Home Care Options
During National Home Care month, I thought that it might be helpful to review some of the options that are available to provide continued health, dignity and independence for you and your loved ones.
Why Home Care? The cost effectiveness of managed care and earlier-than-ever discharges from hospitals has increased both the need for and availability of Home Care services. Many people with chronic illnesses can receive adequate care in a home setting if some type of nursing care and supportive services are available.
Under the guidance of skilled personnel, patients can receive many of the technical services in their own home that were once available only in hospitals. Home care can be appropriate for both short-term needs (after an illness, injury, surgery, or the birth of a baby) or long-term (as in the case of chronic conditions). Creative planning allows the individual and their family the flexibility to make choices that take into consideration their personal situation, making long-term care planning a realistic option.
Finding the right person to assist your loved one in their home can be a stressful and anxious experience. The initial recommendation that intermittent medical help is needed is most often made by the individuals personal physician. They determine what medical care is needed, how long it is needed and establish the guidelines under which it will be provided. If the person was hospitalized and will be returning to their home, the physician and social worker will discuss the needs with them and prepare an appropriate care plan prior to their discharge from the hospital. The care plan often includes "skilled" services that the person is unable to perform for themselves. Skilled services include: a nurse to change a surgical dressing, wound care treatment, preparing and administering insulin for diabetics, and restorative services such as physical, speech or occupational therapy for those learning to regain their independence. These skills will be offered from once to several times a week in accordance with the physicians order.
When intermittent home care is not enough, a private home care agency can be the solution. Each home care patient's needs are unique and by working closely with the physician, practitioner and other care providers, a level of professional support that meets those needs can be ensured. Qualified nursing personnel working in conjunction with your present health care provider and flexible scheduling to provide coverage for the hours you desire can greatly benefit your home situation. Many of these services are fully or partially reimbursable under Medicare, Medicaid or private insurance. Check with your agent for details on your specific coverage.
Home Care Services fall into two basic categories: Non-medical and Medical.
Non-medical Home Care includes: homemaker services - shopping, meal preparation and some light housekeeping; companions who offer support and friendship to those who live alone and personal care aides - bathing, dressing and hygienic needs that a house-bound person may be unable to perform by themselves.
Medical Home Care includes: Certified Nurses Aides (CNA’s) who can provide all of the above mentioned non-medical services plus primary nursing services such as: proper monitoring of the vital signs (blood pressure, pulse rate, respiration, temperature) and measuring weight, following a physicians instructions or a nursing care plan. They are also trained make clinical observations, document medical records and report their findings when appropriate.
Licensed Practical Nurse - performs all of the non-medical and CNA functions, and has nursing skills and training. The LPN can administer medications to the person at home, assess clinical information, and provide reports and documentation to the patient's other Health Care Providers. Can perform sterile and aseptic wound care techniques as prescribed, incorporate therapy programs into the individual's care plan to promote a wellness plan, and implement nursing intervention and management in accordance with the specific patient's needs.
Registered Nurse - all of the above services and skills, plus the ability to provide infusion therapies (I.V.'s). There are many options for obtaining these - and other - services, many of which are fully or partially paid for by Medicare, Medicaid, and insurance.
Elder nutrition programs are also available and can provide well-balanced, hot noon meals for seniors age 60+ and their spouses. All meals are planned by a nutritionist and meet the Recommended Daily Allowance (RDA) for major nutrients. Modified meals are available for elders with dietary restrictions.
Articles by: Christine A. Moriarty