“From personal experience as a case manager, I now realize the need to know more about private home care. Case managers are reluctant to offer home care to patients and their families due to cost. We conclude, as I did, that patients and families cannot afford private care. These assumptions must not be made.
If a patient has no caregiver and/or cannot take care of themselves, home care is a viable option. Private providers can meet the patient’s needs in between VNA and/or hospice visits. CMSA standards make it clear that all available options should be offered so that patients and families can make informed decisions. It is consistent with legal and ethical requirements governing C.M. practice and a condition of participation.” – Mary King, Case Manager
Mary’s remarks on the benefits of home health care are especially important in the time of COVID.
When a patient is in the hospital their meals and medicines are brought to them daily, personal hygiene is attended to, and their vitals are monitored regularly. While they are receiving all of this care, they also have companionship and conversation and are in a safe and secure environment. A case manager will often assign a discharged patient with VNA visitations – usually for P.T. or O.T. These visits usually take place two times a week and last for about a half-hour. Once the patient reaches a plateau, the service is discontinued, leaving them without any in-home health visits or additional social interactions.
These socialization factors are especially important when we look at the effect of COVID on the elderly: physical, isolation, fear, anxiety, depression, and lack of motivation or energy. Once a patient leaves the hospital, an in-home caregiver can recognize distress and watch for obsessive, compulsive behavior, worry, or panic.
Structure, routine, and a clean environment all contribute to a successful recovery. A patient who opts for private care will experience:
- Monitoring of symptoms such as palpitations, excessive perspiration, dizziness, or difficulty breathing.
- Healthy meals, that include dietary restrictions if necessary, prepared by the home health care expert, as well as a daily recording of the client’s intake of fluids.
- Assistance with personal hygiene resulting in showering more often, shaving, and toileting. In-home caregivers also ensure the client’s clothes, hair, and nails are clean, and that the bed linens are changed regularly.
- Reminders to take meds on time.
- Laundry is washed, dried, folded, and put away.
- Transportation to follow-up doctor’s appointments
- Food and/or pharmaceutical shopping is taken care of
- Companionship and conversation: playing cards, doing jigsaw puzzles, crossword, or other hobbies. Having someone who is there just for a patient’s wellbeing fosters a feeling of safety and security.
Going home to an empty house after being hospitalized can be overwhelming, frightening, and lonely. When a caregiver is assigned it often makes all the difference in recovery and recidivism.
Ceci Murphy, Director Abundant Home Health Care + Mary King, Director Case Management