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.
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.
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 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 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.
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.