24 introduction to home care 1. explain the purpose of and need for home health care home health...

24Introduction to Home Care1. Explain the purpose of and need for home health care

Home health care exists because • Hospitals discharge earlier and patients still need care.

• Patients need short-term care, which is less expensive in the home.

24Introduction to Home Care1. Explain the purpose of and need for home health care

Home health care may be required because• Caregivers in the family now work. • Most people prefer care at home. • Longer lives increase chronic illnesses and need for care.

• Medical advances mean people with chronic illnesses live longer and require more care.

• Disabled people are more comfortable at home.

24Introduction to Home Care

Define the following term:

Home health agencies businesses that provide health care and personal services in the home.


2. Describe a typical home health agency

Possible sources of referral to home care agency include the following:• Client’s doctor• Hospital discharge planner• Social services agency• State or local department of public health• Welfare office • Local agency on aging• Senior center• Client himself or family member


2. Describe a typical home health agencyHome health agencies commonly provide the following services:• Physical, occupational, speech therapy• Medical-surgical nursing care• Intravenous infusion therapy• Maternal, pediatric, and newborn nursing care• Nutrition therapy/dietary counseling• Medical social work• Personal care• Homemaker/companion services• Medical equipment rental and service• Pharmacy services• Hospice services

24 Introduction to Home Care

Transparency 24-1: Home Health Agency Organization Chart

24Introduction to Home Care3. Explain how working for a home health agency is different from working in other types of facilities

The following aspects of working in the home will differ from working in other settings: • You may provide housekeeping help• There is generally more family contact • More independence for the aide• Communication skills are essential• You are responsible for transportation to clients’ homes

24Introduction to Home Care3. Explain how working for a home health agency is different from working in other types of facilities

Differences when working in the client’s home (cont’d.): • You need to be aware of safety issues • Every client’s home is different and you will need to be flexible

• The working environment of a home is different from a facility

• You must remember you are a guest in the client’s home

• The client will be more comfortable in his or her own home than in a facility

24Introduction to Home Care4. Discuss the client care plan and explain how team members contribute to the care plan

REMEMBER:• Each client care plan is different. • Activities not listed on the care plan should not be performed.


The following factors are considered in formulating a care plan: • Client’s health and physical condition • Diagnosis and treatment • Goals or expectations • Whether other services and resources, such as transportation, equipment, and additional income are needed


REMEMBER:Input from the HHA is essential to the care planning process. The HHA can inform her supervisor if special equipment is needed or if care plan assignments would put the HHA or the client at risk of injury.

24 Introduction to Home Care

Transparency 24-2: Care Planning Process

24Introduction to Home Care5. Describe the role of the home health aide and explain typical tasks performed

HHAs provide services to their clients by• Providing personal care or assisting with self-care • Reinforcing teachings of other team members • Promoting behavior that improves health, such as diet and exercise

• Maintaining a safe, secure, and comfortable home life for clients and their families


The following tasks may be included in a client’s care plan: • Bathing• Dressing• Grooming• Toileting• Assisting with ROM exercises, ambulation• Transferring from bed to chair or wheelchair• Measuring vital signs• Feeding• Reminding client about medications


The following tasks may be included in a client’s care plan (cont’d.): • Giving skin care• Using medical supplies and equipment, such as walkers and wheelchairs

• Changing simple dressings• Making and changing beds• Light cleaning, including dusting, vacuuming, washing dishes

• Teaching home management


REMEMBER:HHAs are role models and can help promote clients’ independence.


These tasks are outside an HHA’s scope of practice: • Administering medications• Inserting or removing tubes or objects in a client’s body (thermometer is an exception)

• Honoring a request that is outside the scope of practice

• Performing procedures that require sterile technique• Diagnosing or prescribing treatments/medications• Telling client or family diagnosis or medical treatment plan


REMEMBER:• It is important to set and maintain boundaries in your relationships with clients and their families.

• Be friendly, warm, and caring, but behave professionally and follow the agency’s rules and the care plan’s instructions.


Define the following terms:

Policy a course of action that should be taken every time a certain situation occurs.

Procedure a method, or way, of doing something.

Confidential the legal and ethical principle of keeping information private.

24Introduction to Home Care6. Explain common policies and procedures for home health aide

Home health agencies will have policies and procedures regarding the following areas: • Confidential information • Client’s care plan • Reporting to a supervisor • Personal problems • Dependability and punctuality• Following deadlines for paperwork • Delivery of care • Gifts from clients


7. Demonstrate how to organize care assignments

Look at Fig. 24-5 on p. 413 of the textbook and think about these questions:• What is the value of making a list of tasks to be done?

• How do you usually keep track of the tasks you need to complete in your daily life?


8. Identify an employer’s responsibilities

It is an employer’s responsibility to• Provide a written job description. • Provide competency testing and skills evaluation before aides are sent to care for clients.

• Provide initial training and continuing in-service training.

• Provide appropriate and adequate preparation for each assignment.

• Provide supervision. • Provide information about supervision. • Provide proper equipment and supplies for you to safely do your work.


9. Identify the client’s rights in home health care

REMEMBER:Home care clients have legal rights just as residents in long-term care do.


9. Identify the client’s rights in home health care

Read the Client’s Bill of Rights on pp. 415-416 of the textbook and think about these questions:What do these rights mean to HHAs?How are they related to abuse? What action should an HHA take if abuse is seen or suspected?


Chapter Exam1. Which of the following reasons has led to an increase in the need for home care?(A) People with chronic illnesses are living longer.(B) There are fewer and fewer long-term care facilities.(C) Home care is more expensive than care in a facility.(D) Long-term care facilities do not want any new residents.

2. What happens after a doctor refers a patient to home health care and an agency has been chosen?(A) The client checks into a LTC facility to be observed

before home care begins.(B) A home health aide visits to get to know the client and

family.(C) The home health agency arranges a welcome party for the

client.(D) The home health agency performs an assessment of the

client’s needs.


Chapter Exam (cont’d.)3. Which of the following best describes a difference between working as a home health aide and working in a long-term care facility?(A) A home health aide has less independence.(B) A home health aide has more independence.(C) A home health aide does not have to worry about dealing

with the client’s family.(D) There is no difference between working as a home health

aide and working in a facility.


Chapter Exam (cont’d.)4. What is one of the challenges a home health aide might encounter in her work that would not be a problem in a facility?(A) The home might not be organized in a way that makes

caregiving easy.(B) The clients will be in a familiar and comfortable

setting.(C) Clients’ homes are always messy.(D) Family members will never be helpful.


Chapter Exam (cont’d.)5. Which of the following statements is true of a home health aide’s responsibilities if a task is not listed in the care plan? (A) The HHA should perform any task he thinks is best for

the client.(B) The HHA should consult other HHAs to see if they would

perform the task.(C) The HHA should not perform any task not listed on the

care plan.(D) The HHA should only perform the task if the client says

she wants it performed.


Chapter Exam (cont’d.)6. What is one reason an HHA’s observations are essential to the care plan?(A) Observing a client is not a task that the HHA performs.(B) The HHA can decide what medication to prescribe for the

client’s current condition.(C) The HHA can tell the nurse how and when to change the

care plan.(D) The HHA spends the most time with the client and can

provide information nobody else will know.

7. Which of the following is a task an HHA typically performs?(A) Changing a sterile dressing on an open wound(B) Giving skin care(C) Administering medication(D) Prescribing treatments


Chapter Exam (cont’d.)8. Which of the following tasks is outside the scope of practice for an HHA?(A) Inserting tubes into a client’s body(B) Giving a client a bath(C) Helping a client eat dinner(D) Transferring a client from bed to chair

9. Which of the following is a common policy or procedure at a home health agency?(A) HHAs should discuss personal problems with clients.(B) The HHA can choose whether or not to follow the care

plan.(C) HHAs do not give or receive gifts.(D) HHAs can complete their paperwork whenever it’s

convenient for them.


Chapter Exam (cont’d.)10. Why is it a good idea to make a list of tasks to complete when you arrive at a client’s home?(A) So you will have time to watch TV with the client later.(B) Because you’ll have to leave things undone if you don’t

finish everything before it’s time to leave.(C) To make sure you finish all of your tasks and aren’t

late for your next client.(D) So you can decide which tasks you’d rather not do.

11. Which of the following is the responsibility of a home health agency as an employer?(A) To only assign HHAs to work with pleasant clients(B) To provide appropriate preparation for each assignment(C) To guarantee that family members will never interfere

with an HHA’s work(D) To give HHAs company cars and cell phones


Chapter Exam (cont’d.)12. Why do clients have the right to be involved in their own care planning?(A) Because clients know better than doctors and nurses how

to cure disease(B) Because clients do not respect caregivers very much(C) Because care planning is too complicated for the care

team to do on their own.(D) Because clients are more likely to continue treatment if

they are involved in the planning

24 introduction to home care 1. explain the purpose of and need for home health care home health...

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