+ Home Healthcare - Better Than Hospiltalization or Nursing Home Care?

With the rising costs of healthcare, some patients and their families try to deal with a person's injury or illness at home rather than using fulltime hospital or nursing home care. Below is an interview with Jay Saylor who is a Home Health Nurse and Nursing Clinical Instructor. She gives her views not only on the future of home care but also what she would like to see changed about the home care nursing profession.

What is your current job title?
Home Health Nurse and Nursing Clinical instructor

What is your educational background?
Associate degree in nursing 1975
Associate degree in arts Psychology 1980
BSN 1993

Please describe the requirements of your job.
Assessment and evaluation of patients in home setting, wound care, specialized treatments, IV therapy, medication therapy, routine Cardio-pulmonary assessment, Gastro intestinal assessment, Genitourinary assessment, Foley catheter care/change, patient teaching as needed, family teaching as indicated.
Clinical instructor for Practical Nurse students at Arbors Nursing Facility, instructor for Registered Nurse students at Children’s Hospital in Cincinnati.

What do you like best and least about your job?
Best is the flexible schedule and wide range of patient’s, students and facilities.
Worst part is being on call after seeing patients all day and having to go back out or being expected to see more patients than you have mental energy to see.

What would you like to see changed about your job?
I would like to see Nurses be as kind and compassionate to each other as they propose we should be to patients, especially those in charge positions. I would also like to see the financial compensation for nurses to be at least equal to someone entering another profession with comparable education and responsibility.

What factors determine if a person will be cared for at home versus in a nursing home or other care facility?
The decision for home care is based on the person’s ability to safely assume responsibility for portions of their care or family who can do this, and the availability of proper equipment/supplies for the home. Nursing, Physical Therapy, Occupational Therapy, Home Health Aids (for personal care assistance) and Social Workers are included in the range of services for the home patient. Companies specializing in health care supplies and equipment are also part of the care team.
One major determining factor is how the doctor of the patient feels about home care. Some doctors do not like the home care concept and are reluctant to allow care in the home, often at odds with the patient’s and family’s preference.
In general, all health care is controlled to a great extent by insurance companies. There are a few companies who do not allow or cover home health. The bulk of patients are Medicare and Medicaid insured.

What do you think the future of home health care will look like?
As health care has became more technical, costs have risen and insurance coverages have been reduced or rechanneled. I expect to see continued growth in the home health trend as it is proven more cost effective than hospitalization and for most patients, is more conducive to returning to wellness. I also expect to see continued growth in hospice services in the home setting as part of the home care team.