For a Better Commute. For a Better Prince William County.

Smart Living

Caregivers strive to reduce bath-time challenges for seniors

When it comes to helping older adults remain in their homes, bathing can be a challenging issue. But Tessa Lamb of Home Instead Senior Care of Manassas and Herndon has found those concerns can be overcome with the right combination of compassion and experience.

Lamb has been working with seniors since 1996, as long as she’s been a licensed practical nurse. During that time, she realized there are identifiable, key issues that impact bath time. By recognizing and addressing these concerns, home care providers can help their clients age with greater hope and success.

Respecting privacy and independence

Over the years, Lamb has worked with seniors aged 65 up to “the beautiful young age” of 96 who wanted to age in place. That taught her the value of having a good relationship with her clients, she said.

“They all cherish their independence,” she said. “Getting into and out of a shower can be difficult as we age and become less flexible. Many times requiring the standby assistance of a home health aid can be very daunting.”

At the same time, privacy is a key concern for clients. “They have been taking care of themselves for over 60 or more years and now someone needs to help them shower,” she explained. “This can be both frustrating and embarrassing.”

Neither giving nor receiving this kind of care is easy. That’s why cultivating a positive relationship is crucial to protect the dignity of those receiving care, as well as to enhance the quality of life for both seniors and their families throughout the caregiving experience.

Recognizing changes in sensory perception

As people age, the acuteness of the senses decreases, and that can have ramifications for both the person who is bathing and the person who is helping with the process. For example, Lamb pointed out, the ears serve two purposes – hearing and maintaining balance – so the loss of sensitivity affects balance as well as hearing. That can have a significant impact when it comes to bath time.

“If your balance is off, you are not going to want to go onto a wet, slippery surface,” she said.

The same holds true when it comes to vision loss. “The bathroom is a major fall risk area, and thus a very scary place for seniors,” Lamb explained.

Other senses also come into play. When the sense of touch changes, it can result in decreased temperature sensitivity. That means it can be difficult to tell the difference between water that is cool or cold and water that is hot or warm.

When the sense of smell is lessened, seniors might not be able to smell the odor of their body when they have not taken a shower in several days or weeks. Understanding these changes in sensory perception and how they affect a person’s ability or willingness to bathe can help offset concerns a senior may have when it comes to bath time.

Accounting for fatigue or dementia

Another factor that can impact the bathing process is the fatigue that can accompany many of the medical conditions or illnesses that seniors may develop. Even medications can cause people to become tired easily.

Helping bathe clients with dementia and memory impairment requires particular care, Lamb said. “It is very, very important to establish a rapport, trust and a relationship with them before any major task can be performed,” she explained. “Consistency is also key because of the short-term memory loss.”

In Lamb’s experience, a little bit of empathy goes a long way when it comes to overcoming the challenges surrounding bath time. “I recommend that you show seniors love, kindness, patience, respect – and allow them time,” she said. “Give them choices.”

Perhaps a client isn’t up to a bath at a particular moment. That’s when a caregiver should offer alternatives, such as a sponge bath, a warm face cloth, a chair bath or even a bed bath. The bottom line is that there are many options. A good caregiver will understand and offer alternatives, while also respecting the client’s concerns.

“There is also the option of ‘just not today,’” Lamb said. “It is more important to establish a relationship and build trust first than try to obtain the goal of a bath.”

For more information on Home Instead Senior Care in Manassas and to sign up for their newsletter with other helpful articles, visit their website.

How hospice social workers enhance end-stage quality of life

“People don’t know how to die in America.” 

That’s a pretty sobering statement, but it’s one Lorraine Krause of Capital Caring can make with confidence, having served more than a decade as a hospice social worker.

Providing quality holistic care in the mid-Atlantic, Capital Caring is among the top ten largest hospices of the 4,300 nationwide. The organization delivers in-home comprehensive care to more than 1,000 patients daily.

Each patient has a team of people customizing their care – including physicians, nurses, dieticians and spiritual advisers. This team of hospice workers helps manage medical, emotional and spiritual needs of patients and their families at the end stages of their lives. In the center of all this, though not always noticeable, stand social workers.

Diverging paths to hospice social work

Linda Malone and Krause are both licensed clinical social workers for Capital Caring. Malone has been a hospice social worker for the past 17 years. Initially introduced to the idea of social work in high school, Malone worked in the mental health arena, library services, and hospital geriatrics before finding her passion in the field of hospice.

Krause’s path to becoming a hospice social worker was strikingly different and occurred later her life. Married for twenty years, she began volunteering at a women’s center in Blacksburg, Va., when she became initially curious about the idea of social work.


Bingo mixed with aerobics keeps seniors active during winter months

The winter months can be a difficult time for seniors.

Cold temperatures and wintry weather conditions can make it difficult to go outside or to take regular shopping trips and excursions.

The Arbor Terrace Sudley Manor Assisted Living and Memory Care Center near Manassas recognizes this can be a problem and works to keep their residents active and engaged on gray winter days.

One of the ways it does so is by gathering residents in a dining area and playing “Arringo,” an activity that mixes aerobics with bingo to engage the mind, body, and soul.

This post is sponsored by Home Instead Senior Care of Manassas

Manassas in-home care firm awarded Franchisee of the Year


Jack and Jacqueline St. Clair have much to celebrate this year. On October 27, the St. Clairs celebrated owning Home Instead Senior Care for a decade. They also celebrated winning Homecare Franchisee of the Year by the International Franchise Association.

The St. Clairs began their franchise when Jacqueline’s grandmother needed care.

“We know what it’s like to need good care and what a difference it makes to the client and family. Service, quality of care, education of caregivers and quality control all are really important to us.”

In the past 10 years, the St. Clairs franchise of Home Instead Senior Care and their 200 caregivers have provided Prince William and Fauquier counties over 1 million hours of quality care to over 5,000 seniors, the disabled and Veterans in their homes, close to friends and family. With purchasing a Home Instead Senior Care office in Herndon in April of 2014, they are looking forward to serving even more.

The services Home Instead Senior Care offers can include companionship, meal preparation, respite for family caregivers and Alzheimer’s care. Jaqueline noted how essential memory care is and how important it is for those memory care clients that want to stay in their own home.

“We’ve always been ambassadors for the Alzheimer’s Association. So many of our clients have Alzheimer’s.”

The St. Clairs are proud of the accomplishments their franchise has achieved. Looked to as one of the top in revenue, Jack is most proud of their franchise also being looked to as an information resource for caregivers.

“We take great pride that we’re a company that cares for the clients we serve and the people who are the caregivers.”

Honorees of the International Franchise Association’s (IFA) Awards are chosen from among franchisees who have demonstrated excellence within the franchising community. In the St. Claire’s case, the corporate management of Home Instead Senior Care recognized the dedication they show for both their franchises of Home Instead, as well as their community. They were nominated over 700 other Home Instead Senior Care offices.

Home Instead, Inc. was founded in 1994 in Omaha, Nebraska. They provide in-home caregiving and support to help seniors “age in place.”

The International Franchise Association is the oldest organization and represents franchising worldwide. IFA membership includes franchise companies from over 300 different business categories. IFA announced they would be presenting Jack and Jacqueline St. Clair with their award at the Franchise Action Network Annual Meeting in Washington, D.C. This meeting brings together franchise business leaders, policy makers, and other D.C. dignitaries to discuss the economic and community contributions of the franchise sector.

With this award and the quality care they bring to their clients, the St. Clairs do have a lot to celebrate. But Jaqueline said they are celebrating the future as well: “We want to continue,” she said. “We’re looking forward to celebrating 20 years.”

For more information on Home Instead Senior Care in Manassas, visit

How the right in-home care reduces hospital readmissions

Mrs. Dorothy Bologna was born in Manhattan in 1929, in a strong community where she says everybody helped everybody.

But by the time she needed help, she says, “There was nobody left.” Her family had all died or gone to college and moved to areas where they studied. So she moved to the Gainesville area eight years ago to be near her daughter.

All seemed to be going well until Bologna had a fall and ended up in the hospital. Her hospital stay was followed by a stay in Gainesville Rehab for several weeks.

She says they worked on her leg strength. “I wasn’t using them,” Bologna said. “They felt like jelly.

Discharge orders and readmission

For many patients, the trip home from the hospital does not last long. According to the Federal Agency for Healthcare Research and Quality, for some common conditions treated in hospitals, as many as one in  patients is readmitted within 30 days of discharge. And according to the New England Journal of Medicine, as many as one in seven patients undergoing major surgeries are readmitted within 30 days. Roughly 80% of hospital readmissions are for patients 65 years of age and older.

Readmission takes a toll on patients, their families and hospitals. Readmission means that patients are sicker. Readmissions cost Medicare alone an estimated $17.5 billion a year. And with the Affordable Care Act, hospitals receive reduced federal funding based on readmission rates.

Dr. J. Douglas Wall, Vice President of Medical Affairs for Novant Health UVA Health System says, “While we don’t have specific statistics on how many people have to return to the hospital because they don’t/can’t follow the discharge orders, it is one of the most common reasons why patients are readmitted to the hospital. Patients sometimes do not understand the orders or don’t fully follow the instructions. They may be unable to carry out all elements of what their discharge follow-up needs to be, whether those are follow-up appointments, instructions, diet modifications, etc.”

Novant Health UVA Health Systems strives to reduce the amount of people who are readmitted to the hospital. That’s why they have been taking the simple but effective step of calling patients post-discharge to check on them. They ensure patients have made their follow-up appointments, see if they have taken their medications and if not, find out what is preventing them from doing so. They ask if there are barriers to obtaining the right medications, either physical or financial, and screen for those prior to patients leaving the hospital.

Wall says asking questions and getting patients to explain their own discharge orders prior to discharge is a “way of helping the patients to drive home with more than a piece of paper.” They aim to solicit their understanding of healthcare and staying well.

Wall says if a patient needs financial help, case managers can determine what type of assistance is available. In some cases, they recommend home health care.

When more is needed



Providers of home care, Home Instead Senior Care® in Manassas says about one out of every five seniors is readmitted to the hospital within 30 days of initially being discharged. A home care provider often can give the kind of assistance needed to ensure patients are following discharge orders by ensuring patients are taking their medications correctly, accompanying them to medical appointments, cooking them healthy meals and more. The results? Not only are patients healthier, they are less likely to be readmitted for the same reason.

Caregivers at Home Instead Senior Care® are not medical providers, but they are fully trained, bonded and insured. Through the practical care they offer, more seniors live at home instead of in nursing facilities and do not face hospital readmission.

In a study of seniors with congestive heart failure (CHF), a common diagnosis resulting in readmission, by providing home services to seniors in Henrico Doctors’ Hospital of Richmond, VA, Home Instead saw a 35-percent improvement upon the hospital’s overall CHF readmissions rate (16.9 percent); 59- and 58-percent improvements over those of its parent company (19.9 percent and 19.8 percent, respectively); and a 97-percent improvement upon national readmission estimates for Medicare enrollees with CHF (24.6 percent.)

Bologna uses caregivers from Home Instead Senior Care®. She says Home Instead has been wonderful to her. “I’m home with great care,” she says. “I’m very blessed.” If Bologna needs something delivered, like her special order walker with handbrakes, a seat and a basket, Home Instead makes sure she gets what she needs on time. Caregivers do light cleaning, offer entertainment and companionship and ensure she is following discharge orders. And caregivers are “great cooks,” Bologna says. “They know how to save leftovers.”

Toni Adams is one of Bologna’s caregivers. Bologna says, “She’s the kind of person who makes you feel better and likes it.”

“I love elderly people,” Adams says. If it’s not in your heart, you might as well not do it.”

What’s one of Bologna’s favorite things about her Home Instead caregivers? “They make you laugh,” she says. “And that’s the best medicine. It’s priceless.”

Bologna has not been readmitted for the same injuries and continues to improve.

This post is sponsored by Home Instead Senior Care of Manassas.

Local leaders tour Home Instead Manassas, learn importance of in-home care

Local leaders were invited to come and tour Home Senior Care in Manassas

Jack St. Clair, co-owner Home Instead Senior Care Manassas

My name is Jack St. Clair, and I am the owner of Home Instead Senior Care located in Manassas and also the one located in Herndon.

Today, what we did is what we call a “meet a Home Instead Senior Care Senior” where we invited senators and delegates from the State of Virginia to come and meet not only us, my wife and I and our office staff but also our caregivers and their clients for them to see what exactly home care is.

They’re used to seeing nursing homes and assisted living facilities which are brick and mortar buildings, but they’re not used to seeing a facility like ours where we have an administration office in this location serving more than 220 clients in their own homes.

Jacquline St. Clair — co-owner Home Instead Senior Care Manassas

It’s almost like having guests from out of town come in your home, and so, we took what we already have in our office and just spruced it up a bit and took some time, about a month ago, to invite folks to this event knowing that folks are out of session right now.

So we invited in representatives and the local officials. We gave tours today; we showed people our office.

Jack St. Clair

Surveys show that 93% of seniors want to age and die in their own home. So, we are part of the solution to that, and that is by providing much-needed companionship, help, or personal care services to seniors who do want to remain in their own homes.

We have a wide range of clients. We have clients who maybe just need us for a few hours a week, and then we have clients who are actively dying utilizing hospice services who have us come in 24 hours a day, seven days a week to help them age in their own home and eventually pass away in their own home.

We want to be part of that solution. If their wish is to stay in their own home, we want to be able to meet that wish and to be part of that.

This post is sponsored by Home Instead Senior Care of Manassas.

Mall walking keeps seniors fit, healthy (and humorous!)

You can see them bright and early, at 8 o’clock most mornings — walking, talking and laughing in Manassas Mall, enjoying the new layout and the mall extension. They are the mall walkers, an informal group of retirees who are into staying active and getting some social time in, too.

This particular group of mall walkers met each other initially by good, old fashioned, in-person introduction, and before long they formed a strong bond. Members have been walking the mall anywhere from five years all the way up to 20 years. They range from ages 65 to 90 years old and tend to walk alongside those who have similar paces.

While they may not have discovered the fountain of youth, these seniors recognize a healthy habit when they see one. According to the Center for Disease Control (CDC), “The loss of strength and stamina attributed to aging is in part caused by reduced physical activity. Inactivity increases with age. By age 75, about one in three men and one in two women engage in no physical activity.” These stats don’t apply to the mall walkers.  

The benefits of walking are substantial. A study by University College London suggests that walking for an hour or two daily might lower the risk of stroke in both men and women by as much as one-third. Researchers at the Harvard School of Public Health in Boston say women who walk 30 minutes a day reduce their risk of stroke by 20 percent. If they engage in brisk walking, that benefit increases to 40 percent. And a study at the University of Colorado at Boulder found that post-menopausal women who walk up to two miles a day can lower their blood pressure by about 11 points in 24 weeks.

Walker Ruby Willbanks may or may not know about the stats, but she does know what advice to give. “Never give up,” she says. “Just keep moving.

The benefits of mall walking are substantial.
The benefits of mall walking are substantial.
The benefits of mall walking are substantial.
The benefits of mall walking are substantial.
The benefits of mall walking are substantial.
The benefits of mall walking are substantial.
The benefits of mall walking are substantial.

The Social Side

Charles Willbanks half-jokingly says he started walking because his wife Ruby told him to. But he is evidence of what the CDC reports on seniors staying fit: “Social support from family and friends has been consistently and positively related to regular physical activity.”

“I come to the mall because I know where it is,” jokes Richard Perry, who also belongs to a gym. On a more serious note, he adds, “This is social. I don’t know anyone at the gym.”

Mary Griffith, who says she has seen a lot of changes in the mall over the years, has been a faithful mall walker for two decades. Twice a week she also goes to the Manassas Senior Center to take a class called “Stand Tall and Don’t Fall.” She meets her walking friends at the food court for coffee and conversation after their brisk walks.

Most of the group grew up in the area, but there are people from all over the world and from different backgrounds.

Jacob Mathai is from India. He has been walking the mall for about four years. Sporting an iPhone he uses to track his miles, he says, “We come here for exercise, networking and fun. We’re here for each other. The people who come just feel better about life.”

“Every day is a good day,” says Ruby Willbanks.

Rev. Ralph Benson, Pastor of Brentsville Presbyterian, joins the group. He is former military and a former Pentagon chaplain. When asked what the group talks about, he says frankly, “politics and religion.”

The walkers also go on what they call field trips. On the last Friday of each month, they eat at IHOP in the mall. They visit museums together, like the Air and Space Museum, the Marine Corps museum in Quantico and others. They carpool together. Fridays are “hat days” when everyone wears different hats.

The quote they chose for their particular little group?  “Everyone makes us happy — some when they come, some when they leave.”

But, Charles Willbanks adds more seriously, “Everyone is welcome.”

This post is sponsored by Home Instead Senior Care of Manassas.