When I’m 65
It is estimated that around 10,000 people turn 65 each day, a trend that is expected to continue until 2029. At this time, there are more than 50 million seniors, those over the age of 65. According to the Home Care Association of America, a third of those older than 65 live alone.
Other stats show that nine out of 10 Americans 65 and older want to stay at home for as long as possible. There is definitely a market for home health care.
Truth is, long-term care is an industry facing some challenges. Traditional government programs are having a hard time keeping up with the demand, and our current system of institutional care cannot meet the needs of the tens of millions of seniors who need some kind of assistance as they age. Therefore, private pay home care fills a critical gap for the elderly between hospital stays, nursing home care, and care provided by family members and loved ones.
Aging in a home setting has become even more of a focus since the onslaught of COVID-19. With the virus ravaging through long-term care facilities, some are wondering about the role of such congregate care settings moving forward.
A duo from Mankato had the vision of helping all age in place long before coronovirus and quarantine were part of our everyday vocabulary.
Freedom Home Care offers customized and affordable home care and case management services that provide independence, companionship and freedom to age in place with dignity and grace—something its founders, Christine Nessler and Chris Mihm, believe deeply that everyone deserves. They and their team are passionate about providing Southern Minnesota with services to make a difference in the lives of those they serve and their families. Nessler and Mihm have built a team of experienced, compassionate and dependable caregivers who help make their clients’ lives easier and help them retain their independence, while providing their families with the peace of mind that their loved ones are safe.
“At Freedom Home Care, we strive to provide the best possible care for aging adults and their families,” explains Nessler. “This means so much to us because we know the value of taking care of those in need and giving back to the community.
“We are a locally owned business in a small enough community that we feel like we are serving our friends, family and neighbors. We believe that is exactly how all of our clients should be treated—like we are caring for our own loved ones. We are passionate about providing a service in Southern Minnesota that really makes a difference in the lives of our clients and their families.”
The mission of Freedom Home Care is to help aging adults stay independent in their homes for as long as possible with the peace of mind that quality one-on-one care will be provided by a team of compassionate, well-trained and reliable in-home caregivers, nurses, social workers and office staff.
You have care attendants with a population vulnerable to COVID-19. Please talk a little about how the pandemic has affected your business and what you have had to do to adapt?
Mihm: The changes that have transpired with the COVID-19 pandemic have been widespread and have impacted every aspect of our business. A few of our clients have put services on hold, but we have also taken on a number of new clients who needed assistance.
With our care model requiring caregivers to go into people’s homes, it introduces a level of risk that we are trying to mitigate as best as we can with guidance from the CDC and Minnesota Department of Health. Early on, we instituted a “fit for duty” test prior to every shift that a caregiver goes to. The caregiver is required to take their temperature and self-screen for any symptoms and report that back to the office through automated means. In addition, we mandated the use of face masks prior to the official pronouncement from the CDC. Our caregivers have also gone through additional training related to personal hygiene and additional best practices on how to reduce the spread of the disease. Our caregivers are also very aware of monitoring our clients for any early symptoms.
In addition to these, we’ve had to become very familiar with web conferencing and being able to recruit and hire without direct contact. I truly believe that many of these items will strengthen the overall process of caring for our seniors in their homes. We are also looking at this as an opportunity to grow our business with the market expansion and addition of a full-time caregiver experience coordinator. We feel the best is yet to come for Freedom Home Care.
That’s what you are doing now, let’s backtrack a bit. What made you decide to open Freedom Home Care?
Mihm: I have always had a desire to make a difference and decided to start investigating different business opportunities. To be honest, I didn’t really know much about the home care industry, but when I started looking at it more closely I couldn’t help but think of my grandpa who passed away from Alzheimer’s while I was in high school. My grandpa would have been a perfect candidate for home care, but there weren’t really any options available in the late 1980s. I was instantly drawn to the idea of helping as many seniors, like my grandpa, age in place at home.
Nessler: When I was in high school and on breaks during college, I worked as a certified nursing aide at the Timely Mission Nursing Home in Buffalo Center, Iowa. That remains one of my favorite jobs. I enjoyed the hands-on care of our residents and getting to know each of them. For me, the challenge was not being able to spend as much time with each person as I would have liked and knowing that many of them didn’t want to be there, but rather at home. When my partner, Chris, and my husband, Andy, came up with the idea to start a home care business in Mankato, I knew that it was an opportunity to take that experience and help people like those residents who wanted to remain in their homes. It also gave me the chance to provide them with one-on-one care with our in-home caregivers. Now I’m able to see some really special relationships form between our clients and caregivers because of the extra time and attention each client receives.
When did you start Freedom Care?
Nessler: We began our startup business in April of 2014. We created Freedom Home Care from the ground up, in order to fill a need we saw in our community. We both felt passionate about helping others in need.
Who does Freedom Home Care serve?
Nessler: We offer customized and affordable home care and case management services to the aging adults of Southern Minnesota. Having customized services, we are able to help a variety of people, including anyone who wants to age in place with dignity and grace, someone needing a little extra care after a hospital or rehab stay or someone at end of life or in hospice.
Mihm: We also serve those who need extended care after their Medicare benefit has run out for home health services, people living in an assisted living or a memory care community who need extra attention or care, or even just someone who doesn’t have family close by and could use help getting to appointments.
Nessler: Another point of focus for us is people living with dementia, including family caregivers that could use some help.
How many people do you serve?
Nessler: Currently we serve 64 clients, which include traditional home care services, case management, and emergency contact.
What sets you apart from other services like this?
Nessler: Our case management services are very unique. Many people have no family members nearby to serve as an advocate for them, to care for them or to be there for them in an emergency. Or their family works full time and doesn’t have the flexibility to take off work for their care or appointments. Freedom Home Care recognizes the importance of advocating for aging adults and has case management as a service to those in need.
It’s like the icing on the cake for our customizable services. We are able to provide peace of mind to families by offering extra services, including 24-hour emergency contact services, care coordination, discharge planning, assessments and consultations, advocacy and education, and identifying and coordinating resources and services.
Mihm: We also like to think that having a local ownership presence in our community is another distinguishing factor of Freedom Home Care. Our involvement in the community also extends down to the daily operations. We try to really stay on top of the communication with both our clients and caregivers.
What geographic area do you serve?
Nessler: As a service of Southern Minnesota, we cover a 30-plus mile radius in and around the Mankato area. Over the years, that has included hundreds of clients around the region spanning from New Ulm to New Richland and Le Sueur to Delevan, Minnesota. We are extremely excited to be expanding our business for the first time into the Owatonna and Faribault market, which will roll out this summer.
How has the business model changed over the years?
Nessler: As the needs of the community have grown, we have worked hard to fill them. We grew from a basic home care license with the Minnesota Department of Health to a comprehensive license. Our basic home care services include companionship, personal safety and health monitoring, meal preparation, help in and around the house, assistance with bathing, dressing, toileting, personal hygiene and mobility, and regular monitoring visits from our nursing team. With our comprehensive license we have been able to add health care services, including hands-on assistance with transfers and mobility, medication management, coordination of care, and delegated nursing tasks, which means our nurses are able to train our staff on specific client needs, including things like putting on compression socks. Finally, we added case management to help aging adults navigate through the difficulties of aging. That’s what is so great about being a privately owned business. We can change our business model to fill the needs we are seeing.
Freedom Home Care works closely with our community’s hospital, clinics, skilled-nursing facilities, assisted livings, independent livings, home health cares and hospices in order to provide the best combined services to care for the whole person and all their needs, wishes and goals.
What have been your biggest challenges?
Nessler: From a community outreach perspective, I think it has been challenging making people aware of home care as an option for aging adults on the health care continuum. Our home care and case management services provide valuable tools for the care team of our clients. Whether that is working with the therapist from rehab to ensure clients are doing their exercises, helping someone make a safe transition home from the hospital, ensuring medications are taken properly, or providing valuable health information to a doctor or director of nursing at a facility. There are also so many huge benefits of home care, including preventing falls and other common injuries, keeping aging adults healthy at home, providing companionship and personalized care, and helping aging adults remain engaged and connected.
Mihm: I would say that caregiver retention has been one of the biggest challenges we’ve faced as an organization. Clients and family members want to know that there is consistency with the caregivers that will be providing their care and we place a high priority within the company to meet that need. With the unemployment rate being historically low, pre-COVID-19, we’ve had to be innovative in trying new approaches to improve the retention, such as our Caregiver Mentor program, Caring Hearts Club and various incentives. The caregiver turnover rate nationally is approximately 85% per year. Even though we have consistently performed better than this mark, it is still a major challenge that affects all organizations in long-term care settings. We are extremely excited to see the positive impact that the newly created position of caregiver experience coordinator (CEC) will have on caregiver retention.
What has been your biggest surprise?
Nessler: It is amazing to see how valuable our services are to family members of our clients. We have really seen just how important it is to support family caregivers. Caring for a loved one is hard work. Oftentimes you see the caregiver’s own health being affected as a result of the care they are providing. Spouses that are getting burnt out from caring for a loved one on their own. Children who are missing work (and losing wages) to care for parents or take them to appointments. Children who live out of town and worry about their parents’ well-being. Providing that peace of mind that their loved one is well cared for and safe has been very rewarding. Both the home care and case management services have really allowed us to give much needed respite to family.
Mihm: As a new business six years ago, we needed to prove we were committed to the business and making a difference in our community. As expected, it took a little while to earn that trust with potential clients and health care partners, but my biggest surprise has been how supportive everyone has been and continues to be as we grow our business. This is one of many reasons why I feel blessed to be part of this community.
How many employees? And what is the breakdown?
Mihm: We have 70 employees. In the past six years, Freedom Home Care has grown from two employees, actually the two of us, to a team of five full-time office staff, one full-time registered nurse, two part-time registered nurses, one licensed social worker and 65 caregivers.
Has staffing been an issue?
Nessler: We have always been diligent about staying on top of staffing, but it is a balancing act in home care. We need to ensure we have enough staff to fill the needs of our clients, but also be ready for growth. If a discharge planner from the hospital or a rehab facility call, we need to have a caregiver ready to step in and care for the person in need.
Our most recent addition to the team is a caregiver experience coordinator. That role is solely dedicated recruiting, training and retaining our caregiver team.
What made you decide to add this position?
Nessler: The services our caregivers provide to their clients are so valuable to this community. So it’s crucial that we find the right people to fill that role. The caregiver experience coordinator is meant to make sure we have a team of compassionate, confident and competent caregivers. Our CEC has the opportunity to recruit the people that fit well into our mission. I always say you can train someone to be a caregiver, but you can’t train compassion. It is so important to find the person that is looking for more than a job, but rather an opportunity to do meaningful work and make a difference in someone’s life. Once the CEC recruits that person, it is their job to make sure they are trained and ready for the first visit with a client and then provide them with ongoing annual training and support. The CEC always plays a big part in retention. We want our caregivers to feel valued, so the CEC helps coordinate our Caregiver Mentor Program, facilitates ongoing communication with the caregiving team and coordinates any fun events we have that encourage team building with our team.
This position probably positions you well for future growth?
Nessler: It is no secret that most people want to stay in their homes as they age, but there are also a couple more reasons why you’ll see growth in home care over the next several years. First of all, our population is aging quickly. However, the AARP estimates that our ratio of potential family caregivers is decreasing partly due to the growing distance between family members. Home care fills the gaps in existing care for aging adults between care provided by family caregivers in addition to hospital stays and skilled nursing care. I think the COVID-19 pandemic has also shed light on the safety benefits of staying home. With any luck our government will see the value in providing funding for home care as a cost-effective option for long-term care in addition to what they fund for nursing homes and home health services. In the next few years our plan is to grow with the need we are seeing, and that includes offering services in additional communities.
Understanding Home Health Care Versus Home Care
Home health care is clinical medical care provided by skilled medical professionals and is often prescribed as a part of a care plan following a hospitalization. Services include therapy, skilled nursing and wound care. Home health care agencies are also often Medicare certified agencies.
Home care, like services provided by Freedom Home Care, provides nonclinical services, such as activities of daily living, personal cares, housekeeping, meal preparation, medication reminders and companionship.
Many families find that utilizing home health and home care in tandem can be very beneficial for an aging adult who, for example, is recovering after a hospitalization. The home health staff address clinical and rehabilitative needs, while the home care aide can help with personal caregiving and household chores that the aging adult requires assistance with during his or her recovery.
Freedom Home Care has case managers and nurses who can help determine the care that is appropriate for each client’s needs. Coordinating resources and providing peace of mind is what they do.
Getting to know: Chris Mihm
I grew up in Janesville and attended Mankato State University, graduating with a degree in accounting. I moved to the Twin Cities, where I started my career as a CPA in public accounting, serving in that role for six years. My wife, Kristine, and I always had a desire to make Mankato our permanent home, so we relocated back to Mankato in 1999. I worked at Wells Fargo Home Mortgage until starting Freedom Home Care in 2014.
My wife, Kristine, and I just celebrated 25 years of marriage together and have three wonderful kids. Kelsey is currently studying for her master’s degree at the University of Minnesota in healthcare administration. Our son Andrew just finished his freshman year at Minnesota State University, studying in business, and our son Carter will be a sophomore next year at Mankato West. We enjoy spending time together at the lake and have spent countless hours at sporting events watching swim meets and football, hockey and baseball games.
A lot of my hobbies and activities revolve around spending time with family and friends. I enjoy spending time at the lake boating, fishing, sharing stories around the campfire, and working around the cabin. I am very passionate about cooking and sharing some of those skills with the kids. We also enjoy traveling and exploring new things. One of my all-time favorite activities is snorkeling. Someday I would like to become a certified scuba diver. I have enjoyed coaching youth sports over the years and being involved with our church and, the American Diabetes Association and Alzheimer’s Association.
Getting to know: Christine Nessler
I’ve been a part of the Mankato community for more than 20 years since moving to Mankato from Iowa to attend Minnesota State University, Mankato. I graduated from MSU with a degree in mass communications with an emphasis in public relations. My career path in Mankato has provided public relations and marketing experience in the areas of government, for-profit and nonprofit.
My husband, Andy, and I are busy raising three active kids. Max is 13, Liam is 11 and Margo is 7. We keep very busy with the kids’ activities, including music lessons, dance classes, drama classes, confirmation, football, baseball, basketball, golf and more. We love to spend time together with our extended family, most of which live within an hour or so of our home. We also enjoy taking advantage of a few of the 10,000 lakes in Minnesota.
I really love to be active and I enjoy yoga, running, cycling and spending as much time with friends and family as possible. I also really enjoy baking. Cookies are my specialty.
- In the community I am and/or have been active in the following ways:
- Christ the King Church Lutheran Church Sunday school teacher, confirmation guide and server at the Salvation Army
- Hoover PTA, helping with events like the Risser Run and the spring carnival
- Southwest Eldercare Development Partnership Stakeholder Committee for Minnesota Area Agency on Aging
- South Central College Nursing Advisory Board
- Mental Well-Being and Resilience Learning Community
- Mayo Clinic Health System – Mankato Community Health Engagement Committee
- Project 4 Teens board member
- Alzheimer’s Association support group leader and Walk to End Alzheimer’s committee member
- VINE Faith in Action volunteer
Why They Do It
Home care is a unique opportunity to make that difference by providing one-on-one care for individuals in their home, allowing them to retain their independence and have a high-quality of life. We also offer case management services with licensed social workers and registered nurses. Case management is a perfect solution for anyone needing a health care advocate, assistance with medical appointments, an emergency contact and much more.
For our home care and case management clients we strive to serve each of our clients with the following values in mind:
• Quality-trained staff
Freedom Home Care
Photography by Jonathan Smith