Home care, (also referred to as domiciliary care or social care), is health care or supportive care provided in the patient's home by healthcare professionals (often referred to as home health care or formal care). Often, the term home care is used to distinguish non-medical care or custodial care, which is care that is provided by persons who are not nurses, doctors, or other licensed medical personnel, as opposed to home health care that is provided by licensed personnel. [2] Licensed personnel and other persons who assist the individual may be referred to as caregivers[3].
Caregivers may help the individual with such daily tasks as bathing, eating, cleaning the home and preparing meals. For terminally ill patients, home care may include hospice care. For patients recovering from surgery or illness, home care may include rehabilitative assistance[4]. "Home care", "home health care" and "in-home care" are phrases that are used interchangeably in the United States to mean any type of care given to a person in their own home. These phrases have been used in the past interchangeably regardless of whether the person required skilled care or not what are the three major layers that make up healthy skin.
More recently, there is a growing movement to distinguish between "home health care" meaning skilled nursing care (usually provided by a Home Health Agency) and "home care" (provided by Homecare Agency or independent home health aide or caregiver) meaning non-medical care. 2. Individual 3. 2. Financial constraints Figure 1Total health expenditure % of GDP (Divided by geographical location) [6] * North America is way ahead the world’s average, and holds a high growth. * The world’s average is almost the same with Euro area. * The world’s average is actually very high, reaching 11%.
* The growth rates of different regions are similar, except North America. * China stays in the bottom along with Middle East & North Africa(all income levels) and South Asia. Figure 2Total health expendituree % of GDP (Divided by income level) [6] * High income: OECD and high income counties are way ahead the world’s average, and holds a high growth. * The world’s average is actually very high, reaching 11%. * The growth rates of different regions are similar, except High income: OECD and high income counties. * China stays in the bottom along with low income and lower middle income countries.
Figure 3Health expenditure, total (% of GDP) 2008~2012[7] * The traditional western notions spend more their GDP on health care. * Asia, Africa, Latin America spend less their GDP on health care. Figure 4Per capita total expenditure on health at average exchange rate (US$)[8] * Compared to the US, China spends little on health per capita. 3. 3. Socio-demographics 3. 4. 1. Age * In consideration of the high cost, the U. S. aged people provide a health market size over 100 billion dollars. * A tremendous group of aged people is now living in China, means a market size of 100 billion dollars.
* There will be a bigger aged population in future. Education, ethnicity 3. 4. Care recipients’ medical condition Caregivers reported the following medical conditions that led to the hospitalization of their care recipients: Figure 5Medical conditions that led to the hospitalization of care recipients (%) * Heart problems are the main cause that led to the hospitalization of care recipients, totally reaching 24% (11% for heart attack, 13% for other heart condition). * Chronic diseases bother most of care recipients. 3. Interpersonal 4. 5. Social Networks.
Everything is now involved with social networks, and H2H is no different. 4. 6. 2. Traditional social networks Means mostly interpersonal relationship with doctors, families, relatives, friends,neighborhoods and so on. All this can impact one’s level of home healthcare. Participants| Positive impact| Weakness| Doctors| Professional guidance| Discontinuous, Not in time, Distance| Private doctors| Professional guidance, in-time help| Expensive| Families and relatives| Continuous and in-time help| Unprofessional| Friends & neighborhoods| Recommendations, in-time help| Discontinuous| 4.
6. 3. Online social networks The online social networks hold considerable potential value for health care organizations because they can be used to reach stakeholders, aggregate information and leverage collaboration[9]. Figure 6Why it's an opportunity for companies to leverage their influence in social networks? 4. 6. 4. Information support Discharging process Discharge details by Texas Education Agency Find more about Texas Education Agency[10] Planning for the Patient's Discharge[11] A. There are many things to consider when planning for the patient's discharge.
| ? If the illness has not been long, complicated, or severe, no special preparation is made other than general health instructions and information concerning the actual discharge (such as the time and date the patient will be discharged). | | ? For other patients, the discharge process is more complicated. | | ? The patient's attitude towards discharge and continued progress toward recovery must be considered. | B. If being discharged to home, the patient may need reassurance that recovery will continue at home. | ?
The patient may be concerned about being able to manage for himself/herself. | | ? These worries may keep the patient from looking forward to leaving the healthcare facility. | | ? The patient may wonder what kinds of treatment, if any, will be needed at home and how it will be done. | | ? Provisions for special nursing care, such as provided by visiting nurses, may be needed for the patient who is unable to manage his/her own hygiene and personal care. | | ?
Caregivers may help the individual with such daily tasks as bathing, eating, cleaning the home and preparing meals. For terminally ill patients, home care may include hospice care. For patients recovering from surgery or illness, home care may include rehabilitative assistance[4]. "Home care", "home health care" and "in-home care" are phrases that are used interchangeably in the United States to mean any type of care given to a person in their own home. These phrases have been used in the past interchangeably regardless of whether the person required skilled care or not what are the three major layers that make up healthy skin.
More recently, there is a growing movement to distinguish between "home health care" meaning skilled nursing care (usually provided by a Home Health Agency) and "home care" (provided by Homecare Agency or independent home health aide or caregiver) meaning non-medical care. 2. Individual 3. 2. Financial constraints Figure 1Total health expenditure % of GDP (Divided by geographical location) [6] * North America is way ahead the world’s average, and holds a high growth. * The world’s average is almost the same with Euro area. * The world’s average is actually very high, reaching 11%.
* The growth rates of different regions are similar, except North America. * China stays in the bottom along with Middle East & North Africa(all income levels) and South Asia. Figure 2Total health expendituree % of GDP (Divided by income level) [6] * High income: OECD and high income counties are way ahead the world’s average, and holds a high growth. * The world’s average is actually very high, reaching 11%. * The growth rates of different regions are similar, except High income: OECD and high income counties. * China stays in the bottom along with low income and lower middle income countries.
Figure 3Health expenditure, total (% of GDP) 2008~2012[7] * The traditional western notions spend more their GDP on health care. * Asia, Africa, Latin America spend less their GDP on health care. Figure 4Per capita total expenditure on health at average exchange rate (US$)[8] * Compared to the US, China spends little on health per capita. 3. 3. Socio-demographics 3. 4. 1. Age * In consideration of the high cost, the U. S. aged people provide a health market size over 100 billion dollars. * A tremendous group of aged people is now living in China, means a market size of 100 billion dollars.
* There will be a bigger aged population in future. Education, ethnicity 3. 4. Care recipients’ medical condition Caregivers reported the following medical conditions that led to the hospitalization of their care recipients: Figure 5Medical conditions that led to the hospitalization of care recipients (%) * Heart problems are the main cause that led to the hospitalization of care recipients, totally reaching 24% (11% for heart attack, 13% for other heart condition). * Chronic diseases bother most of care recipients. 3. Interpersonal 4. 5. Social Networks.
Everything is now involved with social networks, and H2H is no different. 4. 6. 2. Traditional social networks Means mostly interpersonal relationship with doctors, families, relatives, friends,neighborhoods and so on. All this can impact one’s level of home healthcare. Participants| Positive impact| Weakness| Doctors| Professional guidance| Discontinuous, Not in time, Distance| Private doctors| Professional guidance, in-time help| Expensive| Families and relatives| Continuous and in-time help| Unprofessional| Friends & neighborhoods| Recommendations, in-time help| Discontinuous| 4.
6. 3. Online social networks The online social networks hold considerable potential value for health care organizations because they can be used to reach stakeholders, aggregate information and leverage collaboration[9]. Figure 6Why it's an opportunity for companies to leverage their influence in social networks? 4. 6. 4. Information support Discharging process Discharge details by Texas Education Agency Find more about Texas Education Agency[10] Planning for the Patient's Discharge[11] A. There are many things to consider when planning for the patient's discharge.
| ? If the illness has not been long, complicated, or severe, no special preparation is made other than general health instructions and information concerning the actual discharge (such as the time and date the patient will be discharged). | | ? For other patients, the discharge process is more complicated. | | ? The patient's attitude towards discharge and continued progress toward recovery must be considered. | B. If being discharged to home, the patient may need reassurance that recovery will continue at home. | ?
The patient may be concerned about being able to manage for himself/herself. | | ? These worries may keep the patient from looking forward to leaving the healthcare facility. | | ? The patient may wonder what kinds of treatment, if any, will be needed at home and how it will be done. | | ? Provisions for special nursing care, such as provided by visiting nurses, may be needed for the patient who is unable to manage his/her own hygiene and personal care. | | ?
An important consideration may be whether help will be required for meals, grocery shopping, etc., for a patient living alone and how long such help will be needed. | C. Planning for the patient's discharge involves the entire healthcare team. | ? The patient, the family, the medical and nursing staff, and other personnel working in the facility (such as the social worker and dietician) work together to coordinate the patient's discharge. | | ? The doctor plans the discharge with the patient and leaves a written order on the patient's chart. | | ? The nurse a. The nurse makes sure the discharge order has been written by the doctor. b.
The nurse will then make the necessary arrangements with other departments to prepare for the patient's discharge. c. The nurse will also make sure the patient has been given instructions by the doctor for home care and understands the instructions. (1) taking medications;(2) exercise programs;(3) physical therapy;(4) changing dressings;(5) giving injections;(6) respiratory treatments that will be continued at home. ? If possible, the nurse will give the patient a written copy of the instructions, such as a copy of the diet or an appointment card for a return visit to the doctor| | || | | | | | | | | | | | | | | ?
The nurse will then make the necessary arrangements with other departments to prepare for the patient's discharge. c. The nurse will also make sure the patient has been given instructions by the doctor for home care and understands the instructions. (1) taking medications;(2) exercise programs;(3) physical therapy;(4) changing dressings;(5) giving injections;(6) respiratory treatments that will be continued at home. ? If possible, the nurse will give the patient a written copy of the instructions, such as a copy of the diet or an appointment card for a return visit to the doctor| | || | | | | | | | | | | | | | | ?
The family must be notified of the patient's discharge time so they can make arrangements for transportation. | D. Patient care does not end when the patient is discharged. | ? The patient may receive visits from a home health agency to supervise the care and treatment. | | ? The patient's home care should make use of existing community resources so the patient and the family will not have to undertake the financial and emotional burden of extensive home nursing care alone. |
E. The patient who is not yet ready to care for himself/herself at home may be discharged from a hospital to an extended care facility. | F. When the patient's condition indicates the need for long-term nursing care, he/she may be discharged directly to a residential facility. | The Procedure for Discharge [11] Chart the Patient’s Discharge[11] 4. 6. Some basic questions on post-hospital health care: * Where will you go? Your own home? A family Member’s home? A rehab facility? * Will you need for help getting to follow up doctor’s appointments? To the pharmacy? * Will you need help with meal preparation? Bathing?
Who will assist you? Your family member? A home health aide? * How long will you need assistance? Source[1] 4. Societies/Associations: * HHCAA: Hospital Home Care Association of America, affiliated within NAHC In 1994, NAHC’s Board of Directors established a new unincorporated affiliate within NAHC, called the Hospital Home Care Association of America (HHCAA). In creating this entity, the NAHC Board recognized the fact that home care and hospice services have not been immune to the effects of an unstable marketplace brought about by rapid changes in the hospital environment.
HHCAA was established to influence and communicate the issues, challenges, and opportunities that arise from changes in the hospital environment. HHCAA's objectives will reflect the mission of NAHC and serve the best interests of all home care and hospice providers. HHCAA will assist in NAHC's legislative and regulatory activities to advance issues in the interest of all providers. Specifically, HHCAA will: * Promote quality improvement through model programs that reflect cooperative care planning and clinical partnerships between hospital and home care providers; * Collect data and conduct national research;
* Bring issues to the attention of NAHC that are relevant to integrated delivery networks; and * Provide information on clinical technology as care moves from the hospital to home care and community-based settings. * NAHC: NAHC is the largest and most respected professional association representing the interests of Americans who need home care (including acute, long-term, and terminal care) and the caregivers that provide them with in-home health and supportive services. 5. Conferences: * 13th Annual Hospital in the Home Conference 23 – 24 May 2013, Novatel on Collins, Melbourne.
A Nurse Oriented Program Packed with Comprehensive Case Studies to Improve HITH Services and Maximise Hospital Efficiency throughout Australia * Hospital to Host Care Transitions Conference 9 May 2013, Helen Hayes Hospital Program to focus on easing patient transitions from hospital to home * Hospital to Home Learning Destination - ACC. 13 Expo April 3 – 5, 2011, New Orleans The American College of Cardiology (ACC) is pleased to announce a partnership with Philips Healthcare on a new Hospital to Home (H2H) Learning Destination to be featured as part of the ACC 60th Annual Scientific Session & Expo.
1. Graham, C. L. , S. L. Ivey, and L. Neuhauser, From hospital to home: Assessing the transitional care needs of vulnerable seniors. The Gerontologist, 2009. 49(1): p. 23-33. 2. www. Homecare. com. Retrieved 10 March 2012. 3. "Caregiver". The Free Dictionary By Farlex. Retrieved 2012-15-06. 4. "DEFINITION OF CARING FOR ELDERLY". LiveStrong. com. Retrieved 15 June 2012. 5. "Hospital to Homecare". Hospital to Homecare. Retrieved 10 March 2012. 6. The World Bank, Health expenditure, total (% of GDP),2010. 7. Carol, T. , The mHealth Summit: Local & Global Converge.
caroltorgan. com, 2009. 8. WHO,Health financing Health expenditure per capita by country,2012. 9. Keckley, P. H. and M. Hoffmann, Social networks in health care: Communication, collaboration and insights. Deloitte Center for Health Solutions. Retrieved from http://www. deloitte. com/assets/Dcom-UnitedStates/Local% 20Assets/Documents/US_CHS_2010SocialNetworks_070710. pdf, 2010. 10. The Wikipeida, http://en. wikipedia. org/wiki/Texas_Education_Agency. 11. Texas Education Agency, Admission, Transfer, and Discharge of a Patient, 2012.
Who will assist you? Your family member? A home health aide? * How long will you need assistance? Source[1] 4. Societies/Associations: * HHCAA: Hospital Home Care Association of America, affiliated within NAHC In 1994, NAHC’s Board of Directors established a new unincorporated affiliate within NAHC, called the Hospital Home Care Association of America (HHCAA). In creating this entity, the NAHC Board recognized the fact that home care and hospice services have not been immune to the effects of an unstable marketplace brought about by rapid changes in the hospital environment.
HHCAA was established to influence and communicate the issues, challenges, and opportunities that arise from changes in the hospital environment. HHCAA's objectives will reflect the mission of NAHC and serve the best interests of all home care and hospice providers. HHCAA will assist in NAHC's legislative and regulatory activities to advance issues in the interest of all providers. Specifically, HHCAA will: * Promote quality improvement through model programs that reflect cooperative care planning and clinical partnerships between hospital and home care providers; * Collect data and conduct national research;
* Bring issues to the attention of NAHC that are relevant to integrated delivery networks; and * Provide information on clinical technology as care moves from the hospital to home care and community-based settings. * NAHC: NAHC is the largest and most respected professional association representing the interests of Americans who need home care (including acute, long-term, and terminal care) and the caregivers that provide them with in-home health and supportive services. 5. Conferences: * 13th Annual Hospital in the Home Conference 23 – 24 May 2013, Novatel on Collins, Melbourne.
A Nurse Oriented Program Packed with Comprehensive Case Studies to Improve HITH Services and Maximise Hospital Efficiency throughout Australia * Hospital to Host Care Transitions Conference 9 May 2013, Helen Hayes Hospital Program to focus on easing patient transitions from hospital to home * Hospital to Home Learning Destination - ACC. 13 Expo April 3 – 5, 2011, New Orleans The American College of Cardiology (ACC) is pleased to announce a partnership with Philips Healthcare on a new Hospital to Home (H2H) Learning Destination to be featured as part of the ACC 60th Annual Scientific Session & Expo.
1. Graham, C. L. , S. L. Ivey, and L. Neuhauser, From hospital to home: Assessing the transitional care needs of vulnerable seniors. The Gerontologist, 2009. 49(1): p. 23-33. 2. www. Homecare. com. Retrieved 10 March 2012. 3. "Caregiver". The Free Dictionary By Farlex. Retrieved 2012-15-06. 4. "DEFINITION OF CARING FOR ELDERLY". LiveStrong. com. Retrieved 15 June 2012. 5. "Hospital to Homecare". Hospital to Homecare. Retrieved 10 March 2012. 6. The World Bank, Health expenditure, total (% of GDP),2010. 7. Carol, T. , The mHealth Summit: Local & Global Converge.
caroltorgan. com, 2009. 8. WHO,Health financing Health expenditure per capita by country,2012. 9. Keckley, P. H. and M. Hoffmann, Social networks in health care: Communication, collaboration and insights. Deloitte Center for Health Solutions. Retrieved from http://www. deloitte. com/assets/Dcom-UnitedStates/Local% 20Assets/Documents/US_CHS_2010SocialNetworks_070710. pdf, 2010. 10. The Wikipeida, http://en. wikipedia. org/wiki/Texas_Education_Agency. 11. Texas Education Agency, Admission, Transfer, and Discharge of a Patient, 2012.
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