October 20, 2022
When someone is admitted to a hospital, they are assigned to a certain level of care depending on their condition. Someone with an acute problem, such as a heart attack, will be put into the intensive care unit. After they’re stabilized they may be transferred to the medical/surgical unit or a “step-down” unit. These levels ensure the patient gets the right care at the right time.
“That type of model, well defined and with lots of planning and thought, is what needs to be developed for the home care world,” says Sheila McMackin, MSW, LCSW, the founder of Wellspring Personal Care. McMackin and others in the home care profession believe that assigning levels of care to in-home services will benefit consumers by:
- Making it easier to find the right care or service for their needs.
- Saving them money by eliminating care or services they don’t need.
- Ensuring that people who want to recover from an illness or surgery at home have the option to do so.
The good news for consumers right now is that there are lots of home care agencies that provide a range of services. From doing chores such as taking out the garbage and running errands to providing companionship, these agencies (including Wellspring) can make life a lot easier for family caregivers or anyone who needs to hire their own in-home aide.
The flipside is that consumers may not realize that most home care agencies do not also provide medical or nursing care. That means, for example, that if an aide comes into the home and reminds the client to take their medicine, the aide is not trained or licensed to administer the medicine or, equally important, to notice possible clues about the person’s health status. Agencies like Wellspring are the exception. We have a medical staff (a physician and a director of nursing) that oversees the CNAs and trains them to recognize medically important details about the client. This ensures that the client gets the medical or nursing care they need when they need it—rather than suffering unattended.
McMackin offers a recent example showing that home service aides should not be placed in a position to take care of someone with complex medical needs. Wellspring was recently called in to care for a client who was receiving hospice care at home from one agency and 24-hour home care services from another. “The home service agency had no nursing supervision,” says Sheila. “The caregivers were not sharing information from one shift to the next, and the hospice nurse couldn’t get a consistent connection with anyone to coordinate care.”
Clearly, that was a situation where the client needed a different level of care. And, according to McMackin, it’s not unusual. At the same time, she notes, “More consumers are saying they want to go straight home from the hospital, and they want their services to be delivered at home.” If states were to establish levels of care, it would be much easier for hospital discharge staff to connect patients with the right kind of in-home care. It might be home care aides, it might be home nursing care, or it might be both.
“I believe the best way to start is to bring together a group of stakeholders,” says McMackin, who has been meeting with members of the Illinois Home Care and Hospice Council and others in the healthcare industry. “Our vision is to bring enough like-minded people together to propose a plan for levels of care that would protect consumers and provide more clinical oversight for care in the home.”
Stay tuned for more updates on this effort. In the meantime, you may be interested in these articles:
“From facility to home: How healthcare could shift by 2025”
“Home Health Care Trends for 2022”
https://www.carevoyant.com/home-health-blog/home-health-care-trends-for-2022
“Why leading health systems are focused on high-acuity healthcare at home and an innovative approach for delivering it”