HEALTH CARE TERMS
Home Care
There are two basic types of care in the home—one is Home Health Care and the other is Homecare, also referred to as in-home care. The biggest difference between Home Health Care and Homecare is that Home Health Care is a higher level of care that is deemed medically necessary by a physician.
Home Health Agency
A home health agency provides medical services when a physician has deemed it medically necessary for you or your loved one to receive skilled care in the home. Skilled, specialized care is provided by licensed nurses, therapists, physicians or health aides. A Home Health Agency provides RNs who can administer medication and provide specialized care such as wound care or diabetic care. Specialized caregiving in such areas as physical or speech rehabilitation may also be prescribed. A visit by a home health agency nurse or therapist is usually concluded within one hour. Home health services are paid for by Medicare, Medigap, Managed Care, Medicaid, Veterans Benefits and Private Pay or a combination of each.
In-Home Care
In home care refers to non-medical services provided by a family or salaried caregiver in the home or residence of an elder or disabled individual. Generally, in home care provides support for senior adults and individuals to live independent of a facility. In-home caregivers provide assistance with activities of daily living, light housekeeping, transportation, medication reminders and so on. In home care is usually private pay, but can also be paid for by long term care insurance (depending on the policy terms) and very rarelyby Medigap — and only if the patient is also receiving services from Home Health Agency.
Caregiver
A caregiver is someone who provides assistance to another person who cannot live fully independently due to physical, psychological, or mental disability. Caregivers can be family members, friends, neighbors, or caring, salaried individuals. Caregivers may have duties which are fairly light, such as stopping by someone’s house every few days to tidy up or prepare a meal, or the duties may be more involved, such as living with someone to provide constant assistance with a variety of tasks.
Activities of Daily Living
Activities of daily living are daily self-care activities that help keep a person independent and healthy. A few examples are: bathing, dressing, toileting, medication reminders, walking, transportation and meal preparation.
Live-in Care
Live-in care refers to services provided by a caregiver who resides with the person they care for and is available to assist them during any time of the day or night. Live-in caregivers are usually given a room and expected to sleep, but are “on call” if the care recipient needs help during the night.
When a senior needs care around the clock, such as an individual with dementia, an agitated individual or one who cannot make his needs known, senior care is provided in two twelve-hour shifts with two caregivers. Each caregiver is expected to be fully awake during her shift.
Adult Day Care
Adult Day Care is a service for adult individuals who are unable to function independently in the home or community. It is a non-residential facility providing social and recreational programs, outings, meals and support services. It is an increasingly popular option for family caregivers who work or need some time for themselves during the day. It can be the most cost-effective way for a family to maintain a normal daily schedule.
Adult day care center programs generally offer 8-10 hours of senior care, up to five days a week. For seniors who do not have in home caregivers, adult day care can prevent depression, isolation and meets the elder’s socialization needs. And most adult care centers will provide health, social and related support services to senior adults.
Respite Care
Respite care, simply put, is a break for the caregiver or care provider. Respite care is planned, short-term and time-limited breaks for families and other unpaid care givers in order to support and maintain the primary care giving relationship.
Even though many families take great joy in providing aged care to their loved ones so that they can remain at home, the consequences for the family care provider can be overwhelming without some support, such as respite. Respite provides the much needed temporary break from the many time-consuming and depleting challenges faced by the family caregiver.
Alzheimer’s and Dementia Care
Seniors with Alzheimer’s or other dementia-related diseases have very special care giving needs. Caring for a memory-impaired family member or senior presents challenges that can be particularly stressful. And, if a senior has dementia with behavioral issues, caregiver stress will be higher than a person with only physical disabilities. Family caregivers of seniors with dementia or Alzheimer may experience burnout quickly.
What are some of the challenging behaviors you may need to contend with? Those with Alzheimer’s and related dementias often experience changes in personality and behavior. Some of the most common behaviors include agitation or anxiety, incontinence, repetitive speech or actions, paranoia, sleep difficulties, and wandering.
Independent Living
Independent Living for seniors usually refers to residence in a private apartment or house within a community of seniors where no custodial or medical care provided. It provides seniors with many peers with whom to socialize and has features designed into the housing to provide comfort, security, and safety for seniors. Seniors in an Independent Living Facility must be able to manage their home and personal needs on their own. Independent living communities do not offer medical or custodial care, though if either becomes necessary seniors are permitted to bring in outside providers.
Assisted Living
Assisted living is a residential option for seniors who want or need help with some of the activities of daily living—things like bathing and dressing, cooking meals, getting to the bathroom in the middle of the night, housekeeping, and traveling to appointments.
Services at an assisted living facility typically include 3 meals a day in a common dining room, assistance with activities of daily living, housekeeping services, medication management and social activities to mention a few. Assisted living communities differ from skilled nursing facilities, nursing homes, or long term care facilities nursing homes in that they don’t offer complex medical services requiring physician oversight.
Hospital
A hospital is an institution for health care providing patient treatment, usually for immediate and urgent threats to health. Hospitals have the ability to admit and care for individuals on an inpatient basis. Hospitals generally do not provide services to patients who need extended treatment.
Long Term Acute Care Facility or “L-TAC”
A long term acute care hospital is designed to serve patients with complex medical needs who require an extended treatment program within an acute care setting. Patients who require advanced treatments and therapies, such as pulmonary and tracheotomy care, ventilator management, stroke and neurological rehabilitation, cardiac care and wound management and who need a longer length of stay, 25 days or more, in a long term acute care hospital.
Rehabilitation Center
Rehabilitation centers are specialized hospitals or outpatient facilities that provide therapy and training for rehabilitation for return to the home or residence. For seniors, this generally means physical therapy, occupational therapy, speech therapy and respiratory therapy. Patients are usually admitted to a rehabilitation hospital after a medical hospitalization or long term acute care facility.
Long Term Care Facility
A long term care facility can be a long term chronic care hospital or a nursing home. It is a center that provides medical and non-medical care to adults and seniors that have a chronic illness or disability. Long term care facilities can provide rehabilitative, restorative, and/or ongoing skilled nursing care to patients or residents in need of assistance. A long term care facility can be a temporary placement during a recovering period or for those who require skilled care but only for brief periods of time. Nursing homes, rehabilitation hospitals, and long term chronic care hospitals are all considered long term care facilities.
Nursing Home or Skilled Nursing Facility
Nursing Homes are permanent residences for people who are too frail or sick, or do not have the family, community or financial resources to live at home. Nursing homes can also be a temporary facility during a recovering period. However, many people need a nursing home level of care but would prefer to remain in their own home with the help of their family and friends, community services, and professional care agencies.
Hospice
Hospice care is a philosophy of care that focuses on patient comfort and quality of life rather than curing the patient’s disease. Its goal is to enable patients to be pain-free so that their last days may be spent with dignity and surrounded by the people they love. Hospice neither hastens nor postpones dying. Hospice care is most typically given in the patient’s home with a family member serving as the main caregiver. It may also be given in a hospital, nursing home, private hospice facility or an inpatient hospice unit.
Hospice Support Services
In the early weeks or months hospice of care, it’s usually not necessary for someone to be with the patient all the time, and during this period Hospice does not provide 24 hour around the clock care. Many patients are either cared for by family members, hired caregivers, or nursing home staff. However, since one of the most common fears of patients is the fear of dying alone, Hospice generally recommends someone be there continuously. While family and friends do deliver most of the care, salaried care givers can assist with errands and to provide a break and time away for primary caregivers.
Advocacy
Advocacy is promoting the client’s rights and interests in and between the health care settings. For example, advocacy is at the doctor’s office when the caregiver is takes notes and asks questions for the senior who has trouble with instructions. Advocacy is making sure your loved one gets timely care during a hospital night shift or at the nursing home. Advocacy is filling out a new medicine list if medications are added or discontinued. Advocacy is about good patient care, not just doing a job and going home. A trustworthy and professional caregiver should always be an advocate for the client within all the health care setting.
Tube Feeding
A feeding tube is a medical device used to provide medicine and nutrition to patients whose condition makes it difficult, unsafe or impossible to obtain nutrition by swallowing. Placement may be temporary for the treatment of acute conditions or lifelong in the case of chronic disabilities. Tubes are classified by the insertion site and intended use.
The types of tubes we deal with most frequently are the nasogastric tube and the gastric tube. The nasogastric tube, or NG-tube, is inserted in the nostril then goes down the esophagus and into the stomach. It is generally used for nutrition on a short term basis. The gastric tube, or “G-tube or “button”, is a tube that is inserted through a small incision in the abdomen and then into the stomach. It is used most often when there is a neurologic or anatomic disorder and is more suitable for long term use.
Innovative Nurses & Sitters caregivers are skilled at tube feeding, including bolus feeding.