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Maximizing your home health care experience: Part 2

by Kathryn Kilpatrick

With the length of hospital stays decreasing, many people want to be able to return to their homes and home health care might be a very effective option.

Do you know someone who has received skilled nursing services at home? Perhaps they had a home health aide or were seen for rehabilitation services, including physical, occupational and/or speech therapy. While requirements will vary depending on the payer, in general a person who needs to be confined to home will need a referral from their doctor and require the skills of a home health care professional. For additional information about home care, visit The National Association for Home Care and Hospice.

Looking at the Bigger Picture

As a speech and language pathologist providing speech therapy in the home for more than three decades, I have become a firm believer in the benefits of receiving home health care. When a health care professional enters the home of a patient, there is an opportunity to assess a situation on an ongoing basis. There is often better access to family members and friends who may be able to provide needed details, as well as assist with the plan of care. By actually being in the environment where a person lives, recommendations and modifications can be very specific to the needs of all involved. Additional suggestions may be offered and appropriate referrals can be made to resources as the team shares their input.

Change is never easy, and bringing someone home from the hospital, rehab or a long term care facility can be quite challenging, especially if there are significant changes in the their physical status, mobility, communication and/or cognitive functioning. One of the things I have found to be most helpful is to be able to bring together interested family members and friends and give them possible communication strategies they can use, suggest activity modifications if needed, and provide safety tips as appropriate. When working in their home rather than in an office setting, it is possible to create some very practical communication scenarios related to daily needs and provide the necessary ongoing caregiver education and support.

Prior to Coming Home

If you have been told that your loved one is most likely to be discharged with a recommendation of home health care in the near future, you may want to get a head start on these or other arrangements that may have been recommended.

The first couple of weeks at home are usually very hectic. You may have a little more flexibility with your time in the week or so before discharge to address these issues than later on. You can also take advantage of the services of the social workers, discharge planners and other health professionals in the current setting for their recommendations, resources and answers to the many questions which may come up while planning for discharge.

Here are some possible things to consider:

  • Will you need to obtain a handicapped parking sticker?
  • Do you need to order special equipment for delivery a day or so before being discharged?
  • Do you need to make arrangements for a medical alert system? What are your options?
  • If supervision is recommended 24 hours a day, have you started researching the resources to cover that need. Who can come to stay at your home while you run errands or go to your appointments? Who might be able to stay for a few hours so you can take a break and do something for yourself?
  • Do you need help rearranging furniture?
  • Are there a few other special supplies that you need to get?
  • If the patient is on a special diet due to swallowing problems, does your speech pathologist recommend a thickener for liquids? Do you have some to take home with you? Will you need to find a mini chopper or blender for chopping or grinding up the meats and chewier foods?
  • If the patient is at risk for wandering, what precautions do you need to take to make your home safe? Do you need to contact the Alzheimer's Association about their Safe Return Program?
  • Will you need to make the house more wheelchair accessible?
  • If a ramp is going to need to be installed, have you called to get some estimates?
  • Will you need to sign up for some local transportation services?
  • Are there any particular programs you need to research that might be able to help with respite or fill other needs you anticipate?

In part two of this series on Maximizing Your Home Health Care Experience, I will focus on suggestions to prepare you for the initial home health care visit.

It has been an amazing privilege to be able to enter the homes of those who are facing various levels of challenge due to the medical changes they have experienced. Yes, I have been their teacher, but in more ways than they will ever know, they have enriched my life and enhanced my ability to use their experiences to improve the quality of life of others who have similar challenges. I look forward to sharing stories and more suggestions in my blogs on this topic and welcome your comments.

"Before beginning, plan carefully." Marcus T. Cicero