It seems to happen so fast. One day your older family member is healthy
and active. Then you begin to notice the changes. Suddenly, your older
family member needs help with everyday activities. The Home
Health Care 101 is designed to help you find the basic information
you need so that an older family member can live safely at home.
The Benefits of Home Health Care
As they grow older, most people want to continue living independently
in their own homes. They hope to remain self-sufficient in their familiar
surroundings. But all too often certain situations - a sudden illness,
a chronic condition, and the very fact of aging - affect people's
ability to care for themselves and manage their daily living, creating
health and safety concerns for their families. Since seniors overwhelmingly
prefer to be cared for at home rather than be placed in a nursing
home or other facility, their adult children often become their primary
caregivers, taking on all the responsibilities that go with keeping
up the quality of their parents' lives. But when caring for themselves
becomes progressively too difficult, or when the responsibilities
of adult children become overwhelming, it is time for both seniors
and their families to consider professional home health care.
There are many advantages to receiving health care at home. Seniors
remain in their familiar, comfortable environment and don't have their
lives disrupted by a move. They also receive the full attention of
caregivers who are solely concerned with their particular health needs.
Home health care is often less expensive than care in nursing homes
or other health care facilities. What's more, the breadth and effectiveness
of home health care has been greatly extended by advances in technologies
such as home infusion, telemedicine, and the Internet. Treatments
that once could only be performed in an institutional setting are
now commonplace at home.
Home Health Care Categories
Finding the right kind of home health care can certainly be overwhelming.
Home health care needs vary from person to person but they usually
fit into three categories: skilled professional care, activities of
daily living (ADLs), and instrumental activities of daily living (IADLs).
A patient may require care in one or all of these categories.
Skilled Professional Care
This category covers services that can only be delivered by health
care professionals with advanced training such as nurses and therapists.
These services include administering medication, home infusion (drugs
and other therapies administered intravenously), injections, wound
and ostomy care, oxygen administration, blood tests, pain control,
physical, occupational, respiratory, and speech therapy.
Activities of Daily Living (ADLs)
Many seniors may need help with one or two activities of daily living
- bathing, dressing, getting in and out of bed or chair, going to
the toilet, walking, and eating. Sometimes family members or friends
can offer help on an intermittent basis. But these activities become
a challenge for disabled, frail, and mentally incapacitated seniors
and they need more extensive help in scheduling and performing them.
Instrumental Activities of Daily Living
(IADLs)
IADLs include such activities as shopping, paying bills, cleaning,
doing laundry, taking out the garbage, removing snow, and getting
to medical appointments. IADLs are less basic than ADLs - they need
to be performed, but scheduling them may not be as critical.
Home Health Care Professionals
A home health care team may include, in addition to the patient's
doctor and nurse, a home health aide, rehabilitation therapist (physical,
occupational, speech), social worker, and nutritionist.
A good home health care agency provides the services of the following
professionals who work together as a team when needed to ensure that
the patient receives the proper level of care at all times: patient's
physician, home health care nurse, rehabilitation therapists, social
worker, home health aide, and personal care worker/home attendant.
Nurses
There are two types of nurses licensed by the State of California.
Registered Nurses (RN) provide such services
as developing a plan of care with the patient's physician and in consultation
with the patient and her family, administering medications (orally,
by injection, or intravenously), and educating the patient and family
on self-care methods. Licensed Vocational Nurses
(LVN) may provide most of the care that a registered nurse
does, but may not perform some of the consultative services such a
developing a plan of care. Nurse Practitioners
Nurse practitioners are nurses who have undergone extensive advanced
training after receiving their nursing degree. They are licensed to
perform many of the activities that only physicians have traditionally
performed, such as diagnosing illnesses and prescribing medications.
Nurse practitioners, however, are more restricted in their practices
than physicians - for example, they cannot practice surgery. Many
patients prefer nurse practitioners to physicians for providing primary
medical care, since nurse practitioners are more available for home
visits and tend to spend more time with their patients. For a patient
under home health care, nurse practitioners can be an indispensable
member of the home health care team. Rehabilitation
Therapists
Rehabilitation therapists provide restorative treatments to patients
following surgery, illness, or an accident. Physical
therapists help restore strength, flexibility, coordination,
and general function. Occupational therapists
work to help patients regain the skills they need to function in their
day-to-day activities, such as learning how to dress and to bathe
safely. Speech therapists or speech
language pathologists help patients regain their ability to
produce and understand speech, as well as facilitate their communication
skills. Respiratory therapists help with
respiratory ailments, while nutritional therapists
focus on helping patients adopt short- and long-term diets to maximize
their health given their physical and/or medical conditions.
Social Workers
In the context of their home health care work, social workers are
specialists in helping people cope with the medical, functional, emotional,
psychological, environmental, and financial challenges of living in
their own homes. They are trained in counseling and in how to access
community services, either provided by the government or by community
organizations. Home Health Aides
Home health aides are certified by the California State Department
of Health. They receive extensive training in areas such as working
with immobile patients and Alzheimer's patients, monitoring a patient's
temperature and pulse rate, and preventing infections. Home health
aides can also monitor a patient's medication schedule. However, aides
are not permitted by law to administer medication. Home health aides
often help with household activities such as doing laundry and preparing
meals.
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