Home Care Services May Include Many Options

Home care is provided either by a skilled caregiver within the person’s home, or outside the home, as opposed to direct care offered in nursing homes or group facilities such as clinics. The services include but are not limited to: personal care; medical care; emotional support and guidance; physical support such as companionship and transportation. A skilled and licensed caregiver providing home care services must be licensed through the Department of Health. There are many different types of home care services and some are more commonly referred to than others.

Adult day care Home care is provided primarily for adults, typically in their later years, though children may occasionally need this service as well. The majority of home care services offer supervision and/or therapy if needed, or the provision of meals on a self-service basis. Most adult day care providers are licensed, insured and bonded. In addition, most offer an immediate response to emergency situations that may occur during the day.

In home caregiver program A home care provider offers assistance in helping a person to remain in his or her own home, while following a physician’s health care plan. For example, the caregiver may assist in preparing the meals, shopping for groceries, shopping for medication, and driving the client to appointments. The caregiver is generally not paid for these services. Rather, the agency or caregiver pays the designated caregiver a portion of the fees paid by the client.

In home health aide As the name suggests, a home health aide provides direct, hands-on assistance with activities of daily living. Depending on the needs of the client, this may involve assisting with toileting, meal preparation, light housekeeping, and transportation. Many caregivers have a specialized background in either patient care or long-term care. However, there are many who started out as aides in nursing homes or hospitals, and later opted for a career in a variety of other settings, including physicians’ offices, assisted living facilities and other such facilities. Most also hold licenses at both state and federal levels.

Both the services provided by the social worker as well as the long-term care agency’s caregiver help the client in managing daily living activities. However, there are differences between the two. Social workers are usually hired as part-time employees. They may be on a permanent contract for specific periods of time or be on a contractual hire and firing basis. In contrast, long-term care agency employees are usually hired on a month-to-month basis, and the employee is often on a contractual hire and termination basis.

Home health care services may include professional, medical assistance in the home as well. This may involve a variety of tasks, from assisting with personal hygiene to basic nutrition and weight management. Some home health service providers may also provide medications on a monthly or bimonthly basis, depending on the needs of their clients. These providers may also provide medications such as oxygen, bedding and clothing, among other things. Some may even provide life support systems such as ventilators in cases of severe cardiac conditions.

Evidence Based Practice Implications of Nursing Homes

Home care is medical care or specialist care offered directly by an expert caregiver in the patient’s home, rather than primary care offered in nursing homes or group facilities such as clinics. Home care is also sometimes referred to as domiciliary healthcare, community care or in-house care. There are many types of home care. These include assisted living communities, adult day care centers, residential treatment centers and respite care agencies.

Studies indicate that both positive and negative factors associated with home health care patients are related to the environment in which they reside. Those patients who reside in low-income housing, for example, are more likely to experience health problems and have higher rates of hospitalizations. Similarly, those who are young, black, female and/or old are more likely to experience poor health outcomes and hospitalizations. One study has shown that a rise in neighborhood crime has been correlated with increased hospitalization rates among Medicare and Medicaid home health care patients. This was especially true of assaults.

It is important to identify the sources of these observations, as well as the nature of care given by these caregivers. For example, did the caregiver(s) explain the need for safety during one of their weekly visits to the patient? What were the circumstances surrounding one of the planned hospital admissions? What kinds of medications were being administered at these home health visits? These are some of the research implications that should be examined in light of these observations.

Home health nursing is often controversial due to its focus on non-medical care giving and its emphasis on time and schedule management rather than acute care. However, this focus does not necessarily translate to poor outcomes. For example, many studies have demonstrated that home health nursing has significantly lower rates of unplanned hospital admissions, compared to traditional inpatient care. Also, patients who receive preventative services such as immunizations, receive personalized care and are aware of their health status are less likely to visit the hospital. It is important to note that these findings are only those attributed to nursing-related home health services; other studies have shown that patients who receive both inpatient and declarative care are at no greater risk for hospitalization or mortality.

The second set of research implications focuses on quality measures. Studies have indicated that the most common complaints regarding informal caregivers are inadequate time management and inappropriate levels of support. Both of these areas can be addressed through improved communication and self-care practices. A systematic review and meta-analysis of data from five different settings indicated that self-care and better time management are associated with lower rates of hospitalization, emergency room use and mortality among elderly patients.

It is important to note that although research has identified many potential benefits of home health care, more research is needed to examine the specific areas that should be improved. Some potential areas of concern include medication errors, dehydration, safety practices and the transfer of care recipients between venues. The evidence-based practice implications of this research point to several improvements that need to be made on the front end to effectively reduce risks and create a safer environment. Further studies are necessary to address the possible impact of these risk factors.

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