Creating Personalized Care Plans: The Care Mountain Approach to Home Care in Plano, TX

In the realm of quality in-home care, the importance of highly personalized care plans cannot be overstated in providing a sustainable and long term solution to support Seniors aging at home. At Care Mountain Plano , we understand that each patient has unique needs, and our approach focuses on tailoring care to fit those highly personalized requirements that include clinical, non-clinical and personality elements. This article explores how we create personalized care plans through case studies of two distinct scenarios: a patient with Parkinson’s disease and another recovering from a stroke.

Case Study 1: Parkinson’s Disease Management

Patient Profile:

Meet John, a 65-year-old man diagnosed with Parkinson’s disease (PD). 

• John’s PD diagnosis is more than 10 years old, and over time has progressed. John’s PD is now at a mid to late stage progression. He is mobile, and uses a walker but is hesitant to ambulate more than a few steps. The sit to stand transfer motion is becoming harder for him and he needs assistance. He also has Osteoporosis. 
• From the diagnosis 10+ years ago till now:
  • About seven to ten years ago, his PD was barely noticeable in progression.
  • About 3 years ago, his weight started dropping. About a year ago, his flexibility significantly dropped and since then stiffness, movement, posture has worsened considerably. 
  • He has also seen significant cognitive decline especially in short term memory over the last 6 months. 
  • He doesn’t yet have any slurring in speech but voice modulation  is limiting and he talks more softly and speaks less than before.
  • He experiences motor challenges, including tremors and rigidity, which affect his mobility and daily activities. 
  • His personalized care plan must address not only his physical limitations but also his emotional well-being, and the nuances of his family.

Personalized Care Plan Components:

1. Caregiver Support:

A dedicated caregiver is assigned to assist John with daily activities, ensuring he feels comfortable and secure. This caregiver is trained in Parkinson’s care, understanding the nuances of the disease and how to provide support effectively especially across his mental and physical well being.

2. Physical Therapy (PT):

John’s care plan includes weekly sessions with a physical therapist who specializes in neurological disorders. The therapist would need to do a PT eval and develop a personalized care plan with exercises that enhance his mobility and strength, and is tailored to John’s specific abilities and progress. 

• The physical therapist will be someone who has several years of hands-on experience working with Parkinson’s (PD) patients across various stages of the disease, from newly diagnosed individuals to those with advanced symptoms. The would likely be someone familiar with PWR!Moves (Parkinson Wellness Recovery), or something similar – PWR is a popular approach to PD-specific, neuroplasticity-principled, personalized therapy and exercise plans adaptable for people with PD of any disease severity. 
• Their Therapy approach will be personalized and typically will be on improving the patient’s mobility, balance, strength, and functional independence while reducing the risk of falls. They would typically design personalized treatment plans that address bradykinesia, rigidity, and postural instability using evidence-based techniques to enhance gait, posture, and fine motor skills, and use strength, and flexibility exercises tailored to Parkinson’s progression.
• Additionally, they would educate and empower patients, family members and caregivers about home exercises, energy conservation, and disease management strategies for Parkinson’s.

3. Speech Therapy (ST):

To address John’s communication challenges, a speech therapist will work with him to improve his speech clarity and swallowing techniques. This therapy is crucial as Parkinson’s can affect both speech and eating, and his social relationships with his caregiver, family and friends. The speech therapist would personalize and use an appropriate strategy, for example possibly the Lee Silverman voice treatment approach in this context. 

4. Occupational Therapy (OT):

An occupational therapist assesses John’s home environment and recommends modifications to enhance safety and independence. This includes installing grab bars in the bathroom and using adaptive tools for daily tasks.

5. Regular Assessments:

Care Mountain conducts bi-weekly assessments to monitor John’s progress and adjust the care plan as needed. This ensures that the plan evolves with John’s changing needs.

Case Study 2: Stroke Recovery

Patient Profile:

Samantha, a 72-year-old woman, is recovering from a stroke that has left her with limited mobility on her right side. After a short rehabilitation stay, she returns home, requiring comprehensive support to regain her independence.

Personalized Care Plan Components:

1. Comprehensive Nursing Care:

A registered nurse visits Samantha regularly to manage her medications and monitor her vital signs. This nurse also provides education on stroke recovery, weight management, and preventive measures.

2. Physical Therapy (PT):

Samantha’s physical therapist creates a customized exercise regimen focusing on strength-building and mobility enhancement. The therapist works with her to set achievable goals, fostering a sense of accomplishment.

3. Occupational Therapy (OT):

An occupational therapist collaborates with Samantha to develop strategies for daily living activities, such as dressing and cooking. They introduce adaptive devices that facilitate her independence.

4. Speech Therapy (ST):

If Samantha experiences difficulties in speech or swallowing, a speech therapist is integrated into her care plan to help her regain these essential skills.

5. Emotional Support:

Recognizing the psychological impact of a stroke, Care Mountain includes a counselor in Samantha’s care team. This professional provides emotional support and coping strategies, addressing the mental health aspects of her recovery.

6. Family Involvement:

Family members are encouraged to participate in Samantha’s care plan. Care Mountain provides training for family caregivers, ensuring they understand how to support her effectively.

The Care Mountain Philosophy

At Care Mountain, our approach to creating personalized care plans is rooted in personalization with the client’s specific needs and personality, and collaboration and communication with their loved ones. We believe that involving the patient, their family, and a multidisciplinary team of healthcare professionals leads to the best outcomes. Each care plan is continuously evaluated and adjusted based on the patient’s progress and feedback.

By focusing on the individual needs of our patients, we ensure that their care is not only effective but also compassionate and supportive. Whether managing the complexities of Parkinson’s disease or navigating the recovery process after a stroke, personalized care plans are essential for enhancing the quality of life for our clients in Plano, TX.

If you or a loved one requires personalized home care, reach out to Care Mountain for a consultation. Let us help you create a care plan that truly meets your needs.