With the ever increasing complexity in the healthcare system in America, we though an outline of the types and titles of individuals would be in order when you finally need to have in home care. Below is an outline of the roles and responsibilities of individuals you may be dealing with then care is delivered in your home.
When a physician orders in-home care services to a home-bound patient with verified skilled clinical needs, there can be a variety of support personnel who come into the home to address each of the specific needs. Numerous caregivers can be wonderful, but also confusing. It is important for patients, families, and caregivers to know the role of each discipline and who to call for which services.
Ongoing changes to the allowances for in-home care by insurance companies, Medicare, and Medicaid have made it challenging for people to get the care they need at home when they are ill or injured. In fact, adult children are often considered the sandwich generation as they are caring for their aging parents, their own children, and even their own grandchildren at the same time. While some physician practices have a nurse liaison or care coordinator to assist patients with navigating the challenges of services, families need to strongly advocate to get their loved one the care that is needed to rehabilitate or to be safe in their home.
Once services are ordered, it is imperative for patients, families and/or caregivers to know the focus and tasks of each role:
Registered Nurse: A Registered Nurse, or RN, is a person who will usually get the in-home care started by meeting with the patient, family and/or caregiver (usually a family member) to collect a lot of information in order to create a plan of care for your visits. Even though your doctor may have all of the same information, the RN must still ask these questions in order to correctly capture all of the information. Be sure to have all of the medications and supplements available for the nurse to record.
Licensed Practical (or Vocational) Nurse: Also a nurse, the role of the licensed practical nurse (LPN or LVN) is to provide skilled tasks such as wound care, administering medications and/or patient education. The LPN carries out the tasks related to the plan of care created by the RN.
Home Health Aide: The role of the Home Health Aide (HHA) is to provide direct-care services such as bathing, showering, transferring to a chair or bed, and basic grooming chores. As the HHA is not a licensed caregiver like the RN or LPN, they cannot give medications or advise patients on healthcare issues or concerns.
Social Worker: Many times, patients and families need additional community support and resources to care for someone at home. The role of the social worker (SW) is to connect patients with resources such as applications for financial assistance or respite care. Licensed Clinical Social Workers (LCSW) can assist patients with mental disorders such as depression or anxiety and can help patients and families deal with life-changing events such as a terminal illness. See Social Work
Physical Therapist: Patients who require physical rehabilitation will mostly likely have a physical therapist (PT) providing care in the home. The PT will conduct an extensive interview, similar to the RN interview, along with a physical evaluation to create a plan of care to restore physical function to the patient. The PT’s plan of care will include a list of exercises that the patient, family or caregiver can administer between visits.
Physical Therapy Assistant: The physical therapy assistant (PTA) is a trained individual who helps patients with the exercises that are ordered by the PT. Although the PTA is not licensed, most have received degrees from programs specializing in rehabilitation services and exercise physiology.
Occupational Therapist: Patients who have lost the ability to care for their personal needs such as dressing or eating will need the support of an occupational therapist (OT). The OT provides patients with rehabilitation skills to return to optimal functioning after illness or surgery. The OT can also teach families and/or caregivers how to reinforce these skills in between visits.
Speech and Language Therapist: The speech and language therapist (ST) provides pathology services to patients who need to improve or regain speech and language skills. This specialist also provides evaluation services for swallowing to ensure patients are able to eat and drink safely without the risk of choking.
Over the past decade, Medicare has changed many of the qualifications for home care services which are often reflected in the private insurance world. Now that the question of who is providing the care that is ordered has been answered, which additional services are available and covered may require a bit more digging by the patient’s family and/or caregivers.
About the Author
Catherine Burger, BSN, MSOL, RN is a board-certified nurse executive and contributing writer for www.registerednursing.org
About Well Beyond Care
Well Beyond Care is the only company that teaches families and individuals how to find and manage affordable non-medical in-home care, while solving the chronic problems of caregiver truancy and turnover through the web application, WellBeyondCare.com. The Company’s platform combines the power of the internet with the personal touch of nurses to offer families a pathway to transitional care, allowing our elderly parents to safely age-in-place. Their solution lowers stress in hiring a caregiver and saves families tens of thousands of dollars per year in care costs.