All her life, Alice had been an engaged consumer. She'd frequent businesses that did right by her, and would tell all her friends to avoid places that fell short of her expectations. She always asked for a manager when customer service wasn't up to par, and she has written more than a few letters to corporate offices. When it comes to spending her money, she expects - and accepts - nothing but excellence.
But that bulldog consumerism ends when it comes to the help she gets around the house. She pays a health care agency to send an aide to her house daily to help her get up, fix breakfast and get ready for the day. She likes her aide, Sarah, but doesn't like that she has to get up earlier than she wants to and has to rush through her breakfast so that Sarah can finish and move on to her next client. Alice feels lucky to have Sarah and doesn't want to say or do anything that might jeopardize her ability to get the care she needs, so she puts up with the inconvenience. Alice is receiving appropriate care, but her provider is forcing her to accept the care on its terms instead of hers. Alice would never let a restaurant tell her what to order or what time to eat, nor would she tolerate a business prescribing which products she can buy. So, why does she put up with her long-term care provider that wants to dictate how she starts her day?
There is a movement in the U.S. and in Ohio toward a person-centered approach to health care. In person-centered care, providers tailor their services to each individual's preferences and values. Restaurants do this by providing varied menus and working to reduce staff turnover, so service stays consistent. These practices are catching on in care settings, as well. Providers are re-tooling their business practices and re-training managers and staff to provide care that suits the customers' preferences, not the providers' operational needs.
For person-centered care to be most effective, consumers need to expect - and ask for - excellent service. They must make their desires known to enable providers to meet those expectations. That can be hard for some consumers who, after a lifetime of self-sufficiency, are humbled by the need to ask for and accept the help of others. They fear asking for too much, lest it lead to them not getting what they need.
Regarding health care and long-term care for yourself or a loved one, approach it like you would any other business transaction. Most care providers are smart and caring business people who want to provide excellent care. Just as you may fear losing their assistance, they fear losing valuable customers. If a care provider cannot meet your expectations, negotiate. If negotiations do not lead to an acceptable solution, find another provider and take your business there. Even if you have a social worker or someone else arranging for your service, you have the right to choose who provides it and to direct your care.
Switching care providers may not as simple as switching lunch spots, grocery stores or even banks, but it can and should be done if your expectations are not being met. When it comes to long-term care, the Office of the State Long-term Care Ombudsman can help. Ombudsmen are advocates who work with consumers and providers in many long-term care settings (e.g., home health, assisted living, nursing homes) to promote person-centered care and help resolve service-related issues. They also can provide you with tools to make an informed decision if you decide to change providers. Call the state ombudsman at 1-800-282-1206 for general assistance and for referral to your local ombudsman.
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