Maximizing your home health care experience: Part-1
by Kathryn Kilpatrick
Bringing a friend or loved one home from the hospital or a rehabilitation program is a very important event. The anticipation of being in a familiar place after an extended period of time away can be exciting but also could be worrisome, often for the person returning home as well as their loved ones.
The first part of this series discussed suggestions to consider that might be helpful prior to the initial visit from a home health care professional. If a person has more physical limitations, there can be concerns about how they are going to manage even with help. There can be concerns on the part of some people about all the extra work it might entail. Relatives may be coming from other parts of the state or country to help out in those first few weeks. Sometimes the caregiver is elderly with their own health problems and some may feel nervous.
Home health care professionals coming into your home will bring with them a level of sensitivity to this experience for all involved. If this is the first time someone is utilizing this type of care, knowing what to expect may be helpful. In addition to getting the necessary medical information, the story and circumstances of each situation are equally important. One of the goals is to make sure that the appropriate health care professionals and resources can be brought in during those first few weeks to support the patient's return home. The more information obtained, the better each person can do their job.
Prior to the Initial Home Health Care Visit
If someone is anticipating home health care, some of the suggestions below might help make the first visit go more smoothly for the patient. In addition to the adjustment of coming home, the increased number of people the patient does not know, coming in and out of the home, is often overwhelming and can be upsetting. For this reason, especially when there are problems with memory or cognition, or a family is used to a much quieter routine, there may need to some additional modifications when setting up appointments.
It may be helpful to designate a contact person to co-ordinate appointment scheduling until everyone is used to the home health care schedule. A person's tolerance and strength may be limited in the first week or so after returning home, so it is important to not schedule therapy and nursing appointments back to back, with little time in between. If the patient is diabetic, make sure that there is time set aside for their meal and schedule appointments accordingly.
Provide your home health care agency with several additional contact numbers for the patient if possible, including cell phone numbers. Sometimes the home phone has been left off the hook or the television is very loud because someone has a hearing loss and the knock on the door is not heard. I am most grateful for having a cell phone in these situations. Prior to cell phones, if someone did not answer the knock at the door, I had to leave. The additional numbers may help your nurse, aide, therapist or social worker contact someone to make sure that something has not happened at the home if no one can be reached.
If an unexpected situation arises, make sure that the patient or someone else contacts the home health care agency to alert them of the cancellation, if at all possible. Sometimes an emergency can occur and the patient is taken to the emergency room. It would be helpful if you could inform your health care providers when you are able.
As part of the initial assessment, there will be many questions asked, and if you can put together a summary sheet of the medical history it will be very helpful. If the person is forgetful and is living alone, there should be someone available to provide the information for that initial assessment. Detailed information is needed for the documentation that needs to be obtained by the health care professional team and the patient may be unable or too tired to supply the details. For additional information refer to Take Charge of Your Medical Information and the related blogs.
If there are several health care professionals involved in the plan of care, they will be asking some of the same questions. For some people, this can be a source of irritation. It is helpful to know that each professional is looking information from their perspective. For example, just listening to what information is given, the person's ability to recall, the complexity of the details, the intelligibility of the verbal responses or the word finding skills, can provide me with key information before even beginning a formal speech and language assessment. The physical therapist may be able to assess tolerance for activities or risk for falls while the nurse may hear comments that indicate pain levels or possible depression.
As part of the initial assessment, there will be many questions asked and if you can put together a summary sheet of the medical history it will be very helpful. If the person is forgetful and is living alone, there should be someone available to provide the information for that initial assessment. Detailed information is needed for the documentation that needs to be obtained by the health care professional team and the patient may be unable or too tired to supply the details.