In-home care, also known as homecare, is nonmedical care provided in the client’s home. It includes custodial care for elderly people and assistance with activities of daily living such as eating, bathing and providing medication reminders. In-home care provides seniors with home health care, non-medical care, and even companionship. Everybody loves their home. It provides comfort. If you move out to an assisted living community or nursing home, you’re starting over. You may have to room with a stranger.
Home care nursing is the delivery of quality nursing care of patients in their home environment; it is provided on an intermittent or part-time basis. Homecare workers are professionally trained caregivers who provide companionship and are responsible for maintaining a safe environment for the person receiving care. Caregivers are available to provide assistance that allows many seniors to remain at home – from one afternoon per week or 24 hours a day.
The patient’s caregiver or family and home environment (which include community resources) are viewed as critical elements of a successful plan of care. It is proven than patient-caregiver cooperation and self-determination for optimal health or best level of functioning are important to achieving successful self-care management at home. Home care nurses recognize that health is not solely determined by physiological measurement or dollars for care but represents all the patient is and wants to be.
With in-home care, you’re able to remain as independent as you can be. Independence is a psychological boon, especially when the effects of aging are taking place.
For example, you have hip replacement surgery. And instead of heading to a nursing home for care, you go back home, where a physical therapist helps your recovery. And a home health aide tends to your home until you can. The surroundings are yours. You sleep in your bed. All of this familiarity can help with your recovery. One study found that those who received in-home care visited the doctor 25% fewer times than those that didn’t receive in-home care. Clients with Alzheimer’s or other dementia diseases made almost 50% fewer trips to the doctor.
Home care nursing is an art and a science and dedicated to providing quality patient care in the home and community setting.
In-Home Care Options
There are different types of in-home care to accommodate elderly adults with different needs. In-home caregivers, also known as personal care assistants, come to the home to help with activities daily living, such as light housekeeping, grocery shopping, meal preparation, medication reminders, and grooming. Some provide help with personal care for toileting and bathing. In-home caregivers generally do not provide medical care.
For those who require a higher level of care (deemed necessary by a doctor), home health care is an in-home service in which nurses or trained health aides provide skilled medical care. These caregivers also help with activities of daily living such as housekeeping, eating and grooming, and/or physical therapy. A doctor can also help determine whether in-home care is the best route or whether your aging loved one needs to move to a skilled nursing facility. Care Companions also called elder companions, provide company for older adults living alone, especially those who are home-bound due to frailty or dementia. In addition to helping with daily activities, they help decrease isolation and improve quality of life.
The plan of care, based on the nursing process of assessing, diagnosing, planning, implementing, and evaluating, is directed as follows:
Providing health restorative, rehabilitative, and palliative (hospice) therapies. Health promotional behaviors are viewed as a very important consequence of these therapies
Educating the patient/caregiver about the illness or disability and mutually identified health care needs
Developing patient competence, decision making, and judgment in self-care management at home
Reintegrating the caregiver back into the family, community, and social support systems. Visits by the home care nurse are based on patient needs for self-care and best level of health. Universal factors influencing patient care in the home include the following: age-related and cultural factors (specific patient needs that may vary with the age and cultural preference of the patient)
Psychobiological factors (mental, emotional, spiritual, and physiological needs); specific disease manifestation (chronic, con-genital, short-term, or terminal)
Socioeconomic and environmental factors (availability of family support systems to assist with the plan of care, availability of medical supplies, adequate food, and housing, access to the medical system). In-home care, advances practice nurses such as clinical nurse specialists (CNSs) serve as educators, consultants, caregivers patient and staff advocates, speaker bureaus, and community liaisons. CNSs have many duties – for example, writing policies and procedures or serving on product evaluation, quality assurance. Their primary focus should be patients and staff. In addition, nurse practitioners can assist with care plan oversight issues, which may include recommending medications and treatments to the physician for his or her consideration.
There are different types of In-Home Care. There is service for any kind of need. For example, a man shows signs of Alzheimer’s but is otherwise physically healthy. He may just need help with paying his bills, getting to appointments, etc. He won’t necessarily need medical help yet.
Licensed medical professionals can include physicians, physician’s assistants (PA), nurses, physical and occupational therapists, and some specialty home health aides who work under the direction of a physician.
A recent survey by Home Instead Senior Care of over 1,600 caregivers showed the following services used by clients:
- 60% used home-health nurses
- 59% used physical therapists
- 32% used occupational therapists
- 37% had at least one in-home visit from a PA or nurse practitioner
- 17% had an in-home visit from a physician
Non-medical paraprofessionals include as home health aides, personal care attendants, homemakers, and companions. Home health aides provide hands-on care and assistance to with ADLs (see below). They can also help with cooking, shopping, and laundry.
Homemakers or companions provide services such as light housekeeping, transportation, and companionship. These activities are known as instrumental ADLs (see below). People with Alzheimer’s will often use a companion to assist them.
Activities of Daily Living (ADLs)
- Oral Care
- Walking or using a wheelchair
- Change linens
- General shopping
- Meal preparations
- Managing money
- Medication management