In mid-April, President Biden issued a first-of-its-kind White House executive order aimed at improving the nation’s care infrastructure by “expanding access to affordable, high-quality care” and “providing support for both care workers and family caregivers.”

According to Boston Consulting Group (BCG), whose research was cited in the executive order, approximately 56% of U.S. workers have care responsibilities outside their full-time jobs, and 40 million of these caregivers rely on outside, paid care in the form of nannies, day cares, nursing homes, and more to stay in their jobs. While the basis of this order is fiscally motivated, designed to address key supply and demand gaps in the nation’s care system, which BCG reports will create a $290 billion crisis if left unaddressed, the order’s impact on everyday people and their families is no less significant.

The Executive Order At-a-Glance

Outlined in the order are more than 50 actions the White House has directed government agencies at nearly every cabinet-level to take, beginning October 1, 2023, to expand support for family caregivers, long-term care workers, early educators and veterans. Many of these initiatives are specific to advancing access to early childhood education and care, but several guidelines are intended to enhance the long-term care experience for both caregivers and clients by:

• Enhancing job quality and compensation for long-term care workers under Medicare and Medicaid. The long-term care industry has one of the highest rates of annual employee turnover, with more than 65% of employees leaving their roles in 2020. As part of the executive order, the Department of Health and Human Services (HHS) is instructed to consider issuing regulations to ensure workers have the support and resources they need in their role.
• Expanding resources for the nation’s 11 million dementia caregivers. The order directs HHS to consider testing a new payment and service delivery model to better support families and workers caring for someone with dementia.
• Ensuring hospitals are actively involving family members in the hospital discharge process. In addition to increasing awareness of best practices from the Administration for Community Living, HHS is instructed to promote partnerships with community-based care organizations during the discharge planning process.
• Expanding training pathways and professional learning opportunities in the care workforce. The need for long-term care is likely to become more acute as the nation’s population ages. By 2060, there will be approximately twice as many adults over the age of 65 than in 2016, and projections indicate that there will be around 8 million long-term care job openings over the next decade. The order directs federal agencies to examine resources and grant programs to support existing care workers and to create more opportunities to attract new entrants to the workforce.
• Advancing equity for people with disabilities and older adults. The order directs the Secretary of Labor and the HHS Secretary to conduct a joint review to identify gaps in knowledge about the home- and community-based workforce and to launch new efforts to ensure individuals with disabilities and older Americans have equitable access to care resources and support.

These broad set of actions have been endorsed by several of the nation’s leading care-focused organizations – including the National Council on Aging, the American Association for People with Disabilities, the National Alliance for Caregiving, and more – and stand to positively impact millions of families and care workers. However, these changes are just getting started and it will take time before many of them have an impact. But this doesn’t mean older adults need to wait to access quality care.

The Family & Nursing Care Difference

Family & Nursing Care is one of the oldest and most well-respected private duty home care businesses in the greater Maryland and Washington, D.C. area. Since 1968, we’ve helped tens of thousands of families by providing access to caregivers who assist older adults with activities of daily living, including bathing, dressing, mobility assistance, errands, meal prep, light housekeeping, medication reminders, companionship, and more. As an industry pioneer, we know what it takes to deliver the quality, compassionate care clients and workers desire and deserve. When it comes to supporting families’ long-term care needs, this is just some of what sets Family & Nursing Care apart:

• Only the top 8% of Caregivers who apply meet our unwavering standards of excellence, ensuring every caregiver we work with is the best-of-the-best.
• It is vitally important to us that those who provide care for our clients feel enthusiastic about continuing to work as caregivers, which is why Family & Nursing Care is dedicated to empowering these best-in-class Caregivers through professional development opportunities and competitive compensation.
• Family & Nursing Care is an eight-time winner of Bethesda Magazine’s Best of Bethesda Readers’ Poll. We’re also rated an A+ company by the Better Business Bureau and are included in the National Business Research Institute’s Center Circle of Excellence, making it no wonder why more than 25% of Family & Nursing Care employees have been with the company for over 10 years.
• Our longstanding relationships with hospitals, senior living communities, skilled nursing facilities, and long-term care insurance companies allow us to liaise in the coordination of what can often be an overwhelming process for clients and families. Whether it’s coordinating home care when a sudden need arises or supporting families following a hospital discharge, clients know our team stands ready to support them 24/7, 365 days-a-year.
• We have teams of people dedicated to ensuring our clients receive excellent service – from when they initiate care throughout their entire care journey. Our client services managers are always on hand to provide a high-level of support to clients and their families, while our care coordinating managers work to match the right caregiver to each client. In addition, our skilled accounting and long-term care insurance teams are available to guide clients and their families through the billing and insurance reimbursement process.

To learn more about our leading home care services and what makes Family & Nursing Care an employer of choice, visit the Why Us? page on our website.

The Family & Nursing Care mission – to allow older adults to age with dignity – is one that extends to every facet of our brand, including the Family & Nursing Care Foundation, which since 2008 has awarded grants to organizations that help lower-income adults gain access to the home care services they need, while empowering the next-generation of Caregivers to earn their Certified Nursing Assistant (CNA) training.

This year, thanks to the continued contributions of our community and donors, the Family & Nursing Care Foundation, which operates as a fund of the Greater Washington Community Foundation, was proudly able to award $60,000 to the following organizations during the 2023 grant cycle:

• $20,000 to Home Care Partners
• $20,000 to Community Reach of Montgomery County
• $20,000 to the Jewish Social Service Agency (JSSA)

These funds provide more than 7,000 hours of comprehensive home care services each year, allowing for more low-income seniors to remain in their homes.

Additionally, the Family & Nursing Care Foundation has established a $50,000 scholarship fund to support students pursuing their CNA license. The fund, created in partnership with Montgomery College, awards $10,000 each year of a five-year period to select CNA candidates applying for financial assistance.

“The number of Americans ages 65 and older is projected to more than double to over 98 million by 2060, making the need for quality, accessible home care – and the demand for trained professionals to care for the aging population – greater than ever,” said Sandy Kursban, founder of Family & Nursing Care and founder and chair of the Family & Nursing Care Foundation. “The Family & Nursing Care Foundation was created to address this growing challenge head-on by providing lower-income seniors with devoted home care and deserving students with scholarships to build their future CNA careers. Now in its 15th year, we could not be prouder to continue helping organizations that share the Foundation’s commitment to advancing life-changing work in our communities.”

To read the stories of individuals who have been helped by the Family & Nursing Care Foundation or to make a donation to support next year’s grant cycle, please visit the Foundation webpage.

While the “most wonderful time of year” still seems far away, now is a great time to start thinking about your needs during the holiday season. Whether your plan is to host loved ones at home or to join the millions of Americans hitting the road during the holiday season, managing a care plan for yourself or a loved one shouldn’t be a source of added holiday stress. We’ve outlined several ways Family & Nursing Care can help clients ensure the smooth planning and execution of their care plan heading into the end of the year.

Planning Ahead 

It can be challenging for families to find caregivers during the holidays. Kelly Ann Sharp, Director of Client Services for Family & Nursing Care, explains that “industry-wide, the holiday season is typically when demand for quality caregivers is at its highest, as many families plan to travel and gather out of town, and as winter weather events increase, so do older adults’ risk of fall-related injuries.”

As a 24/7/365-days-a-year business, Family & Nursing Care prides itself on being ready to help older adults and their families whenever a sudden home care need arises. However, it’s never too early to begin evaluating and planning for holiday care needs. To better provide high-quality support, Sharp and fellow Director of Client Services, Natalie Blickman, recommend clients reach out to their Client Services Manager as soon as holiday travel and gathering plans are solidified.

Accommodating Clients’ Unique Needs

Home care is not a one-size-fits-all approach and, during the intake process, the company’s Client Services Managers will work one-on-one with clients and their families to determine what level of care and services best suit their holiday needs.

Clients may prefer to simply request the same services they regularly use throughout the year on a specified holiday; in other cases, clients and their families needing extra support during the busy season may request one-time services outside of their typical care plan. Examples of holiday-specific care clients may request include:

• Overnight support, while a primary family caregiver is out of town
• Mobility or companionship assistance during family gatherings
• Transportation to and from gatherings outside the home
• Assistance with packing for holiday travels
• Support/assistance for seasonal traditions, such as mailing holiday cards or preparing a special recipe
• Companionship, to ensure your loved one isn’t alone during this time

“The holidays can be a special opportunity to gather, celebrate and reconnect with loved ones near and far. It’s also a time when families may feel the most time and resource-starved,” said Sharp. “Our aim at Family & Nursing Care is simple: give clients and their families peace of mind when they need it most. This promise is one we uphold year-round, with compassionate, genuine support and Caregivers who feel like family, so older adults and their loved ones can spend less time stressing and more time enjoying life’s fullest moments.”

Getting Started

To arrange home care services during the holidays, current clients and families simply need to contact their Client Services Manager, who will review clients’ unique care requests and answer any questions you may have before scheduling care.

The holidays may also be a time when older adults consider initiating first-time home care services.

“During holiday gatherings, people tend to spend more one-on-one time with older family members and may notice ways in which their loved one could benefit from additional support. Whether they’re interested in help with daily living or companionship services, our team is a resource for helping older adults access the quality care they need to maintain their independence at home,” said Blickman.

To get started, new clients may call Family & Nursing Care at 1-800-588-0517 to connect with one of the company’s Clients Services Managers. During the intake process, Client Services Managers will ask a series of demographic and lifestyle-oriented questions to help match clients with the best Caregiver for their unique needs.

To learn more about Family & Nursing Care and its holiday and 24/7/365 services, new clients can also visit the Home Care Services or Contact Us webpages.

Along a family’s care journey, circumstances can change, and clients and families may need to reassess their needs and consider whether it’s time for additional caregiver support, either on a short-term or long-term basis.

At Family & Nursing Care, Client Services Managers are here to engage with clients and families. They are with you every step of the way and can provide insight and assistance around all care decisions.

Kelly Salb, Vice President, Client Services, Kelly Ann Sharp and Natalie Blickman, Directors of Client Services, and Celina Quismorio, Director of Nursing, Family & Nursing Care Select, recently sat down to discuss their experiences in guiding clients and families through the process of arranging additional caregiver support.

Additional Support for Short-Term Needs
“It’s important for our clients and families to understand that we are flexible and able to provide support beyond what is originally scheduled when short-term needs arise,” says Salb. The team readily identified various situations which could trigger a need for additional short-term Caregiver support:

• Vacation/travel – Caregivers can travel with families to care for clients so that everyone can relax and enjoy their time together.
• Events – (weddings, reunions, graduations, etc.) – Caregivers can help clients get ready and assist them while at the event.
• Hospital/Rehab Stay – Many family caregivers dread leaving their loved ones alone in a hospital or rehab setting, even for a little while. A Caregiver can offer respite to the family members by staying with their loved one in the hospital, even overnight. Caregivers can also learn about and help clients digest information about continuing exercises, diet, and other changes needed to help the client successfully recuperate at home after discharge.
• Discharge/Recovery Support – Caregivers can accompany clients home from the hospital or rehab and/or continue to provide additional support while they recuperate at home. Caregivers can watch clients who may be a fall risk in a weakened state, remind them to take medications, and much more.
• Respite care – Caregivers can provide fill-in support while a family caregiver is away/on vacation or when they just need a break.
• Emergency/back-up care – Caregivers can provide fill-in support when a family caregiver has an emergency.
• Moving support – Moving can be a difficult adjustment for anyone. A Caregiver can offer support and assist a client in acclimating to their new home environment (especially when the move is to an assisted living community or memory care).

“I often ask family members, what would you do with your Mom or Dad if you could be here?” says Quismorio. “I explain that Caregivers can fill in for those needs – help to go up the stairs, keep them company, take them out to lunch or to the doctor. Really anything the family caregiver would like to do for their loved one but can’t because they are not available.”

Consistent Additional Support
Client Services Managers form strong relationships with their clients and keep close tabs on their changing needs. Even more importantly, they pay close attention to feedback from Caregivers on how their clients are progressing. If a Caregiver observes noticeable changes in a client’s condition, they are encouraged to share their concerns with Family & Nursing Care so that Client Services Managers can have a conversation with the client and/or family about the possibility of needing more Caregiver support. Some changes Caregivers have observed include:

• balance issues
• confusion
• depression
• poor sleep
• risk for wandering
• hygiene issues (soiled linens, household tasks not completed)
• worsening medical conditions
• forgetting to take medications

“We definitely rely on feedback from Caregivers to alert us to changes with a client’s condition. However, family members should know that if they observe changes or have concerns, we are here for them and can help talk through options for additional care,” says Sharp.

Couple Care
Salb says that clients who are already actively using Family & Nursing Care services have found a lot of value in adding couple care services. “Many clients don’t know that we offer couple care services at a much lower rate than we would charge for two individual clients,” she says. “For example, if a Caregiver is providing services for a client, and along the way the client’s spouse feels that they could use a Caregiver too – either for a short time while they recover from an illness or injury, or on a regular basis. In that case, we can set up a couple care plan.”

It should be noted that couple care is not only for spouses. Couple care plans and rates can be applied to care for any two individuals living in the same household – parent and child, siblings, friends, etc.

Family & Nursing Care in Action
A client named Pam is the primary caregiver for her husband Ron who suffers from dementia. She came to Family & Nursing Care to set up care for Ron that included a Caregiver coming to their home for four hours a day to give her some respite and time for self-care. Then one weekend, Pam fell and was admitted to the hospital. “This unexpected emergency left us panicked. Without someone reinforcing his usual routine, Ron would become confused and forget things like taking his medications, eating, and letting out the dogs,” she recalled. “Our Client Services Manager was able to quickly refer additional Caregivers to give Ron 24-hour support until I could resume my responsibilities.”

When Pam was discharged from the hospital several days later, she was still weak and tired, so the Caregivers began providing care for both Pam and her husband. When Pam regained her strength and health, they changed their schedule back to what it had been before the crisis hit.

“I was very impressed with how Family & Nursing Care’s client services helped us seamlessly change our care situation as our needs shifted. The unparalleled hands-on and emotional support from Family & Nursing Care and the exceptional care from the Caregivers made a world of difference,” said Pam.

Communication is Key
Blickman says that when it comes to working with your Client Services Manager, communication is key to a successful relationship. “We are in this together to try to provide the best outcomes for clients,” she says. “Whatever you might be thinking about, whatever questions you have, just reach out and ask. If we can’t provide the service or solution, we will offer suggestions for resources that can.” Family & Nursing Care maintains great relationships with area senior living communities, aging life care professionals, rehabilitation facilities and hospitals, and can help with guidance and resources for clients and families looking to take a next step.

From the responsiveness and flexibility of the Client Services team to the high-quality, sincere, and enthusiastic Caregivers, we offer the support, empathy and respect every family needs to navigate their care journey, through every twist and turn along the way.

CEO Neal Kursban, attended the Home Care Innovation Forum from June 4-6, 2023 in San Diego, CA, where he joined with other home care executives to connect and learn from each other, and explore new ideas, solutions, and technologies in the industry. Neal was a featured speaker at the conference where he presented on the topic of “How to Retain Your Culture While You Scale.”

At Family & Nursing Care, we don’t just talk about culture – we live it. Our staff abides by a set of 15 Guiding Values that emphasize respect, integrity, excellence, compassion, collaboration, and personalization. The Guiding Values serve as a compass for our staff, providing clear guidance on how to approach work and every interaction.