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Thread: Home Health Care, Your Thoughts

  1. #1
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    Home Health Care, Your Thoughts

    I have been asked to be a member of a focus grouip to lay forth ideas and to help shape a high quality home health care program for our city. The entity proposnig home health care for Aiken, S.C. is called Still Hopes, an Episcopal retirement community in Columbia, S.C., and is seeking local input for homr hralth care.

    I am soliciting from CC members who utilize home health care your experiences and what you consider to be the most important factors in home health care.

    Off the top of my head, three priorities come to mind: Reliability; health/nursing skills and honesty.
    You C.A.N.
    Conquer Adversity Now

  2. #2
    Hi Waza, Good topic and thanks for being involved.

    My spouse needs AM and PM care as I gradually realized I could not physically manage it alone, though none of the particular cares bother me.
    It is too much for one person.

    Finding an agency to take a high level quad in our mid city area was impossible.
    Finding our own people to train for his needs uncomfortable at first even after warning from rehab, but after experience it is possible.

    Once you get used to people coming and going it is less stressing.

    Yes. reliability is a huge problem even if we are appreciative,pay decent and offer small perks.

    Really, actual "nursing" skills are less important than being willing to learn and follow direction of care from you or spouse (if you are unable to) than a licence.

    Keeping an open mind is hepful.

    Hope I helped. Keep me posted or pm with any specifics.

  3. #3
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    Health Care Focus Group

    Linda, thanks for your keen insight. You're completely correct in saying nursing skills are not foremost for home health care.

    My wife has reached the age where rolling me over and helping me dress is becoming a real chore for her. My needs are in the morning and at bedtime. I'm pretty self sufficient during the day.

    I am looking forward to taking your remarks and those of others to the focus group.

    I appreciate your reply.
    You C.A.N.
    Conquer Adversity Now

  4. #4
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    Our local home healthcare company seems to try to fill their allotted time regardless of when the work is completed. They will hang around and have conversation or fill out paperwork in your presence when you are trying to fall asleep. Some are very good at fitting seamlessly into your house, but not many.

  5. #5
    Been getting home health care through the big bully local hospital. No one else in town can take Medicare. Mediocre skills and no consistency is the best way to sum it up. So far there have been no security issues, but I certainly can't trust them to be proactive with her overall health. When they do take action I have to monitor it closely to make sure they aren't doing more harm than good. I can only conclude basic bandaging skills and product usage aren't taught in nursing school. One nurse went through 3 catheters just trying to change it. I had to put Hill Rom and KCI in touch with them so they could get wound numbers for Medicare billing. A stave IV wound healed by the time Hill Rom could bill. I have yet to see one bit of billing or statement myself.

  6. #6
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    I think I've said this before, but I will repeat ruefully that though I have had some really just wonderful caregivers, I also have met the most dishonest, unkind, lazy, unprincipled and just unpleasant people I ever have known fillng that role. It never ceases to amaze me. Though the people helping me now are really great, the upshot of my caregiving history is that I can say with no hesitation that other than the obvious, needing to live my life mediated by caregivers is the worst thing ever to happen to me.

    I'll work tomorrow on some useful suggestions.

  7. #7
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    Since quality of life is so dependent on these and their skills.

    1. Honesty/Trustworthiness: If they come into your home to do a job, the patient needs and should be able to trust that they are professionals and will do just that. The patient should be able to direct his/her care from all levels with no problems from un-educated home health staff. They know their bodies.

    2. Skilled workforce: If this home care agency is going to be high quality then they are going to have to hire "creme of the crop" which costs money to do background checks etc and train their workforce in the patients that they are going to be serving. Like Linda and NRF said....

    3. Billing: Lots of these homecare agencies lose money because they don't have someone who knows the ins/outs of Medicare/Medicaid billing. It is expensive to hire someone and pay them a decent salary to collect and bill correctly but it is cheaper than it is to farm it out to a billing service who relies on the documentation that NRF is referring to. I can tell you the OIG(big brother) is looking at homecare agencies this year and their billing.

    The money is there to be made but you have to have a knowledgeable clinical billing staff and someone who can stay on them to document those visits and bill for them. A nurse is not the person for this job.

    I know lots of home health agencies try to save money by hiring CNA's and their are lots of great CNA's out there. So if your focus group really wants to build a high quality program for your city, they will look at providing a benefit package and continuing education so they can retain the best, brightest employees. Then train them to follow the patient's directions as in Linda's case or to be trained by other technicians to take care of patients like Dave. An employee with a benefit package is likely to be a long term employee and a happy employee and patients in your city will likely not have to deal with high turnover and home health not showing up.

    Just my two cents.....
    T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

    My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

  8. #8
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    Home Health Care

    You all are tremendous sources of useful information on this subject. Aiken,l S.C. has several HHC agencies, fortunatly none of which I have needed to use.

    As I receive all my health care from the VA, I'm not sure why I was picked to be on this focus group, but looking forward to the experience and putting "our collective" two cents in.

    The group meets the 22nd of this month. If nothing else comes from this, at least I will get free meal.
    I will keep you informed of the gruop's activities.

    I Am Well Grounded,
    Clay Dhurt
    You C.A.N.
    Conquer Adversity Now

  9. #9
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    I can't think of anything else, seems like everyone did an excellent job giving you ideas, but wanted to say hubby and I will be in Aiken, SC on April 20th for the weekend. He got selected as a Wheelin Member to go turkey hunting there at the Savanah Dept. of Energy or something like that.

  10. #10
    Quote Originally Posted by Random View Post
    I can say with no hesitation that other than the obvious, needing to live my life mediated by caregivers is the worst thing ever to happen to me.
    x1000

    It's a double-edged sword - aides with some medical experience and/ or sci caregiving experience tend to take instruction and correction as some sort of personal affront, whereas with aides who are less trained but more willing to learn, you have to start from scratch.

    So I agree that attitude is by far my most important criteria for hiring, BUT, if a person lacks things like common sense and decent hand-eye coordination, no amount of being nice can overcome that.

    Most of the local caregiving training programs are 100% aimed at elderly non-sci clients. There is a crying need for courses specializing in paralysis and the particular care needs that ensue.

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