Slide 1 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing Assistants Chapter 42 – Introduction to Home Health Care

Slide 2 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. What is Home Health Care?

Slide 3 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Home health care, also known as home care, makes it possible for people who are not critically ill to receive health care in the comfort of their own homes A person who is receiving the services of a home health care agency is called a client What is Home Health Care?

Slide 4 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The person may have just been discharged from the hospital following an acute illness or injury The care provided in a hospital is costly, and the number of beds in the hospital is limited For these reasons, a person may be discharged from the hospital as soon as she is out of danger, but before she is fully recovered In this situation, a home health aide may be needed to help care for the person at home until she has made a full recovery Why a Person might Become a Client of a Home Health Care Agency

Slide 5 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The person may have a chronic illness or disability that makes it hard for him to manage some tasks independently For example, a person who is paralyzed might need a home health aide to help him get out of bed and ready for work each morning Why a Person might Become a Client of a Home Health Care Agency

Slide 6 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The person may have an illness, such as dementia, that makes it dangerous for the person to be left alone in the house In this case, a home health aide might come to the home on a regular basis to provide care and companionship for the person and to relieve the primary caregiver Care that allows the primary caregiver to rest or leave the house for a short period of time is called respite care Being able to “take a break” and leave the house is critical for managing the stress that can be caused by providing constant care for a family member who is ill Why a Person might Become a Client of a Home Health Care Agency

Slide 7 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The person may be terminally ill Hospice care is often provided in the person’s home A home health aide who works for a hospice agency will receive special training in providing end-of-life care Why a Person might Become a Client of a Home Health Care Agency

Slide 8 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Home health care is paid for in many different ways A client may pay for home health care entirely from his own income or savings OR He might have insurance coverage that covers all or part of the costs Paying for Home Health Care

Slide 9 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Insurance coverage is provided by insurance companies and by government agencies, such as Medicare or state Medicaid Insurance companies and government agencies often have strict rules regarding what type of care is covered, and under what circumstances. For example, many times the client must be completely homebound before the insurance company will pay for the costs of home care Homebound means that that person is unable to leave the house without a lot of help from another person Insurance companies and government agencies may also control the length of each visit and the number of visits a person may have each week Proper documentation (recording) of the care provided to the client during each visit is necessary to justify continued payment for home care services and to determine the frequency and length of future visits Paying for Home Health Care - Insurance Coverage

Slide 10 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The health care team consists of The client The client’s family members The home health aide A nurse A doctor A case manager Other specialists The health care team provides care in the home as directed by the client’s care plan The care plan is a set of instructions for the client’s care, created by the case manager with input from all members of the health care team The case manager, usually a registered nurse, is responsible for overseeing all of the client’s care, from admission through discharge The Health Care Team

Slide 11 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The home health aide is a very important member of the health care team Because the home health aide is often scheduled to visit the client on a frequent, routine basis, he has the best chance to observe changes that could indicate a change in the client’s health The client may feel most comfortable with the home health aide, and as a result, may tell him things she might not tell other members of the health care team By communicating his observations to the rest of the health care team, the home health aide becomes the “eyes and ears” of the members of the team who do not see the client as frequently For this reason, communicating with the case manager and other members of the health care team is an essential part of the home health care aide’s responsibilities The Health Care Team

Slide 12 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Team members travel to the client’s home according to their own individual schedules and may rarely see each other In the home health care setting, most communication among team members takes place through documentation As always, you must accurately document the care you provide on the appropriate paperwork, including the Date Time Duration of the visit Proper documentation is necessary to ensure that all members of the home health care team are kept “in-the-know” The Health Care Team

Slide 13 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Responsibilities of the Home Health Aide

Slide 14 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The home health aide usually assists clients with Tasks related to personal care  Bathing  Grooming  Repositioning Light housekeeping duties  Cleaning  Preparing meals  Doing laundry The home health aide’s responsibilities are clearly outlined in the client’s care plan Any changes to the care plan must first be approved by the case manager Responsibilities of the Home Health Aide

Slide 15 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Documentation of the care provided Necessary to keep all of the members of the health care team informed of the client’s status Responsibilities of the Home Health Aide

Slide 16 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Documentation of your daily activities How much time you spent at each client’s house How much time you spent traveling between houses Your mileage for the day Keep accurate notes so that the information you record will be accurate Responsibilities of the Home Health Aide

Slide 17 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. DO’s when at a client’s home: Remember that you are a guest in the client’s home Care for their home the same way you would care for your own Be careful not to allow your opinions about how a person lives affect the care that you provide If you feel that something about a client’s home environment puts the client at risk for injury, report your concerns to the case manager Responsibilities of the Home Health Aide

Slide 18 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. If you think that a client is at risk for injury because he or she does not have a certain piece of medical equipment, ask the case manager for advice If medical equipment cannot be obtained, you may need to be resourceful and use items that are readily available in the home  For example, if the person’s bed is not adjustable, you can use extra pillows or a back rest to position the person in Fowler’s position  SAFETY IS A TOP PRIORITY! Responsibilities of the Home Health Aide

Slide 19 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Homemaking involves meal preparation and light housekeeping duties, such as dusting and doing laundry You will document the homemaking duties that you perform on a homemaker flow sheet, according to your agency’s policies The homemaker flow sheet becomes part of the client’s medical record Responsibilities of the Home Health Aide - Homemaking

Slide 20 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Preparing meals is a duty frequently assigned to the home health aide Some states require home health aides who will be preparing and serving food to have a food handler’s permit Responsibilities of the Home Health Aide - Homemaking - Meal Preparation

Slide 21 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Preparing the meal: When preparing a meal, consider the special needs and individual preferences of the client The meal should be nutritious If the person is on a special diet, such as a restricted- sodium diet, then you must make sure that the meal you prepare meets the diet’s requirements For some clients, you will have to cut the food into very small pieces or puree it in a blender before serving it Responsibilities of the Home Health Aide - Homemaking - Meal Preparation

Slide 22 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Serving the meal: Serve the meal or snack at the time specified in the care plan Make meal time as pleasant as possible Present the meal in an attractive way, and sit down and talk with the person as she is eating Involve the person in the process of eating by allowing her to do as much as she can for herself Responsibilities of the Home Health Aide - Homemaking - Meal Preparation

Slide 23 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Depending on the client’s needs, you may be responsible for: Dusting Vacuuming carpets Mopping floors Disinfecting kitchen and bathroom surfaces Changing the client’s bed linens Washing and drying the client’s bed linens and clothing Responsibilities of the Home Health Aide - Homemaking - Housekeeping

Slide 24 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. When providing housekeeping services, care for the client’s home as if it were your own Pay attention to details When using cleaning solutions, make sure that the product you are using is approved for use on the surface you are cleaning, to avoid causing permanent damage Be respectful of the client’s home and its contents When you show respect for a client’s home and personal belongings, you are letting the person know that you truly care for him or her Responsibilities of the Home Health Aide - Homemaking - Housekeeping

Slide 25 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Qualities of the Successful Home Health Aide

Slide 26 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The most successful home health aides: Enjoy working independently and are self- motivated Are organized and able to manage their time well Are reliable Are able to set professional boundaries Qualities of the Successful Home Health Aide

Slide 27 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. As a home health aide, you will be working in a client’s home without direct supervision most of the time To work in the home health care setting, you need to be very comfortable with your own caregiving and problem-solving skills You also need to be self-motivated No one will be there to help you, or to tell you what to do next Qualities of the Successful Home Health Aide - Ability to Work Independently

Slide 28 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Because you will be working independently, you will be responsible for making sure that you complete your assigned duties as scheduled. Organization is one key to working efficiently and safely. Gather all of the supplies you will need before you enter the person’s home Keep each item in its special place in your nurse’s bag  Forms needed for documentation, and a pen  Personal protective equipment (PPE)  Equipment used for taking vital signs  Supplies for cleaning your equipment  Alcohol-based hand rub Qualities of the Successful Home Health Aide - Ability to be Organized and Manage Time

Slide 29 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. An organized nurse’s bag: Makes it easy for you to see if you need to restock your nurse’s bag Makes it easy for you to check that you have everything you need before you leave for the day Helps you to complete your paperwork efficiently Qualities of the Successful Home Health Aide - Ability to be Organized and Manage Time

Slide 30 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Planning is the other key to working efficiently and safely Plan your day so that you visit clients in an order that allows for the most efficient use of travel time AND takes into account each of your clients’ preferences and needs Qualities of the Successful Home Health Aide - Ability to be Organized and Manage Time

Slide 31 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Clients who receive home care depend on the home health aide to arrive and provide the appropriate care Failing to keep appointments is not only inconsiderate, it can cause the client harm You are guilty of abandonment if you fail to fulfill your responsibilities to the client by not coming to the client’s home or leaving the client’s home before your assigned work is completed Qualities of the Successful Home Health Aide - Reliability

Slide 32 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Notify the home health care agency and the client if: You are running late You are unable to report to work at all A personal emergency arises during your work day that would make it necessary for you to leave before completing your scheduled visits and care duties Qualities of the Successful Home Health Aide - Reliability

Slide 33 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Professional boundaries are necessary to prevent clients or their family members from taking advantage of you If you ever have any question about whether or not it is acceptable to perform additional duties or “favors” for a client or family member, make sure you ask your supervisor first Qualities of the Successful Home Health Aide - Ability to Set Professional Boundaries

Slide 34 Copyright © Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. End of Presentation