home care in elderly

7/24/2019 Home Care in Elderly

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Home care in elderly


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Defnition

Home care encompasses all medical and supporservices provided in the home.

These services may include visits by physicians nurses; intravenous therapy; physical, speech, aoccupational therapy; social work; and home he

aide services.


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Rationale or home visits

Cared at home without bein transported to hospital Di!culties with vision, mobility, and limited drivin c

barriers to keepin medical appointments

Helps in understandin the patient in the conte"t o tenvironment # provides clues and inormation importthe patient$s overall health and well#bein, such as hnutrition, support, and potential or elder abuse

%nderstandin o compliance issues

&unctional assessment is best evaluated in the homeenvironment


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'rovides insiht into unction and saety not obsa clinic

'atient$s social situation and careiver issues anstresses are also more apparent and reconi(ab

Reduces clinic sta) time o no show


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Types o home visits

*llness Home +isits# merency

# -cute illness

- Chronic illness

Dyin 'atient Home +isits

# Terminal care

# 'ronouncement o death

# rie support


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Types o home visits

-ssessment Home +isits# 'olypharmacy and/or multiple medical problems

# "cessive use o health care services

- *mmobility, social isolation, or suspected abuse o

- Recent catastrophic dianoses or possible need nursin home placement

Hospitali(ation &ollow#up Home +isits

# -cute illness, in0ury, or surery


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-cute skilled care


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Roles o the home care teammembers

The home care team may be composed o a 'hysician who makes house calls and/or provide

medical direction

- house call coordinator,

Home health care nurses, and

1ther health care proessionals and services


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House call coordinator

'oint o communication -ssists with schedulin o patient visits, patient

and coordinatin telephone consultations betwemembers

&indin aid appropriate billin

-rranements or dianostic testin, delivery omedications and supplies, special clinic appointm


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Home care nurses

'atient assessment monitorin o prescribed treatment reimens inc

medication administration and compliance

2ound care and dianostic services

in0ections, immuni(ations, urinary catheteri(atio

ostomy care

'atient and amily education

dietary modifcations


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Rehabilitation therapists

'hysical, occupational, speech, and respiratory therapi

'hysical therapists provide instruction in strentheninbalance e"ercise prorams, ait assessment and trainihome saety evaluation. *n addition, they are trained ino varyin modalities or pain manaement

1ccupational therapists provide assessment o patientunctional status and ability to live independently throuevaluation o activities o daily livin 3-D4s5 and instruactivities o daily livin 3*-D4s5


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6peech therapists provide trainin and e"ercisesminimi(e defcits in lanuae and swallowin un

Respiratory therapists assess and treat respiratodisorders and review supplemental o"yen nece


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'hysician house calls and palnn

economically viable 'hysician may choose one hal#day session per w

perorm house calls, averain about fve patiensession

lean heavily on history#takin and physical e"am

skills


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'lannin ahead

anticipate potential interruptions or problems duvisit

Time en route can be a rustratin

Coordinate and plan visits and drivin routes inadvance, confrmin any uncertain directions or

addresses. Divide patient visits into 7uadrants or clusterin

alon certain routes minimi(es e"cessive orunnecessary drivin


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'lannin ahead

1rani(ation o e7uipment helps prevent delays need or repeat visits

1rani(in medical records


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*ssues to address on the home v

*nitial home visit re7uires e"tra time or history a

e"amination environment and social situation # Hsafety evaluation


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Ha(ards can be identifed and remedied with plao rab bars in bathrooms or kitchens, applicationonstick material to showers and bathtubs, and o stray electrical cords or rus

home care in elderly

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