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What is Home Care?
Excerpted from various websites including by Vicki Salemi
“Home care” is a simple phrase that encompasses a wide range of health and social services. These services are delivered at home to recovering, disabled, chronically or terminally ill persons in need of medical, nursing, social, or therapeutic treatment and/or assistance with the essential activities of daily living.
Generally, home care is appropriate whenever a person prefers to stay at home but needs ongoing care that cannot easily or effectively be provided solely by family and friends. More and more older people, electing to live independent, non-institutionalized lives, are receiving home care services as their physical capabilities diminish. Younger adults who are disabled or recuperating from acute illness are choosing home care whenever possible. Chronically ill infants and children are receiving sophisticated medical treatment in their loving and secure home environments. Adults and children diagnosed with terminal illness also are being cared for at home, receiving compassion and maintaining dignity at the end of life. As hospital stays decrease, increasing numbers of patients need highly skilled services when they return home. Other patients are able to stay at home to begin with, receiving safe and effective care in the comfort of their own homes.
What Types of Services Do Home Care Providers Deliver?
Home care providers deliver a wide variety of health care and supportive services, ranging from professional nursing and HCA care to physical, occupational, respiratory, and speech therapies. They also may provide social work and nutritional care and laboratory, dental, optical, pharmacy, podiatry, x-ray, and medical equipment and supply services. Services for the treatment of medical conditions usually are prescribed by an individual’s physician. Supportive services, however, do not require a physician’s orders. An individual may receive a single type of care or a combination of services, depending on the complexity of his or her needs. Home care services can be provided by the following professionals, paraprofessionals, and volunteers.
Physicians visit patients in their homes to diagnose and treat illnesses just as they do in hospitals and private offices. They also work with home care providers to determine which services are needed by patients, which specialists are most suitable to render these services, and how often these services need to be provided. With this information, physicians prescribe and oversee patient plans of care. Under Medicare, physicians and home health agency personnel review these plans of care as often as required by the severity of patient medical conditions at least once every 62 days. The interdisciplinary team reviews the care plans for hospice patients and their families at least once a month, or as frequently as patient conditions and/or family circumstances require.
Registered nurses (RNs) and licensed practical nurses (LPNs) provide skilled services that cannot be performed safely and effectively by nonprofessional personnel. Some of these services include injections and intravenous therapy, wound care, education on disease treatment and prevention, and patient assessments. RNs may also provide case management services. RNs have received two or more years of specialized education and are licensed to practice by the state. LPNs have one year of specialized training and are licensed to work under the supervision of registered nurses. The intricacy of a patient’s medical condition and required course of treatment determine whether care should be provided by an RN or can be provided by an LPN.
Physical therapists (PTs) work to restore the mobility and strength of patients who are limited or disabled by physical injuries through the use of exercise, massage, and other methods. PTs often alleviate pain and restore injured muscles with specialized equipment. They also teach patients and caregivers special techniques for walking and transfer.
Social workers evaluate the social and emotional factors affecting ill and disabled individuals and provide counseling. They also help patients and their family members identify available community resources. Social workers often serve as case managers when patients’ conditions are so complex that professionals need to assess medical and supportive needs and coordinate a variety of services.
Speech language pathologists work to develop and restore the speech of individuals with communication disorders; usually these disorders are the result of traumas such as surgery or stroke. Speech therapists also help retrain patients in breathing, swallowing, and muscle control.
Occupational therapists (OTs) help individuals who have physical, developmental, social, or emotional problems that prevent them from performing the general activities of daily living (ADLs). OTs instruct patients on using specialized rehabilitation techniques and equipment to improve their function in tasks such as eating, bathing, dressing, and basic household routines.
Dietitians provide counseling services to individuals who need professional dietary assessment and guidance to properly manage an illness or disability.
HCAs/home health aides assist patients with ADLs such as getting in and out of bed, walking, bathing, toileting, and dressing. Some aides have received special training and are qualified to provide more complex services under the supervision of a nursing professional.
There also is an array of services provided in the home by agencies that are not licensed by the state or subject to the same oversight. Among them are these:
Homemaker and chore workers perform light household duties such as laundry, meal preparation, general housekeeping, and shopping. Their services are directed at maintaining patient households rather than providing hands-on assistance with personal care.
Companions provide companionship and comfort to individuals who, for medical and/or safety reasons, may not be left at home alone. Some companions may assist clients with household tasks, but most are limited to providing sitter services.
What is Hospice Care?
Hospice care focuses on providing care, comfort and support to people with life threatening illnesses. The goal of the care is to help people with end life illnesses have peace, comfort and dignity. Care can be provided in a variety of settings including:
- The patient or caregivers home
- At a hospice center
- In a hospital
- In a skilled nursing facility
What does hospice provide?
- Physician services for the medical direction of the patient’s care
- Regular home visits by nurses
- Medical supplies, such as catheters and bandages
- Medical equipment, such as hospital beds and wheelchairs
- Delivery of medications, medical supplies and equipment
- Medications for pain relief and symptom management
- Home health aide services for personal care, such as dressing and bathing
- Social work services
- Spiritual care
- Grief counseling
- Volunteer support to provide companionship to the patient and help for family members
- Short-term inpatient and respite care
- Physical therapy, occupational therapy and speech/language services
Who uses Home Care and Hospice?
- Those who need short-term assistance at home following an illness or hospitalization
- Persons with a chronic illness or disability who need assistance to stay living at home
- People with advanced illness who wish to receive end of life care in the comfort of a home environment
- People of all age; older adults who chose to live independently rather than in a nursing home; adults who are recuperating from an acute illness; persons with long term disabilities children and infants who require complex and high tech care for serious childhood illnesses.
Why Choose Home Care?
- Home care is delivered at home. When we are not feeling well, most of us want to be in the comfort and familiarity of our home.
- Home care keeps families together by keeping people at home rather than in the hospital and helping families care for their loved one.
- Home care prevents or postpones institutionalization.
- Home care promotes healing since patients heal faster and recover quicker at home.
- Home care is safe. Many risks, such as infection, are eliminated or minimized when care is given at home.
- Home care allows for the maximum amount of freedom for the individual. Patients at home remain as engaged with their usual daily activities as their health permits.
- Home care promotes continuity. The patient’s own physician continues to oversee his or her care.
- Home care is personalized and tailored to the needs of each individual. Patients receive one-on-one care and attention.
- Home care is less expensive than other forms of care, especially lengthy inpatient hospitalization
- Home care is the form of care preferred by the American public.
- Home care can prevent rehospitalization and decrease the need for urgent care.