Author: Jane Rowley

Home health care helps older adults with illnesses or injuries live productive, independent lives for as long as possible. The program covers a wide range of services, involves active participation from the patient and caregiver and can often delay the need for long-term placement. With technological improvements, we are seeing more patients manage their chronic illnesses and recover in the home instead of in facilities. Home health care is often a preferred, cost-effective form of patient care.

The health care system of the 21st century will be community-based, providing many alternatives for care. With the population aging and the influx of baby boomers seeking health care, patients will begin to determine when and where they receive health care services. There really is “no place like home,” and the aging boomer population will insist on a patient-centered model of care that takes place in the home and involves family and health care providers.

As the aging population struggles with multiple chronic conditions such as dementia, heart disease, chronic obstructive pulmonary disease, depression, diabetes mellitus and stroke, home health becomes an important alternative in the provision of services to meet their medical needs. Home health can provide these patients and their families with early support and education regarding disease processes in the comfort of their own home.

Maximizing self-care and independence is the cornerstone of home health, and the program is designed to care for patients with specific medical and psychiatric needs. Patients participating in home health must be homebound, have had a face-to-face visit with their physician who certifies the need for services and have a plan of care established by the physician and home health care team. The plan of care generally includes a broad array of professional and support services in the home designed to include participation by the patient, family, and caregiver. The patient’s physician provides oversight for all patient treatments.

The home health nurse is the patient’s key to wellness in the community. The goal is improving patient outcomes by providing 24-hour availability and response, medication management and patient, family and caregiver education on disease processes. The home health nurse, under the direction of the patient’s physician, coordinates all home care and treatment and continually educates the patients and their families on the plan of care and anticipated outcomes.

In addition to skilled nursing, the home health team includes various support services that encourage patient and family participation to focus on allowing the patient to remain self-sufficient. Rehabilitative therapies are provided in the home to treat and instruct with an emphasis on returning the patient to independence.

Physical therapists provide treatment to help patients increase mobility, strength, balance, and coordination. The occupational therapist provides rehabilitative services to help restore or maintain the patient’s ability to perform tasks used in activities of daily living, often modifying or adapting activities in order to increase the patient’s self-help and homemaking skills.

Speech-language therapies are provided to treat physical and cognitive disorders that cause difficulty with communication and swallowing. Speech therapists help patients develop their language and speech skills to regain control and improve their communication. They also teach patients and family members safe and appropriate swallowing techniques.

Medical social workers often participate in the patient’s treatment plan and address social, psychological and economic needs of the patient and help the family address these issues in the home environment. Home health aides provide the patients with personal care services including assistance with bathing, dressing, grooming and some light housekeeping.

Modern technology has allowed additional service providers to be an active part of the patient’s treatment plan. Many laboratory services can be performed in the home by the health care team as well as X-rays, ultrasounds, EKGs, wound vacs, infusion therapy, nutritional feedings, PT/INR coagulation checks, glucose monitoring and ostomy education and care.

Finally, the most important part of the health care team is the patient and his or her family and caregivers. The success of the patient’s home health plan of care depends almost entirely on the ability of the home health provider to gain the participation of the patient and their families in attaining the treatment goals. Continued education and patient compliance are vital to the success of the home care team.

Home health care has made many strides recently in their ability to provide medical care and education to patients and their families. Increased technology has made numerous services available in the home setting. Home health programs have shown they are able to help physicians effectively manage most illnesses and injuries in the home while educating patients and their families on ways to regain independence and remain as self-sufficient as possible.

Many studies indicate that home health services are less costly, as well as the preferred form of health care for the elderly, and as that population continues to increase, so will the need for continued improvement and expansion of the home health program.

Ten Signs of a Quality Home Health Agency

• The staff is polite and treats patients and families with respect.
• Staff explains patient’s plan of care to the patient and family and allows the patient to participate.
• The staff is properly trained and licensed to provide patient care.
• Agency explains what to do if the patient has a complaint.
• Agency responds quickly to patient request.
• Staff checks patient’s physical and emotional condition at each visit.
• Staff responds quickly to changes in patient’s health or behavior.
• Staff checks patient’s home and suggest changes to meet special needs and safety issues.
• Staff instructs patients on what to do in an emergency.
• Agency and staff protect patient privacy.