Home health care helps seniors live
independently for as long as possible, given the limits of their medical
condition. It covers a wide range of services and can often delay the need for
long-term nursing home care.
More specifically, home health care may include
occupational and physical therapy, speech therapy, and even skilled nursing. It
may involve helping the elderly with activities of daily living such as
bathing, dressing, and eating. Or it may include assistance with cooking,
cleaning, other housekeeping jobs, and monitoring one's daily regimen of
prescription and over-the-counter medications.
At this point, it is important to understand the
difference between home health care and home care services. Although they sound
the same (and home health care may include some home care services), home
health care is more medically oriented. While home care typically includes
chore and housecleaning services, home health care usually involves helping
seniors recover from an illness or injury. That is why the people who provide
home health care are often licensed practical nurses, therapists, or home
health aides. Most work for home health agencies, hospitals, or public health
departments that are licensed by the state.
How Do I Make Sure That Home Health Care Is Quality Care?As with any important purchase, it is always a
good idea to talk with friends, neighbors, and your local area agency on aging
to learn more about the home health care agencies in your community.
In looking for a home health care agency,
the following 20 questions can be used to help guide your search:
- How
long has the agency been serving this community?
- Does
the agency have any printed brochures describing the services it offers
and how much they cost? If so, get one.
- Is
the agency an approved Medicare provider?
- Is
the quality of care certified by a national accrediting body such as the
Joint Commission for the Accreditation of Healthcare Organizations?
- Does
the agency have a current license to practice (if required in the state
where you live)?
- Does
the agency offer seniors a "Patients' Bill of Rights" that
describes the rights and responsibilities of both the agency and the
senior being cared for?
- Does
the agency write a plan of care for the patient (with input from the
patient, his or her doctor and family), and update the plan as necessary?
- Does
the care plan outline the patient's course of treatment, describing the
specific tasks to be performed by each caregiver?
- How
closely do supervisors oversee care to ensure quality?
- Will
agency caregivers keep family members informed about the kind of care
their loved one is getting?
- Are
agency staff members available around the clock, seven days a week, if
necessary?
- Does
the agency have a nursing supervisor available to provide on-call
assistance 24 hours a day?
- How
does the agency ensure patient confidentiality?
- How
are agency caregivers hired and trained?
- What
is the procedure for resolving problems when they occur, and who can I
call with questions or complaints?
- How
does the agency handle billing?
- Is
there a sliding fee schedule based on ability to pay, and is financial
assistance available to pay for services?
- Will
the agency provide a list of references for its caregivers?
- Who
does the agency call if the home health care worker cannot come when
scheduled?
- What
type of employee screening is done?
When purchasing home health care directly from an individual
provider (instead of through an agency), it is even more important to screen
the person thoroughly. This should include an interview with the home health
caregiver to make sure that he or she is qualified for the job. You should
request references. Also, prepare for the interview by making a list if any
special needs the senior might have. For example, you would want to note
whether the elderly patient needs help getting into or out of a wheelchair.
Clearly, if this is the case, the home health caregiver must be able to provide
that assistance. The screening process will go easier if you have a better idea
of what you are looking for first.
Another thing to remember is that it always helps to look ahead,
anticipate changing needs, and have a backup plan for special situations. Since
every employee occasionally needs time off (or a vacation), it is unrealistic
to assume that one home health care worker will always be around to provide
care. Seniors or family members who hire home health workers directly may want
to consider interviewing a second part-time or on-call person who can be
available when the primary caregiver cannot be. Calling an agency for temporary
respite care also may help to solve this problem (see the Respite Care fact
sheet for more information about these services).
In any event, whether you arrange for home
health care through an agency or hire an independent home health
care aide on an individual basis, it helps to spend some time preparing
for the person who will be doing the work. Ideally, you could spend a day with
him or her, before the job formally begins, to discuss what will be involved in
the daily routine. If nothing else, tell the home health care provider (both
verbally and in writing) the following things that he or she should know about
the senior:
- Illnesses/injuries,
and signs of an emergency medical situation
- Likes
and dislikes
- Medications,
and how and when they should be taken
- Need
for dentures, eyeglasses, canes, walkers, etc.
- Possible
behavior problems and how best to deal with them
- Problems
getting around (in or out of a wheelchair, for example, or trouble
walking)
- Special
diets or nutritional needs
- Therapeutic
exercises.
Clothing the senior may need (if/when it gets
too hot or too cold)In addition, you should give the home health care
provider more information about:
- How
you can be contacted (and who else should be contacted in an emergency)
- How
to find and use medical supplies and medications
- When
to lock up the apartment/house and where to find the keys
- Where
to find food, cooking utensils, and serving items
- Where
to find cleaning supplies
- Where
to find light bulbs and flash lights, and where the fuse box is located
(in case of a power failure)
- Where
to find the washer, dryer, and other household appliances (as well as
instructions for how to use them).
A WORD OF CAUTION . . .
Although most states require that home health care agencies
perform criminal background checks on their workers and carefully screen job
applicants for these positions, the actual regulations will vary depending on
where you live. Therefore, before contacting a home health care agency,
you may want to call your local area agency on aging or department of public
health to learn what laws apply in your state.
HOW CAN I PAY FOR HOME HEALTH CARE?
The cost of home health care varies across states and within
states. In addition, costs will fluctuate depending on the type of health
care professional required. Home care services can be paid for directly by the
patient and his or her family members, or through a variety of public and
private sources. Sources for home health care funding include Medicare,
Medicaid, the Older Americans Act, the Veterans' Administration, and private
insurance.
Medicare is the largest single payer of home
care services. The Medicare program will pay for home health care if all of the
following conditions are met:
- The
patient must be homebound and under a doctor's care;
- The
patient must need skilled nursing care, or occupational, physical, or
speech therapy, on at least an intermittent basis (that is, regularly but
not continuously)
- The
services provided must be under a doctor's supervision and performed as
part of a home health care plan written specifically for that patient
- The
patient must be eligible for the Medicare program and the services ordered
must be "medically reasonable and necessary"
- The home
health care agency providing the services must be certified by the
Medicare program.
To get help with your Medicare questions, call 1-800-MEDICARE
(1-800-633-4227, TTY/TDD: 1-877-486-2048 for the speech and hearing impaired)
or look on the Internet at http://www.medicare.gov.
WHERE CAN I LEARN MORE ABOUT HOME HEALTH CARE?
There are several national organizations that
can provide additional consumer information about home health care services.
These include the following:
- The
National Association for Home Care, which can be reached at 202-547-7424
or by visiting its website at www.nahc.org. The postal address is: 228 7th
St., SE; Washington, DC 20003.
- The
Visiting Nurse Associations of America, which can be reached at
617-737-3200 or by visiting its website at http://www.vnaa.org. The postal
addresses are: 99 Summer St., Suite 1700; Boston, MA 02110.
To find out more about home health care programs
where you live, you will want to contact your local aging information and
assistance provider or area agency on aging (AAA). The Eldercare Locator, a
public service of the Administration on Aging (at 1-800-677-1116 or http://www.eldercare.gov can help
connect you to these agencies.
Case Study
WHEN IS HOME HEALTH CARE APPROPRIATE?
Because it is not always clear to the average person when an
ailing senior needs home health care and when he or she needs nursing home
care, it is usually best to consult a medical professional for advice. The
following case study describes one situation in which home health care proved
to be the right choice.
Francis is 84 years old and recently had a stroke. She was
hospitalized briefly and then discharged to continue recovering at home. To
enable her to return home, her doctor called a home health care agency, and the
agency gave Francis a complete home health care plan for six weeks. Since the
doctor ordered the home care for Francis, Medicare paid for it.
For the first week after Francis went home, a
nurse visited her every day. The nurse met with Francis's family to discuss her
special dietary needs and to arrange for exercise therapy to help Francis
regain her strength. Once that was done, the nurse visited Francis twice a week
to check on how well she was recovering. The home health care agency also sent
a homemaker, a personal care attendant, and a physical therapist to visit
Francis several times during the week. The homemaker would do the shopping and
cook light meals. The personal care attendant would help Francis bathe, get
dressed, and walk. The physical therapist would keep Francis moving and see to
it that she got some exercise to aid in her recovery.
source
: http://www.articlesbase.com/wellness-articles/fact-sheets-home-health-care-1540249.html
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