Home is the Center of Health Care

Each year, the National Association for Home Care & Hospice (NAHC) celebrates November as National Home Care and Hospice Month, and invites all communities to recognize the millions of nurses, home care aides, therapists, and social workers who make a remarkable difference for the patients and families they serve. For the aged, disabled, or ill, remaining in the homes they know and love can become increasingly difficult unless they can obtain services they need to support them. Whether it’s for two days a week, for continuous twenty four hour care, or end of life support, home care can allow patients to remain in their homes, protect their independence, and preserve their dignity.

There are four different themes for this year’s celebration, chosen by NAHC to best represent the different services provided. For Home Health the theme is “Home is the Center of Health Care”. Hospice is honored with the theme: “Hospice = Love in Action”. For the Private Duty sector, the theme is “Loving Care Tailored to Each Family’s Needs”. Home Care Aide Week (November 9-15, 2014) has its own theme: “Caring in Action”. During the month of November, members of the staff at Lincoln Medical Home Health and Hospice will provide weekly articles to provide information about home care. Lincoln Medical Home Health and Hospice, an affiliate of Lincoln County Health System, is one of several agencies providing home care to the people of Lincoln and surrounding counties.

“It’s important for the public to understand the different services available in home care, and the availability of agencies that provide those services”, states Susie Compton, Administrator of Lincoln Medical Home Health and Hospice. “Non-medical home care and medical, skilled home health care are two very different things. Non-medical home care is ideal for individuals, especially seniors, who would prefer to remain in their own home rather than move into an adult community, but need some assistance to do so comfortably and safely. This type of home care is usually referred to as personal care or companion care, and services range from transportation, errands, light housekeeping, meal preparation, and assistance with activities of daily living.”

Linda Mills, Social Worker for the agency explains, “For the most part, non-medical home care is a private pay service, meaning it is not covered by Medicare or Medicaid programs and must be paid for independently. However, there are some government programs, like “Choices”, that individuals may qualify for that will assist in payment for these services. Although our agency does not currently provide non-medical home care, we are able to furnish sitter lists and information on non-medical provider agencies or other resources available to assist with these services.”

Medical home health care is appropriate for people suffering from chronic illness and/or recovering from acute injury or illness and needing skilled care to remain at home. Home healthcare services are covered by Medicare, Medicaid, most private insurances, and veteran’s benefits. The laws governing these services and what exactly can be performed by home health care agencies vary from state to state. There are also limits to the numbers and types of visits a patient may receive, depending on the type of insurance.

Ellen Poarch, RN, Case Manager states, “Home Health services include medication management; wound care; physical, occupational, and speech therapies; and other skilled services provided by licensed individuals. It requires a physician’s order, and requires that the patient is under the care of a physician. If patients have these type of skilled services, then we are also able to utilize home health aides to provide personal care if needed.” Poarch adds, “In most cases, insurance providers stipulate that a patient must be home bound and need intermittent, skilled services to qualify for home health. Home bound doesn’t mean that a patient must be bedbound or confined to home, but it must be very difficult for the patient to leave home unassisted. Patients can attend church, see their physicians, and leave the home very infrequently to go to the beauty parlor or barber shop, but if a patient is able to drive, go out to eat or shop, then he or she will likely not be considered to be home bound”.

Another important distinction to know is that medical home health covered by Medicare and private insurance companies is NOT intended to be a continuous service. The goal is not for the nurses and therapists to come in and “take over”, but rather to assess what the patient needs, communicate and collaborate with the physician to ensure the best possible care plan, and to teach the patients and/or their caregivers how to manage their own health care.

Patients come home from hospitals and other facilities with many needs, and without the support of home health, many would likely not be able to manage their care. “We are amazed at how sick some of the patients are when they are discharged from the hospitals”, states Amy Bates, RN. “They may have complicated wounds, multiple medications, IV therapy, drains and tubes. But we are almost always able to teach that patient and/or his caregivers how to manage those things and recover fully”.

“Studies have shown that patients would much rather have health care provided in their home and that they recover better at home”, Compton states. “Teaching patients about their disease process, educating and coaching them regarding medications and safety, and providing direct skilled care such as therapy, wound care and IV therapy, can prevent or shorten hospital stays. This greatly reduces the cost of healthcare for many patients. In today’s economy, with an aging population and the rising incidence of chronic illnesses, keeping people healthy at home is an obvious solution to decreasing health care costs. Not only do patients want to stay home, but insurance providers definitely want home to be the center of health care. Skilled home health can be the key to being able to achieve that goal”.

Next week: Hospice IS love in action.

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