Services now covered through Silver Lining:
What is it?
The Home and Community based service program through the State of Delaware strives to keep Delawareans at home instead of having to go to a facility for care. Often called the “Medicaid Waiver” or “Long Term Care Waiver” program, there are several services available through the program including companion care, personal care and nursing care. The plan is administered by two insurance companies in Delaware; one of those companies is Amerihealth Caritas. Silver Lining is now a credentialed provider to provide the approved services through the program to any client in the State of Delaware.
Who is eligible?
Any patient with the Amerihealth Caritas insurance that is eligible, as defined by the program and State of Delaware. Eligibility is determined by Utilization Management (skilled services) or Case Manager (LTSS – nonskilled services) at Amerihealth Caritas. All services require a pre-authorization prior to starting care (sent to Silver Lining by Amerihealth). To know if someone is eligible, contact one of these numbers.
LTSS Personal Care Connector Team – 1.855.260.9544
Rapid Response Team (for support with care coordinator and member access to services) – 1.844.623.7090
Utilization Management – 1.855.396.5770
Skilled care (nursing services and complex care) require a Certificate of Medical Necessity signed by the physician.
Have a client for us? Want to become a client?
Silver Lining contact information:
Having trouble? Have a question? Email Jackie! firstname.lastname@example.org or submit a contact us form on our website here.
We are pleased to offer our clients the services of Handyman Humphries, your honey-do list specialists. From picture hanging to porch sweeping, Handyman Humphries provides cost-efficet and reliable services for anyone who can’t safely (or who doesn’t want to) perform household maintenance activities. For more information or to schedule services, call us at 302.724.7902 or email us at email@example.com.
Types of Items Included:
Let us handle your on-site business safety screening, so you can focus on your business at hand. Silver Lining Home Healthcare can help your business operate in a safe environment, protecting your employees, your customers and our communities. We have the capacity to work with large and small businesses and the creativity to customize solutions for your unique situation.
For more information, call us at 302.724.7902 or email us at firstname.lastname@example.org
All nursing services are done in accordance with a physician’s order (which Silver Lining obtains prior to starting services). Some of our most common nursing services are below; if you’re not sure if what you need can be done at home, just ask!
Download our Medication Management Checklist here if you want to do this on your own, or see how we do what we do.
Dementia Care trained professionals are being increasingly more important. Dementia is an umbrella term that means a loss of memory and other mental abilities severe enough to interfere with daily life; someone can have many different kinds of dementia related to many different diagnoses and conditions. Different types of dementia examples are Lewy Body Dementia, Huntington’s Disease and Alzheimer’s Disease. See a full list here.
Our Clinical Director at Silver Lining is a Certified Dementia Practitioner and beyond the typical training required of all our direct-care team members, each one also goes through additional dementia training at orientation and annually.
Services that Silver Lining provides as it relates to someone with a dementia diagnosis:
While not all dementia clients have Alzheimer’s, all Alzheimer’s clients have dementia. Alzheimer’s is a type of dementia. And 1 in 10 seniors age 65+ has Alzheimer’s dementia. The Alzheimer’s Association is a powerful resource to anyone that has been diagnosed with Alzheimer’s or has a loved one diagnosed with Alzheimer’s. Here they talk about in-home care and what to expect. Depending on the stage of the disease, different services will be necessary.
Because Silver Lining is a skilled medical agency, we can provide assistance throughout the entire Alzheimer’s journey. This is unique in the home care world. Most home care companies can do the hands-off care (companion care, cooking, cleaning) and hands-on care (bathing, dressing). Silver Lining does that and in addition, we can provide advanced hands-on care (heavy transfer assistance, transfer assistance with devices, delegated care such as ostomy care) as well as nursing care (reassessments, specimen collection in the home, nursing support services as stages of the disease progress).
Services that Silver Lining provides to Alzheimer’s clients:
This is a unique service area in home care, and it’s such an important part of life. The Silver Lining team are deep believers in life choice, especially at end of life. Being Mortal by Adul Gawande provides insights into some of the philosophies we abide by, namely that death is a natural part of life and that each and every person gets to decide what quality of life looks like for themselves.
There IS a difference between Palliative Care and Hospice Care. Palliative Care could go on for years; the focus of care is on someone with a chronic disease. Hospice Care is typically for someone that has a prognosis of less than 6 months to live. A common misconception is that if you’re on hospice, you will die. In fact, hospice services are meant to support individuals with a poor prognosis but if you get better, you can “graduate” hospice and no longer be eligible for services. For a more in depth review, read our post about it.
Because of our skilled license, we have the ability to do the more advanced care often required in palliative care and hospice situations, including transfer assistance and medication administration. Major medical insurance will typically provide specific services under their policies, but are often to specific tasks for a small period of time. For instance, a hospice client with home health covered by insurance may have a nurse coming out twice a week for an assessment last 30-60 minutes, and a home health aide coming out 45-60 minutes three times a week for assistance with bathing. Because palliative care and hospice clients often require much more hands on care than this, private home care is extremely common as a supplemental service. That’s where Silver Lining comes in. We supplement the services covered by Major Medical Insurance. We can be in the home as little as 3 hours a week or as much as 24 hours a day.
Services often provided for our palliative care and hospice clients include:
*Long-term care riders on insurance policies, or life insurance policies with a Living benefit may assist in covering these out of pocket costs. Veteran’s Administration and Long Term Care Waiver programs may also assist.
Respite Care provides short-term relief for primary caregivers. It’s meant to provide supplemental service options so the primary caregiver can have downtime or a break. When paying out of pocket, one can have as much respite care as they want! For an insurance policy, the amount of respite care is dependent on the policy. Some policies have a specific number of hours per day (ie 4 hours per day for 6 days) and some policies have a set number per year (ie 336 hours per year in respite). Long Term Medicaid Waiver programs in Delaware (Amerihealth Caritas and Highmark Blue Cross) as well as the Veterans Administration all have the ability to pay for respite care for eligible clients.
Respite Care is an all inclusive term for IADL’s and ADL’s that a client may need. Services vary depending on the services you choose and may include:
Until the COVID-19 pandemic in 2020, in-home medical precautions were quite rare. Typically when someone is at home, he or she is not tested for things like MRSA, VRE or viruses like one would be in a facility or hospital. This lead to a low adoption of medical precautions in the community environment. For instance, if someone goes into the hospital with a wound, the wound would be swabbed to see what type of bacteria may be present. If it came back positive for MRSA, then contact precautions would be implemented. If that same person was seen at a physician’s office, wound care orders were prescribed, and the client went home, then potentially no swab would have been done and no one would know that the client had MRSA. Our protocols of appropriate care would still protect our team members (using universal precautions).
When a client requires additional medical precautions, Silver Lining is ready! Because we have an entire Clinical Department overseen by a Registered Nurse, we have the expertise and resources to administer safe and effective home care. Common transmission-based precautions include:
Different precautions mandate different types of Personal Protective Equipment and regulation.
Our infectious control processes mean that we’ll be up front when there is a situation we cannot properly handle in your home. An instance of this would be Airborne precautions, where a negative pressure environment is necessary during treatment to ensure healthcare workers are protected. Unless you have a negative-pressure room in your home, that means a hospital or appropriately prepped facility is where you would need care. Most facilities have a designated room or wing that can be negative-pressure if necessary.
To read more about transmission-based precautions, visit the CDC website on the topic!
Hiring a Companion is a great way to provide personal assistance, light housekeeping and meal preparation, and friendship for your loved one who otherwise would spend much of their time alone. There is no formal schooling required to be a Companion and requirements vary from employer to employer. We consider not just work experience, but life experience as well. We look for individuals committed to helping others with warmth and compassion.
Certified Nursing Assistant (CNA)
A CNA assists patients with activities of daily living, monitors medication reminders and vitals, and offers emotional, physical, and social support. A CNA reports to an LPN or RN, and will always have oversight. He or she will have 75-150 hours of training in a CNA program and must pass a state-sanctioned competency test. A Home Health Aide is an individual who has completed a state-approved program of at least 75 hours of training, but has not taken the CNA exam. So a home health aide is between a companion and a CNA.
You probably know the medical assistant as the person you meet upon entering an exam room at a doctor’s office. He or she will ask you for some health history, record information, and may take your vitals. A medical assistant will also perform appointment scheduling and data entry. Completion of a one-year certificate program or Associate Degree is standard; certification is not legally mandated. This person differs from a CNA in the type of training; CNAs are typically more trained for ‘hands-on’ care like bathing/dressing, while a Medical Assistant may be more trained in procedures like performing an EKG (a heart monitoring test) or doing lab draws.
Licensed Practical Nurse (LPN)
An LPN reports directly to an RN and can carry out most of the same job responsibilities, with a few tasks that they must have an RN do for them. They are responsible for the tasks associated with the care of their patients and are expected to report even minor changes in a patient to an RN or other medical professional. Typically, becoming an LPN requires about one year of education culminating in a certificate. An individual must pass the National Council Licensure Examination for Practical Nurses.
Registered Nurse (RN)
Registered Nurses are the primary go-to practitioner for most doctor’s offices, hospitals, and facilities because they can do almost anything a physician orders, are trained on assessments, and have the expertise and critical thinking skills to operate without extensive oversight. RNs coordinate care, perform diagnostic test and analyze results, instruct patients on how to manage illnesses after treatment, and oversee other workers such as LPNs, nursing aides, and home care aides.
Registered Nurses all have to pass the same exam nationwide, called the National Council Licensure Exam (NCLEX) for Registered Nurses. Some RN’s start with an Associate Degree (ADN) and some have a Bachelor of Science in Nursing (BSN). Regardless of level of education, all have to pass the same test.
Silver Lining has Registered Nurses overseeing all care and working closely with LPNs and CNAs to administer the right customized care.
Licensed Clinical Social Worker
A social worker is committed to improving the social environment and well being of people by facilitating, and developing resources. Our social worker at Silver Lining is Jeanne Dukes of Lewes Counseling. Jeanne is an invaluable resource in helping seniors transition to home health care, and for understanding a variety of other options. She also specializes in mental health.
Advanced Practice Nurse
An Advanced Practice Nurse is someone who started with a degree as a Registered Nurse and then moved on to higher education and has at least a Master’s degree. Advanced practice nurses provide and coordinate patient care and they may provide primary and specialty health care. There are four types of Advanced Practice Registered Nurses (APRN or APNs): Certified Nurse Practitioner, Certified Registered Nurse Anesthetist, Certified Nurse Midwife, and Clinical Nurse Specialist. APNs can be primary care providers depending on the area that you live.