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Home Health
Home Health or Skilled Care provides a registered nurse who will make a visit to the home to determine eligibility. Home Health is able to provide dressing changes, teaching, I.V's, blood draws and other skilled nursing services.Home Health aides may assist with bathing, other personal care and some light housekeeping. Also available might be physical therapy, which can help people regain their strenght and walking skills.Skilled nursing serves all ages and those who are Medicare, Medicaid and private insurance eligible. Registered nurses are usually on call seven days a week, 24 hours a day.You will need to ask the agency you contact if they have this service.Skilled care services provide a coordinated plan of care, ordered by a physician.An example of some of the things a nurse could do are Dressing changes, foley catheter changes, feeding tube changes, teaching, monitoring for complications of Diabetes or Congested Heart Failure. The doctor, nurse, and family all work together to develop the plan of care. If you qualify for Skilled Services, then you also qualify for a HomeHealth Aide. One requirement of the aide is, she/he must give a bath to their patient, then housework, cooking or laundry. Usually an aide is in your home for two hours a day. This is also determined when your plan of care is developed.
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A Living Will
A Living Will is a document in which you tell others of your wish to be allowed to die a natural death - if you should become unable to express your wishes in the future.The Living Will tells medical professionals and members of your family to what extent special means should or should not be used to keep your body alive if you are incurably ill.The Will allows you to refuse certain medical procedures that may only prolong dying, or maintain the body in an unconscious state.The Living Will is to be used only if you become terminally ill or permanently unconscious.
Should you have a Will?
It is not necessary that you be seriously ill or anticipating illness in order to benefit from having a Living Will. In fact, a Living Will can help protect your family members from unnecessary emotional stress resulting from having to make important decisions in an unexpected crisis. A Living Will enables you to control the extent to which extraordinary measures will be used to prolong your life, and it relieves others from the responsibility of having to make such decisions.
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What is a Health Care Proxy?
You can choose to have another person make health care decisions for you, if you should become unable to make decisions.The person your choose is called your "health care proxy". A proxy can be helpful if circumstances arise that are not covered in your Living Will.
How to Make A Living Will or Health Care Proxy.
To make a Living Will, you fill out the form that will be given to you and have two other adults witness your signature. If you have decided to name a proxy, an optional Healthcare Proxy would need to be filled out.
What to Do With Your Living Will
It is important that your doctor and family members know about your Living Will and have a copy of it. Take it with you to the hospital. It is important that your doctor and family members know in advance about your Living Will.
What if I change my mind?
Your Living Will or Healthcare Proxy can be revoked at any time by telling your doctor and family members that your wishes have changed. All copies of a will to be revoked also should be torn up and thrown away.
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Elder Abuse
It's the mistreatment or neglect of an elderly person, usually by a relative or other caregiver. Examples of Elder Abuse are physical violence, threats of assault, verbal abuse, financial exploitation, emotional abuse, neglect, violation of an elderly person's rights. The typical victim lives with a family member and depends on the relative for daily care. Victims are most likely to be: Age 75 or over, Women, Dependent on the abuser for basic needs, or suffering from a mental or physical illness.
Physical Abuse: Victims are kicked, punched, slapped, beaten - even raped. Pain, injury or death may result.
Neglect: Failure to provide medicine, food or personal care {such as help to the bathroom} is a common form of abuse. Financial Exploitation: abusers may steal or mismanage money, property, savings or credit cards. Elders may be forced to sign a will or turn over assets.
Psychological Abuse: Elders may be purposely isolated or denied companionship. Threats or degrading language may be used.
Rights Violations: Victims may be unfairly confined or forced out of the home. Behavior may be strictly controlled.
Other: Elders may be allowed to live in unsanitary conditions or unventilated, poorly heated rooms. Overmedicating, or withholding aids {eyeglasses, dentures, etc.} constitures abuse too.
Possible reasons on why this occurs: Resentment, Longer-life spans, Retaliation, Our Attitudes Toward Violence, Lack of Services, Life Crises, Lack of Love and Friendship, No Money, or Social Problems.
Caregivers: Talk out problems if you're experiencing conflict with family members or elderly relatives. Plan Free Time to do something you enjoy each day. Seek Assistance from friends and family members when you need it. Join a Support Group for care providers. Many communities have one. Contact Organizations that provide elder abuse and protective services in your area, such as Department of Human Services, Department of Human Resources, or your Attorney General's Office. Concerned Citizens: Be a friend to an elderly person. Help provide transportation, home repair, and your sympathy and understanding. Report suspected cases of elder abuse to social service agencies or the police.
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Finding An Approved Agency:
You can find a Medicare-approved agency by asking your doctor or hospital discharge planner,senior community referral service, or other community agencies involved with your health care.You can also refer to your telephone directory Yellow Pages under "home care" or "home health care" for home health care agencies that indicate they are Medicare certified. Medicare will only pay for home health services provided by a home health agency that meets Medicare quality standards. Medicare inspects home health agencies every year to assure that they meet the standards.
You have the right to choose the home health agency from which you get services and to have your choice honored by your doctor, hospital discharge planner, or other referring agency. If, however, you are a member of an HMO, your choice of home health agencies is limited to those agencies that are affiliated with the HMO. If you get services from a doctor or a home health agency that is not affiliated with the HMO, neither the HMO nor Medicare will pay the bill.
Before selecting an agency, you may want to ask these questions:
What is a Care Plan:
Your doctor authorizes a plan of care for you. Working with a home health care nurse, your doctor decides what kind of services you need, what kind of health care professional should provide your services, and how often you will need the services. Be sure the doctor knows your personal preferences so that you can be as comfortable as possible with the services you get
Your plan will include such things as the kind of home medical equipment you need, the results the doctor expects from your thearpy, and what kind of foods you need.
The home health agency staff provide care according to your authorized plan of care. Your doctor and home health agency personnel review your plan of care as often as the severity of your condition requires, but at least once every 62 days.
Home health agency professional staff are required to notify the doctor promptly of any changes that suggest a need to modify your plan of care.
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Hospice Care:
In our society most deaths do not occur in the home, and so, for many of us, death is a distant, frightening and sometimes mystical event. This pattern is changing and more patients and their families are sharing the death experience in the same home where they have shared their living experiences. One of the main goals of hospice care is to help patients live comfortably until they die and help the family live with them as they are dying.
Care for the Caregiver:
It is important to realize that although disease and its symtoms happen to the patient, illness has an effect on the entire family. Caring for the hospice patient at home can be rewarding, however it is physically and emotionally draining for both the caregiver and the family.
During the illness, the patient at times may act angry or strange towards the caregivers. This can cause hurt feelings or anger on your part. In most cases, the patient's lashing out actually means "why did this have to happen to me?" This behavior is most often directed towards the persons the patient knows will continue to love and care for them in spite of these bad moods. Try to realize that this anger is a result of frustration. If the patient does act angry or hostile, try to discuss your feelings with them. Be aware however, that the patient may not realize that they are acting differently. You can share your fears and frustrations with members of the hospice team. They are there to help the entire family cope with this diffcult time.
It is important that you, the caregiver, take time for yourself, as well as take care of yourself. The physical demands of home care for the hospice patient are often strenous. Plan time for yourself to get out of the house. Other family members or friends can help, and sometimes they are just waiting to be asked. Children have some special needs in dealing with illness and the impending death of someone they love. Depending upon their age and stage of development, death may have different meanings to them. It is import to answer their questions honestly and in a way they can understand. Having the children spend time with the patient as well as letting them help with the care of the patient is a good idea. This involvement will usually go a long way to lessen their fears. Children will need extra comfort, affection and structure during the time since their normal routine has been upset.
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Volunteers:
Most hospice programs have volunteers as part of the team to provide additional support to the patient and family. These volunteers are specially trained to work with dying patients and their families. They can offer you, the primary caregiver, a chance to get out of the house without having to worry about the patient. A volunteer may also provide companionship, and an open ear to listen to your fears and frustrations.
Social Workers:
Most hospice programs have a social worker available to the patient and family. The social worker provides support and counseling to the patient and family as they attempt to deal with changes in their roles and relationships. Support may include help identifying community resources and providing advice concerning financial problems that occur with a prolonged illness. In addition, the social worker acts as a patient and family advocate in a variety of other ways, such as assistance in planning funeral arrangements.
Preparing for Death:
Just as each person's life is unique, so is their death. Because of this it is difficult to give hard facts about what the actual death of the patient will be like when it happens. Instead, some common concerns and approaches will be shared here.
Although difficult, it is a good idea for some pre-death arrangements to be made by the patient and the family. This topic can be difficult to bring up, as it is another way of acknowledging the patient's approaching death. Your primary nurse and social worker can help open discussions on this topic.
The patient can provide for survivors and prevent legal problems for the family after their death by having a current and well prepared will. Your social worker can give your advice about whom to contact to draw up a will or to make changes in a current will.
Making funeral plans before the patient's death may seem morbid to you. However, it is a good idea to contact the funeral home you plan to use and discuss with them the patient's and your wishes for funeral arrangements. Although it is difficult to discuss this with the patient, involving them in planning for what could be a meaningful service can provide reassurance that you have acted according to the patient's wishes.
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 Susan - AutumnsAngel
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