Home Health Care
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Home Health Care

Home health care allows for the recovery and the facilitation of treatment in the comfort of one’s own home. When someone suffers an injury or has a debilitating illness, they need extra medical care. Home health care lets people receive that care in their own home rather than at a facility while receiving the same quality of care. More than 4 million Americans avail themselves of home health care. Seniors, in particular, can find a wide range of home health care services available to them. They can receive many of the routine services they need in a long-term care facility or a hospital.

1.What is home health care?

What is home health care?

Home health care involves the provision of assistance with medical and everyday living tasks at home. Home health care requires trained professionals to go to someone’s home to deliver healthcare services, such as lab work, occupational therapy, routine medical checks, and light housekeeping and home services, in combination with medical care. Home health care goes by different names depending on the individual provider. These are some of the common ways to refer to home health care:

  • In-home health care;
  • Private duty nursing;
  • In-home skilled nursing care;
  • Medical home care;
  • Home health;
  • Home health assistance.

FAQ: What is the difference between home health care vs. nursing home?

The major difference between home health care and a nursing home is that one occurs at home while the other refers to care at a long-term care facility. Home health care involves medical professionals, usually nurses, going to a patient’s home. To receive care at a nursing home, the patient would need to reside at the facility either permanently or temporarily during a period of rehabilitation.

1.1 Home Care vs Home Health Care

Home care and home health care sound quite similar. These terms do include some similarities. Home care involves assistance with activities of daily living and instrumental activities of daily living. Some home health care aides may also engage in light housekeeping, mobility assistance, or activities of daily living limited due to a medical condition. Unlike a home caregiver, those delivering home health care deliver skilled medical services. Especially home health care specialists, rather than home health care aides, do not assist with activities of daily living. Home health care visits are also considerably shorter and more limited in scope than home care.

2. What are the benefits of home health care?

What are the benefits of home health care

Home health care can provide a range of benefits for patients and their loved ones, depending on the services that someone receives.

  1. Patients experience increased safety by having a trained professional provide services in the home.
  2. Hiring at-home health care can help avoid hospital readmission.
  3. Home health care is more affordable than long-term residential care, such as a nursing home.
  4. Patients receive one-on-one attention for personalized health care.
  5. In-home health care helps keep patients at-home where they can maintain their independence.
  6. Patients and their families can get expert help in understanding and following medical instructions for treating conditions at home or after surgery.
  7. It provides a comfortable environment for injections and lab work, especially for nervous patients.
  8. Nurses can keep wounds clean and free of infection.
  9. At-home health care providers can check for issues in the home that may lead to falls.

3. What is quality in home health care?

Quality in-home health care comes from trained professionals. Home health care providers should provide proof of education, training, licensure, bonding, and insurance. Providers also need previous experience with similar clients. Families can also check communication procedures.

4. How to Find Home Health Care

There are different ways to find home health. These are some of the most common ways to procure it to figure out the best path for each patient.

Home Health Care Agencies

Home health care agencies are private companies that have a roster of services and provides to connect patients with the care they need. These are some of the pros and cons.

Pros:

  1. Agencies conduct pre-employment background screening to guarantee qualifications.
  2. In-home health care agencies manage taxes and payroll of their employees.
  3. Home health care agencies supply workers’ compensation and liability insurance to their employees to relieve the burden from individuals.
  4. Agencies offer supervision to ensure that patients receive consistently satisfactory care.
  5. Agencies provide training and onboarding services for their employees.

Cons

  1. It requires time to go through possible at-home providers to find the right one.
  2. Patients and their families need to determine if insurance applies, although some agencies may provide some assistance.
  3. The patient typically receives short-term care.

Hospital and Residential Referrals

A patient can receive home health care through a doctor’s prescription and receive a referral through a hospital or residential care facility following a patient’s release. These are some of the pros and cons.

Pros

  1. Home health care providers will likely have experience working through the referral.
  2. People working for the institutions have experience selecting care providers.
  3. Care can align well with the specific condition that creates a need for home health care.
  4. Facilities can try to find an in-network referral if someone has the appropriate insurance to cover it.

Cons

  1. There may not be a selection of providers, as hospitals and long-term care facilities rely on their approved networks to refer care.
  2. Patients may have a limited ability to shop around for their budget.
  3. The facilities do not perform any background checks or screening, only referrals.

Independent Aides

People can also hire independent contractors directly to provide home health care services.

Pros

  1. There is flexibility in the person that someone hires.
  2. Patients can take their time interviewing a range of candidates.
  3. Clients can negotiate wages and avoid agency overhead costs.

Cons

  1. Patients and families must handle all taxes and payroll themselves.
  2. Patients and families must conduct their own background screenings, which may have limits due to state laws.
  3. Patients may incur issues with liability.
  4. The patient would not have anyone to cover the home health care provider if they needed to miss a day.
  5. Depending on the local market, it may be difficult to find qualified candidates.

5. What are home health care services?

What are home health care services

Patients can choose from a myriad of home health care services depending on their needs. Before receiving services, agencies and providers create a home health care plan to identify these needs and then base care on the plan and the progress of the patient. These are some of the services patients can access.

  1. 24-Hour home health care: Home health care aides can provide care at any time of the day or night.
  2. Physical therapy: Physical therapists can come to a patient’s home to help them rebuild their strength and coordination through specific exercises.
  3. Occupational therapy: Occupational therapists providing at-home health care can use the home setting to help patients regain the ability to perform their activities of daily living in the home.
  4. Speech therapy: In the comfort of a patient’s home, speech therapists can work to improve the speech of patients, such as after a stroke when mobility impairment may also be an issue.
  5. Medical nutrition therapy Nutritionists and specialized nurses can develop meal plans and nutrition plans to specially address the needs due to certain conditions, such as cardiovascular problems or diabetes.
  6. After-surgery home health: Nurses can monitor a patient’s recovery after surgery, help patients follow care instructions, and care for sutures.
  7. Hospice care at home: Hospice patients can die surrounded by loved ones at home with the use of in-home hospice care for the administration of medicines, delivery and use of medical equipment, and emotional support of trained medical professionals.
  8. Overnight home health care: An overnight nurse can assist with home health care monitoring and support throughout the night, such as providing care in an emergency or preventing bed sores by alternating the patient’s position throughout the night.
  9. Palliative care: In-home palliative care provides medicine and other assistance to relive symptoms and pain during the last six months of life.

Who benefits from home health care?

Many different types of people and those with different conditions can benefit from at-home health care. These are just some of those who can benefit when home health is needed:

  • Patients that recently had an injury, hospitalization, or illness that requires rehabilitation;
  • Patients recovering from a hip replacement or shoulder replacement surgery;
  • Someone who needs regular lab work or injections;
  • People who need end-of-life care, such as due to terminal cancer;
  • Patients with physical disabilities or mobility issues that make going to the doctor difficult;
  • Neurological disorder patients; and,
  • Seniors who cannot drive.

In what settings home health care is provided?

While the term “home health care” may seem self-explanatory, it can take place in many residential spaces. These are the different places that home health care providers go.

  • Providers go to someone’s private home or apartment to administer services.
  • Home health care providers can go to assisted living facilities that only provide home care rather than health care.
  • Adult foster care patients can avail of treatment in their current residence.
  • Privately hired home health care providers give one-on-one support in nursing homes and other long-term care facilities.
  • In-home health care providers can see patients while they are in their adult day care during the day.

6. What does home health care include?

What does home health care include

Different home health care providers have specific variances in services and approaches, but these are the common tasks of in-home health care.

  1. Health monitoring: Nurses and aides can provide continued monitoring of patients. This may include monitoring progress and making reports. Providers can flag potential issues and coordinate with the rest of the care team.
  2. Pain control: Nurses and doctors can deliver pain medication for patients. Specialists, such as physical therapists, can also help alleviate pain due to injuries or conditions like arthritis at home. Providers can also help the patient by monitoring the effectiveness of pain management plans.
  3. Wound care: Nurses and other health providers can help patients take care of wounds after an injury, surgery, or hospitalization. Nurses can engage in wound dressing by applying bandages in a safe and sanitary way that avoids infection. This can help keep patients out of the hospital due to improper wound care.
  4. IV or intravenous therapy: Only medical professionals can insert IVs or administer pharmaceuticals through them. At-home health care can include placing a line, cleaning, changing IVs, and administering treatments through it. Patients who need daily or frequent IV care can avoid the hospital with this service.
  5. Injections and administering medicine: Some patients need frequent injections or other non-oral medication that patients and family members may have difficulty conducting. Some treatments also require a licensed professional to administer them. Home health care providers can provide these treatments and do so in a way that keeps patients comfortable.
  6. Check vital signs: Many patients need vitals took regularly, such as blood pressure, temperature, heart rate, and oxygen saturation. Trained professionals know how to properly use medical tools and understand their readings. This leads to reliable checking of vital signs that can alert to issues in the treatment plan.
  7. Medical tests and imaging: Some medical tests can occur at home rather than at the hospital or an imaging center. Blood tests, urine tests, and some x-ray services are available from a qualified medical professional in the home. This eliminates the need to go into the hospital or use uncomfortable machinery.
  8. Patient and caregiver education: Instructions and diagnoses from doctors can include a lot of medical language. This can make it difficult for people to understand. Nurses can provide clarity of instructions, treatments, and general health questions from patients and caregivers.
  9. Check home safety: Home health care providers know what parts of the home can come with dangers in combination with an injury or other condition. They can identify potential hazards to prevent injury. Subsequently, they can devise a plan to eliminate safety hazards in the home and make it safe for the patient to live there.
  10. Pharmaceutical services: Nurses, doctors, and specialists have access to pharmaceutical services. This means those with the licensed qualification can prescribe after a consultation. It also means that they can fill and administer pharmaceuticals to the patient to make it easier to take them.
  11. Tracheostomy care: A tracheostomy involves cutting into the throat and placing a line to enable breathing. This involves a lot of care at home after the procedure. Home health care assistance helps patients keep their trach tubes clean and care for their maintenance to keep patients healthy.
  12. Ventilator care: A ventilator is a sophisticated piece of equipment that helps people breathe when they are unable to do so adequately on their own. At-home health care involves the delivery of equipment, properly placing patients on a ventilator, providing any necessary medications, and monitoring equipment. Healthcare professionals can also take patients off of the ventilator when the time is right.
  13. Respiratory treatments: Especially as people age, they can encounter more problems breathing. Nurses and pulmonologists can deliver breathing treatments to patients at home. This can especially benefit these patients as physical exertion to go into the doctor’s office for treatment could exacerbate breathing problems.
  14. Catheter and ostomy care: The need for a catheter or ostomy bag may be permanent or temporary while in recovery. Patients who have this equipment need special catheter and ostomy care. Nurses can monitor the function of the equipment, clean the equipment, teach patients and their families how to use it, and order new supplies.
  15. Gastrostomy (feeding tube) care: When patients have a feeding tube and are at home, they need care and regular monitoring. In-home health care can provide nurses to monitor their nutrition, care for the equipment and administer feeding. They can educate patients and families and clean equipment to reduce infection possibilities.
  16. Nasogastric (N-G) tube care: A nasogastric tube provides nutrition and medication through a tube that goes down through the nose. These require special cleaning and monitoring that skilled nurse services can provide. They can also teach caregivers to properly use the equipment and report back to doctors on the effectiveness of treatment.
  17. Social services: Many people in need of medical care at home, especially the elderly, may need to access other services. At-home social services as part of a coordinated health care team can assist in accessing appropriate government or medical programs. They can also connect patients to counseling services.

What does home health care not Include?

People may confuse the duties of home health care, especially as it relates to home care. While there may be some crossover of duties, they are fairly segmented. These are the duties that are not a part of home health care.

  1. Homemaker Services: Homemaker services include general housekeeping, cooking, and other everyday services. While some nursing staff or other health staff may provide light help in some of these areas, such as assistance with meal prep, people cannot get standalone homemaker services through home health care.
  2. Personal Care: Personal care involves assistance with activities like grooming and toileting. Occupational therapists or nurses may provide medical interventions to aid patients in learning to do these activities on their own during rehabilitation. They do not provide these services directly.
  3. Companionship: Companion services provide social and emotional support to those who may experience limited social stimulation, especially seniors. Patients may inadvertently receive companionship care through chatting with their home health care providers, but it is not typically a standalone service. Those in hospice or palliative care may receive a type of companionship within their treatment.

7. Who is involved in-home health care?

Who is involved in-home health care

There is a range of medical professionals who can provide in-home health care. These are some of the most common.

  1. Medical Doctors: Medical doctors may perform routine visits at home for patients or more likely coordinate with at-home care professional teams to manage a patient’s care. Doctors can order prescriptions and prescribe particular treatments. Doctors also need to prescribe at-home health care for patients to qualify for support.
  2. Nurses: A range of nurses from CNAs to RNs or even Nurse Practitioners who can also prescribe medications can provide much of a patient’s at-home care. This involves administering medications, monitoring, and reporting changes, providing basic care assistance, and many other tasks. They can also provide education and respite care to families.
  3. Physical therapists (PTs): After an injury, stroke, or other debilitating condition, patients need access to physical therapy to regain mobility and strength. Physical therapists help patients regain their independence by providing specific exercises for their condition. These generally do not require the patient to have any particular at-home equipment.
  4. Occupational therapists (OTs): Occupational therapists help patients regain the ability to take care of themselves and perform everyday tasks, such as bathing or cooking. Occupational therapy takes a whole-person approach into account to determine the range of physical, emotional, and social barriers that exist for recovery. They can then create a plan to work on these specific aspects to help patients regain independence.
  5. Speech-language pathologists (SLPs): After a neurological issue or cancer, patients may need assistance regaining their ability to speak or swallow. Speech-language pathologists can do this and help slow degeneration. Working at home with patients is especially ideal for those who also suffer from mobility issues.
  6. Medical social workers (MSWs): Medical social workers have special training to help patients access services. They can identify programs that may alleviate legal or financial burdens and help families navigate the process. MSWs can also connect patients to community organizations to provide a range of relief.

FAQ: Which healthcare professional would advise on modifications to the home?

Skilled nurses and home health aides with the appropriate training can identify potential hazards around the home and address ways to make modifications for safety. Occupational therapists and physical therapists can recommend ways to improve the home and equipment to use in meeting the requirements for activities of daily living and instrumental activities of daily living.

8. How to Pay for Home Health Care

How to Pay for Home Health Care Services

There are many different ways to pay for home health care. Below are some of the options.

Medicare

Medicare typically does not cover the costs of long-term care. Some patients qualify for coverage of short-term home health care costs if they meet particular requirements, such as a recent discharge from a hospital or residential care facility. Rehabilitative services and even some equipment are typically covered by Medicare. Things like 24-hour home care and housekeeping are not a part of Medicare coverage. To use Medicare, patients must have a doctor’s order for at-home health care. They must also choose a Medicare-certified provider.

Medicaid

Medicaid coverage for home health care varies by state. Only low-income individuals can avail of Medicaid, and the income requirements also vary by state.

Long-term Care Insurance

Home health care coverage from long-term care insurance varies based on the policy. Coverage typically applies to more comprehensive policies.

Private Pay

Many people pay for home health care through private pay, which is also known as paying out of pocket. Funds can come from savings, investments, a reverse mortgage, annuities, or other options.

Workers’ Compensation

Laws for what Worker’s Compensation must cover can vary by state. Some states do condition that Workers’ Compensation provides for limited coverage of home health care services.

Veteran Benefits

Veterans who otherwise qualify for Veterans Affairs benefits may also qualify for VA assistance for home health care.

Sources

1. Home Health Care – Centers for Disease Control and Prevention

2. Home Health Care – Eldercare Locator

3. Personal Care – Milne Library

4. Home Care: More Than Just A Visiting Nurse – National Library of Medicine

5. What’s home health care? – Medicare.gov

6. CENTERS for MEDICARE & MEDICAID SERVICES 

7. Find the Right Home Health Aide for Your Loved One – AARP

8. Types of Home Health Care Services

9. Nasogastric feeding tube – Medline Plus

10. Personalized care when and where you need it

11. Can You Afford a Home-Care Worker? – AARP

12. Home Health Care for California’s Injured Workers – RAND

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