JILL SCHRAMM/MDN Peggy Vandall, left, takes a walk at Edgewood Healthcare March 18 with CaringEdge occupational therapist Hailey Sebelius as part of her therapy following a broken hip.

Keeping people in their homes longer, and possibly for their entire lives, is the goal of home health provider CaringEdge of Minot.

CaringEdge, which offers both health and hospice services, has seen its client base grow since it first opened to serve residents of Edgewood Healthcare’s assisted living communities.

“The real vision behind CaringEdge came from some of the leadership with Edgewood assisted living noting that folks were needing to move out of assisted living because of higher needs with their care than what assisted living is allowed to provide,” said Jenna Perlichek, administrator for CaringEdge in Minot.

CaringEdge exists in other locations around North and South Dakota, Minnesota, Montana and Wyoming, but the first office opened in Minot about eight years ago.

Seeing limited home care options in Minot generally, the agency expanded to provide services to anyone living within a 45-mile radius of Minot. A number of clients are rural, located miles from the closest hospital, so bringing care that keeps them in their home communities is important, Perlichek said.

Data backs up that CaringEdge’s services are fulfilling the goal of keeping residents in their homes longer, Perlichek said.

“We are seeing a trend, too, of less hospital visits,” Perlichek said. With a nurse on call 24/7, individuals who need help managing symptoms day or night can avoid emergency room visits.

A former nurse, CaringEdge client Peggy Vandall of Minot compliments the work of the staff members who have helped with her care. Vandall temporarily moved in January to Edgewood Healthcare to receive services from CaringEdge after breaking her hip in a fall.

Nearly two months of therapy had her walking with a walker as she found herself “getting my independence back.”

She also had a strong motivation that drives her to work hard at her therapy.

“I want to get home,” she said of the goal that, in March, appeared to be in reach.

CaringEdge was providing regular physical and occupational therapy, and Vandall said she is confident she will be ready when the time comes to return home, where she plans to continue with the therapy exercises that will make her even stronger.

One of the more common questions received at CaringEdge relates to qualifications for service. Perlichek said a medical necessity is required and is determined by the person’s health provider. Home health is available only with a provider’s order.

Perlichek said status as homebound can be a qualifier. The homebound definition applies to anyone for whom leaving the home is a taxing effort. Someone who requires oxygen or who uses a walker might qualify based on that definition.

Typically, home health referrals come following a change in condition that requires therapy to restore a previous level of independence, Perlichek said. Recovery from surgery is a common example.

Individuals also may need home health if there is an exacerbation of a medical condition, such as lung or heart ailments. In some cases, home health might be required longer term, such as with degenerative diseases.

The level of home health services also varies depending on client needs and provider directives. Perlichek said CaringEdge staff respect a client’s goals and privacy in determining the frequency of visits.

Every week, the care team for a client meets to share information that provides a holistic look at the patient and ensures everyone’s goals are on the same page, Perlichek said. A care team might include nurses, physical and occupational therapists, certified nursing assistants and a social worker, whose knowledge about available resources augments the work of the medical staff.

The team also serves as the patient’s liaison in communicating with the client’s provider, whose orders guide the care plan.

Perlichek said it is important that either patients or their designated family members are involved in the care and decision making. Contact between the care team and family members is tailored to the desires of the patient and family. The care team also communicates with medical staff in assisted living centers where clients might be staying.

Home health is a medically covered service by insurers. Perlichek said CaringEdge works with clients to determine the services they qualify for and coverage levels under their health policies.

CaringEdge nurses are cross-trained in home health and hospice, so if a patient does transition into hospice, their nurse can follow them into the new type of care.

“The wonderful thing about home health is you’re coming into their home, and so you become a part of their circle. You become a part of their family. So they do have a level of trust with us, which is a really big privilege,” Perlichek said.

Hospice can be an option for individuals whose conditions are terminal, defined as natural life expectancy of six months or less. However, the time frame isn’t the critical factor, and hospice patients may stay in the program as long as their condition warrants.

Perlichek said the number of inquiries about hospice has increased in recent years. Hospice can be an intimidating word, but people are curious and asking questions, she said.

“Knowledge is power. And so, even if right now isn’t the right time for hospice, I think it is great to at least have the education and the information in your tool belt so that if, down the road, it is something that you or a loved one needs, you’re better prepared to make those steps,” Perlichek said.

CaringEdge’s goal for the future is to continue to grow the number of people it can help, which means enlisting more health professionals with a heart for home and hospice care to join the team, she said.

Trinity Health’s announcement in mid-February that it was closing its home health and hospice operation left a void that CaringEdge and other existing services in Minot are having to fill.

Perlichek said referrals to CaringEdge are up. CaringEdge views it as a compliment when families turn to them as the place they want their loved ones cared for, she said.

“We are all members of this community, and so we take pride in that, and the privilege of taking care of the folks here in this community is wonderful,” she said.