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Many acute medical care services are now available at home for people discharged from the hospital. Home health providers are helping the chronically ill, aged and disabled regain and retain their independence. Although home care is associated with the elderly, it can be a major help to people of all ages, including children and families. In fact, one out of every four people currently receiving home care is under age 65.
WHAT SERVICES ARE AVAILABLE?
Home care services can range from fairly sophisticated high tech care (similar to what a patient would get in a hospital) to help with the activities of daily living such as housecleaning and meal preparation. Each person’s home care program must be tailored to match his or her needs with appropriate services. A variety of home care workers could be involved in an individual’s plan for home care services. The two main types of home care are:
* Rehabilitative home care is a provided to people who are convalescing from an illness or are in a rehabilitation program. Many of these patients have been recently discharged from a hospital. The rehabilitative health-care team may include a physician, nurse, nutritionist, homemaker, home health aide as well as various types of therapists.
Skilled nursing is the most common rehabilitative home care service. Nurses change dressings, administer drugs and monitor patients for complications or serious changes in health. They also teach newly discharged hospital patients and their families how to perform skilled nursing procedures so they can eventually perform them themselves.
Nurses are divided into two groups: registered nurses (RNs) and licensed practical nurses (LPNs). RNs, who hold a four-year college nursing degree or BSN (Bachelor 0f Science in Nursing), are trained to make independent judgments about a patient’s condition and care, and can perform basic patient examinations. LPNs undergo much shorter training that focuses on mastering routine nursing tasks.
* Basic home care refers to the kinds of services provided to patients who otherwise might be unable to remain a t home because of a disabling health condition. Continued health supervision with an emphasis on health promotion enables these patients to maintain both a stable of health and relative independence. Homemaker and home health aide services are the least expensive hone care service. Many of the recipients of such care have a chronic illness or disability.
Homemakers, also referred to as companions, are responsible for a wide variety of tasks that keep the home clean and safe, and they generally contribute to a person’s well-being. A homemaker’s responsibilities include basic housekeeping, (tidying rooms, vacuuming, making and changing the bed, preparing and serving meals, shopping for food) and personal care (helping patients to wash and dress.)
Home health aides perform three general types of services: personal care, basic nursing and incidental homemaking. Aides can not provide skilled nursing care. For example, although they can take and record your temperature, pulse and respiration rate, and make sure you follow simple medical recommendations such as getting more exercise, they generally cannot administer drug injections.
IS HOME CARE RIGHT FOR YOU?
The first step in determining whether home care is appropriate for you is to discuss the issue with your physician. Make sure your doctor knows you are willing to work with him or her to reach a decision on home care. You can also evaluate options with a hospital discharge planner, whose job it is to discuss local home care services with you.
If home care is deemed appropriate, your home care agency will conduct an assessment. This is a detailed evaluation of your situation that confirms the need for services ordered and identifies any other beneficial services. The assessment is usually made by an RN either in the hospital or at homer. The agency then tailor’s a home care plan to your needs and reviews it with you. Before finalizing the plan, the agency advises your doctor of its assessment and presents the plan for your doctor’s approval. The plan outlines key details, including treatment goals, the specific services and supplies that may be needed.
HOW DO I PAY FOR HOME CARE?
Some agencies are certified by Medicare to provide services to Medicare patients. To find out whether you or someone you know qualifies for home health services under Medicare, talk to the hospital discharge planner or your doctor, or call the agency directly. For those patients who are not covered by Medicare, most home health agencies accept reimbursement from private insurance companies or from the patient directly.
To be eligible for Medicare paid visits, a patient must first qualify for skilled care, such as that provided by an RN. Medicare does not cover basic home health care services limited to assistance with bathing, dre4ssing and/or feeding. If a Medicare patient qualifies for se4rvice under the agency’s guidelines, Medicare is billed directly; a bill is usually not sent to the patient. In some instances, though for example, when the patient is not homebound, Medicare will pay 80 percent of the cost, leaving the patient responsible for the remaining 20 percent.