable medical
equipment and supply dealers provide equipment to the patient at home.
Equipment may include respirators, wheelchairs, walkers, catheters,
and more. The equipment is often delivered to the home and installed
if necessary. If the patient requires it, the company may also train
the patient and family to use the equipment. Some companies are
licensed, depending on state requirements.
?	staffing registries and private duty agencies:
Staffing registries, or private duty agencies, are employment agencies
for home health care workers. Workers are matched up with patients
depending on need, such as nursing, homemaker, home care aide, or
companionship. Usually the agency receives a "finder's fee."
?	independent providers:
Health care workers can also be hired outside of any agency. The
patient can privately employ nurses, homemakers, companions, or other
professionals. The hiring, supervision, and payment of these health
care workers are the responsibility of the patient and family.
(source: http://www.uchospitals.edu/online-library/content=P00613)

However, after researching all of the organizations listed on the
Spinal Injury Association of Illinois, I was unable to locate an
organization that provided ALL of the services provided by VNSNY,
including shopping assistance and billing on a monthly (rather than
weekly basis).

Therefore, I decided to contact the Visiting Nurse Association in
Boston Massachusetts, who also was able to refer me to their Web site:
http://www.vnaa.org

From there, I was able to do some more research on the various
services offered by these respective organizations, and Evanston
Northwestern repeatedly came up as a search result.

I then contacted ENH?s Home Health service:
(847-581-1717/www.enh.org), and spoke with a home health care provider
who informed me that, while they were able to provide all of the
skilled nurse services, the household help services fell under a
different category of care, called ?custodial.?  I am listing these
guys as a good possibility for you, because I am VERY familiar with
the amazing health care provided by Evanston Northwestern Hospital,
having recently lived in Chicago for seven years, and having gone to
ENH on more than one occasion for emergency care.
However, that?s still not good enough!  Determined to find precisely
what you seek, I continued my search on Google.

I want to reiterate that I am listing ENH as a good option, but I have
been informed that, in order for your mother to receive the home help
that she needs, you will have to go the private route, where the
service wouldn?t be considered an ancillary and ?custodial? duty.



After a variety of combination of search terms, I believe that I have
found precisely what you seek!!!

http://www.lifestyleoptions.com/

Lifestyle Options, Inc!  

Here is an excerpt of their services:
Our services are custom designed for you. Our caregivers and nurses
are our employees which means that we are responsible for taxes,
insurance, liability, background checks and supervision. Our Employees
are carefully screened including criminal background checks, complete
reference checks, on-site training and additional supervision.
All private duty services are available on an hourly or live-in basis.
We can usually supply an appropriate caregiver or nurse within 24
hours. We specialize in providing professional, experienced and
compassionate care.
Examples of ways in which we can help are:
o	Assistance with bathing and personal care 
o	Housekeeping 
o	Meal preparation 
o	Chores and errands 
o	Medication reminders 
o	Companionship 
o	Exercise, walking, transferring 
o	Dementia and Alzheimer?s Care 
o	Pet Therapy 
o	Licensed Nurses (RN or LPN) hourly only 
All private duty services are available on an hourly or live-in basis.
We can usually supply an appropriate caregiver or nurse within 24
hours. We specialize in providing professional, experienced and
compassionate care.
(source: http://www.lifestyleoptions.com/services/services.html)

I am most pleased with this service for the following reason:

?At LifeStyle Options we are passionate about quality. Proof of our
commitment is our accreditation by the Joint Commission on
Accreditation of Healthcare Organizations. LifeStyle Options is the
only Illinois personal care and support services company to seek and
obtain this achievement. Our customers have the confidence of knowing
they?ve made an excellent selection in choosing LifeStyle Options.
We chose to be reviewed by the Joint Commission because it stands for
quality health care, and so do we.  The Joint Commission is an
organization you should know because its mission is to improve the
quality of care provided to the public.  It sets high standards of
care and evaluates health care organizations against those standards. 
The Joint Commission, together with its parent organizations--the
American Medical Association, the American Hospital Association, the
American College of Surgeons, the American College of Physicians, and
the American Dental Association--leads our nations efforts to improve
the quality of health care provided to all of us.
WE ARE ACCREDITED.

(source: http://www.lifestyleoptions.com/aboutus/aboutus2.html)

Referring back to the University of Chicago?s breakdown of the
different types of services, I have been able to luckily locate one
which, while private, is completely accredited, and is NOT an
employment agency (the people they send out to your mother?s home are
THEIR employees, meaning THEY assume all liability), and are willing
to provide all of those wonderful services you found in VNSNY.

Yippee!  I contacted them to get a feel for the types of folks that
work there, and let me tell you, they were unbelievably compassionate
and knowledgeable.  The nurse with whom I spoke wanted me to inform
you that they are the #1 most-recommended service in all of Illinois!

Here is their contact information:
1-888-342-INFO (4636); www.lifestyleoptions.com

Here is another excerpt from their Web site: 

Our company was founded in 1989 by Molly K. Miceli, a registered
nurse. "I wanted to be part of a company that people could really
count on; a company that offered the most reliable home care options
available," says Molly. "People want safe, secure home care options
that help them to age in place in surroundings they prefer, and I?m
proud to say we continually work to be the best company to meet those
needs. Every person at our company wants to make certain the care we
provide is absolutely the finest it can be. "
And so the dream began at Miceli?s kitchen table . . . 15 employees
the first year, 50 in the second to well over 500 caregivers in the
Chicago area alone. Our expertise has even expanded beyond home care.
Numerous assisted living and senior housing organizations rely on our
professional staffing services, training programs and information
systems.
In 1997, we first received our prestigious Joint Commission
Accreditation of Healthcare Organizations, an independent nonprofit
rating organization which is the nation's predominant standard setting
and accrediting body in health care. (See Joint Commission page)
LifeStyle Options is now the company most often recommended by health
care professionals. Why? While many factors are involved, the main
reasons can be narrowed down to a combination of three key things:
o	fierce attention to detail, 
o	outstanding customer service and 
o	a great team of loyal, caring staff.
Our caregivers are carefully screened, insured, bonded and trained.
They are dedicated to making a difference in our clients' lives.
Working closely with our care managers, our clients find that our
company?s superior standards result in an excellent match between the
caregiver and the client. We can usually provide a caregiver within 24
hours and our high-tech/high-touch philosophy streamlines the decision
making process.
LifeStyle Options is a member in good standing of:
o	Better Business Bureau 
o	Life Services Network of IL (recipient of Seal of Confidence Award) 
o	Assisted Living Facilities of America 
o	American Society on Aging (appointed to Health Care Leadership Council) 
o	American Staffing Association

(source: http://www.lifestyleoptions.com/aboutus/aboutus.html)

Here is a recommendation for Lifestyle Options from Life Services
Network, ? Advancing Quality and Innovation in Older Adult Services:?

LifeStyle Options Celebrates Sweet Sixteen 
On March 22, Schaumburg Village President Al Larson issued a
proclamation honoring the 16th anniversary of LifeStyle Options. The
proclamation reads in part, "?LifeStyle Options, Inc. has achieved the
highest levels of customer satisfaction as measured and benchmarked by
Life Services Network."
(source: http://www.lsni.org/)

I truly hope that this information will be of UTMOST benefit.  I hope
you can sense the care and energy that I have taken in crafting this
answer for you as completely as possible. If for any reason, you
desire clarification on any of the concepts provided to you in this
answer, PLEASE feel free to request clarification!

Thank You SO Much For Using Google Answers!
Aliciadenney-ga

---

Request for Answer Clarification by tmonk-ga on 24 Sep 2005 18:59 PDT

Thanks much for the quick and detailed answer.  
But I am not sure you have been able to find what I need.  I really
like the idea that the Visiting Nurse Service of NY provides "A "core"
personal-care team that typically includes a nurse care manager, a
supervisory RN, administrative supervisor and a home health aide," and
that "the RN manager visits your mother in her home and performs the
needs assessment, ultimately creating a customized care plan."  From
the Lifestyle Options website, and your description, it doesn't seem
that they provide that kind of service.  Am I wrong? Does the Evanston
Hospital service provide this type of service team and needs
assessment?  I couldn't tell from the website.  If they do, then I
would go with them and find household help elsewhere.  Unless there
really is another service out there that does it all.
Thanks again for your help (you seem to really care, and I appreciate
that very much).

---

Clarification of Answer by aliciadenney-ga on 26 Sep 2005 14:15 PDT

Hello!

I have spoken with Sue (I am not listing her last name for privacy),
Operations Manager at Lifestyle Options, who has informed me that:

* They can/will/do perform an initial needs assessment.....
*Based on that information, they will, at your request, compile a core
team of individuals who will be the caretakers of your mother during
each and every interaction.

Her direct line is: 847-585-1718

I do believe that this service is willing to provide everything that
you have stipulated in your original request.  I do wish you the best
of luck in ultimately hiring a service to care for your mom!

Thanks Again...
aliciadenney-ga

The answer was very helpful and by using the information it provided I
was able to use the web to find more providers of the service I was
looking for--providers that the researcher did not find.

I just wanted to let you know that I have left messages with several
of these services, in an effort to find a team-approach to your mom's
care.
As this is Sunday, everyone is closed.  I will get back with you tomorrow.  

Thank You!

Hi. I see you are looking for a home care agency in the Chicago area.
I am an RN specializing in home care (Medicare rules and regs are my
forte). Were anyone to ask me to recommend a Medicare certified home
care agency I would refer them to Home Health Compare, a web site
hosted by CMS (Center for Medicare and Medicaid). By implementation of
the Balanced Budget Act of 1997,  Medicare began collecting uniform
data about a patient's status during a home health episode. Home Care
agencies participating in the Medicare and Medicaid programs are
required to transmit this data they collect to the state agency that
oversees the Medicare/Medicaid programs for the Federal Government.
This data is then systematically compared, measured and risk adjusted
to determine the percentage of patients that improved, stabilized, or
declined in a defined set of functional activities while under the
agency's care. CMS published the results of 10 quality measures that
it monitors (in actuality there are many more, however only 10 are
publicly disclosed at this time). The purpose of the CMS Home Health
Compare website is for consumers to have a tool with which they can
make an informed choice about the selection of a home care provider.
The dilemma is that patient choice is largely directed by the
physician ordering care, although in reality it is the patient's right
to choose the home care provider. Of course physicians can recommend
who they believe to be good providers, however physicians should
always honor patient choice first and foremost. It is ethically and
legally the right thing to do. I recommend you log onto the Home
Health Compare website (I've included the link below) and compare the
different home care agencies in your mother's area. By doing this you
can make an informed choice. However, in addition to taking into
consideration the results on the HHC website, I would inquire with the
agency whether they are accredited by an accrediting body. Home care
agencies that are accredited (usually by JCAHO or CHAPS) are held to a
higher standard than non-accredited agencies. If the agency is
accredited you can usually see the results of their accridation status
by logging onto their accreditation organizations website (typically
this information is found in the consumer area.) You can also call the
home care agency to find out about their care management style. One
very important aspect of care is care coordination. How do they
accomplish this task? You may ask when and how often care coferences
are held. Does the care team meet physcially to discuss your case and
how often? How do they handle the drug regimen review that is required
by Federal Conditions of Participation for home care agencies. Do they
have an electronic means for comparing the drugs being taken for
potential adverse effects, significant interactions, and duplicate
drug therapy and if so, how do they act on the information? Do they
run the profile each and evey time a new drug is added to the profile.
You may be surpised to know that something like 33% of the elderly
will be hospitalized at some point for drug related complications. For
every dollar spent on drugs in United States nursing facilities, an
estimated 1.33 dollars in health care resources are consumed in the
treatment of medication-related medical complications. Were a
mortality rate assigned to drug related adverse events it would be
considered the fifth leading cause of death. You may also ask the
agency how do they mitigate fall risk? Falls among the elderly are of
grave concern and have serious health consequences.

I hope this information was helpful and I wish more health care
consumers would do their research and exercise their right to choose
their home care provider. Good luck to you in finding a competent and
qualified home care agency.

Home Health Compare can be accesed through the following link: 
http://www.medicare.gov/HHCompare/Home.asp?version=alternate&browser=IE%7C6%7CWinXP&language=English&defaultstatus=0&pagelist=Home&CookiesEnabledStatus=True