Home Based Care

8/6/2019 Home Based Care

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HOME BASED CARE

Presenter: L.Tikoimaleya



Objectives

At the end of this study students are able to:

1.) Explain the aims of home based care.1.1 With clients suffering with

communicable diseases

2.) Identify relative eligible for continuity of care at home.



Cont

3.) Describe activities to be carried out

3.1 Preparation of the visit

3.2 During the visit

3.3 After the visit



4.) Demonstrate skills in:

4.1 Planning a visit

4.2 Establishing, maintaining, terminating arelationship with client & family

4.3 Assessing the individual/family in self care4.4 Assisting the individual/family develop self

reliance through health education

4.5 Referring the individual /family toappropriate resources when needed

4.6 Recording the visit



What is home based care?

The delivery of care includes services and productsprovided to clients in their home that are needed tomaintain, restore, or promote their physical,psychological and social well being (Kozier,Erb,Berman & Snyder,2004).

Aim:

To ensure the continuity of care is maintained until the

client or patient is fully recovered or deceased.

The focus of home based care is the individual and their families.



Who needs home health care?

Clients who need home health care have a

variety of medical needs e.g. bed ridden,tuberculosis, diabetes.

Socio-economic problems e.g. malnutrition

(indirectly), welfare.

Psychological problem: mental

illness/problems.



Nurse¶s role and functions

The nurses functions independently in variety of

unfamiliar home settings situations.

Distribution of power at home differ from institution

Establish trust & rapport with client and family

Individual family empowerment

Family function independently



Advantages

* Intimate home settings* Cultural belief and practices are

more visible

* Lesson the burden of the nation¶seconomy



Disadvantages

* Physiologic psychosocial problems

± long term care* Complex responsibilities due to

health care cost

* Inadequate living condition andsupport system will compromise

client care



Home Health Care Systems

Developed country's privilege

Locally to some extentIndividual with extremelycomplex needs may need the

service of an agency with adirect link to a medicalequipment company



Nursing Specific Roles

Advocator

Caregiver

Educator

Case Manager



Advocator

The nurse advocator for the client by:

Assistance to community resources

Make informed decision

Coping mechanism to changes in life style

Negotiation for legal issues

Collaborate with other health care

professionals



Caregiver

Major role is to:

Assess and diagnose the clients actual potential

health problem

Plan care and evaluate clients outcome

Direct actual care e.g. bathing, feeding etc.

Carry out and direct specific procedure and

treatment e.g. I.V., ostomy care, wound care



Educator

Educative role focuses on:

Illness care

Prevention of problem

Promotion of well being



Education is ongoing and is

considered the crux of home based

practice

Nurses should be skilled in teaching

and learning principles, strategies that

facilitate learning.

Responsible for the secondary client

who are the caregivers (who are the

major impact on the client wellness)



The nurse coordinates the activities of allother health professional involved in theclients care:

Dietitian Physiotherapist

Physician

Nurse practioner

Report any changes in the client condition Bring about and inform changes in the care

plan

CASE MAN AGER/COORIDN ATOR



Selected Dimension of Home Based

Care

Clients Safety:

Hazards in the home are major causes

of falls, fire, poisoning, ect. Improper use of house hold equipment

Evaluate or appraisal of hazards ±

suggestions for remedies.



Cont

The nurse should express concerned and help the

family to react appropriately

�

Clients living alone/ with family members for emergency

� Post a list of all emergency telephone

numbers e.g. police, ambulance, fire or

physician beside the phone.



Cont

Post list of clients medication andpotential side effect in a centrallocation/refrigerator door

Help the client and family to apply for medical alert system such as bracelet,necklace.

Enroll your client in an emergencyresponse system especially if your clientlives alone.



Communicable Diseases

Def: Communicable disease is one that can betransmitted from one person to another (Allender & Spradley,2005)

It is caused by an agent that isinfluenced and is transmitted from onesource or reservoir to a susceptiblehost e.g. HIV/AIDS, Diarrhoea Typhoid,Measles, Chickenpox (varicella),Smallpox, Poliomyelitis, Tuberculosis,Dengue Fever, Viral Infection, Leprosy.



Cont

Knowledge of communicable disease isfundamental to practice of community healthnursing because these diseases spreadthrough communities of people.

Understanding of the basic concepts of communicable disease control as well asnumerous issues arising in this area helps acommunity health nurse work effectively toprevent and control communicable disease

in population and groups. It also helps nurses teach important and

effective preventive measures to community



Cont

Advocate for those affected

Protect the well-being of uninfectedpersons including nurses themselves.

Important areas of concern for CHN:

Despite significant decline in morality,communicable diseases are

responsible for persistently highmorbidity among various age andpopulation groups.



Cont

Rates of some communicable diseasesespecially tuberculosis (TB) and (STI)remain disproportionately high in

selected population groups. Current researchers reveal that

infectious agent may be responsible for anumber of chronic diseases includingsome form of cancer.(Allender&Spradley,2005)



Aim

The aim of home based care with clientssuffering from non communicable disease isthe continuous supervision of client care

through drug supervision and basic care andactive participation in the control of theinfection/contamination.



Cont

To allow the continuity of care in a home environment

the nurse should identify and appoint a family member

who will be tasked as a care giver.

Identify in this context means the care giver is trained

to: Meet the physical needs e.g.

� Bathing/infectious condition e.g.HIV

� Feeding

� Administration of medication

� Observation of sterile techniques

� Proper procedure of disposal of items used



Meet the emotional/spiritual/psychological

needs of clients

Give some comfort when necessary

reassurance when required

Support when needed



How can the community nurse

Identify

Training family members/significant

others

Relatives that may have some form of training

Strengthen commitments of relatives

who are on the job.



Preparation of the Visit

Initiation Phase:[The first contact

between Nurse and the family.]

Clarify source of referral for visit(referral or discharge note from

hospital)

Clarify purpose for home visit

Share information on reason and

purpose of the visit with the family



Cont

Pre-visit Phase:

Initiate contact with family

Establish shared perception of purpose with family

Determine families willingness for

home visitSchedule home visit

Review referral and/or family record



Cont

In home Phase:

Introduce self & professional identity

Interact socially to establish rapportEstablish nurse client relationship

Implement nursing process

Interview Assessment

Nursing diagnosis

Implementation



Cont

Terminating Phase:

Review visit with family, what has

occurred ± purpose of the visit hasbeen accomplished.

Post Visit Phase:Record visit & services provided

Plan for visit next visit



Non Communicable Disease

Personal health habits continue to

contribute to the major causes of morbidity

globally

Encouraging the pursuit of health life

styles and essential if we are to achieve

health for all by 2010



Cont

Scientific evidence linking life style

and health is reflected in the interests

people focusing on living a healthylife style.

Public health programs emphasize

living a healthy life style for the

population who are at risk.



Cont

People in many countries recognize the

need to exercise regularly, maintain their

weight at recommended levels & manage

stress in their lives.

Initiating and maintaining a healthy life

style is complex and requires different

approaches directed towards individuals,

families and the environment in which they

live.



Cont

Studies show that there is no better way to

promote health and improve the quality of

life of individuals than through basic health

habits or behavior such as:

Exercise

Balanced nutrition

Developing a positive & optimistic look Not smoking



Aim: The aim of home based care in clientssuffering from non-communicable diseases isthe continuity of care of clients at home. Carein this context includes drug supervision,

health education, monitor of their progresstowards normally

e.g. of non-communicable disease are:

Hypertension

Diabetes Anemia

Cardiovascular disease e.g. CVA,RHD



Continuity of care at home requires

strengthening of family support through:

Health education

One to one discussion

Family discussions/talks

Preparation of the visit:

Initiation Phase



Cont

Pre-visit phase

What is the object of the visit

Collect all necessary tool for the visit

Nursing bag (sphygmomanometer,Stethoscope,glucometer,drugsupplies)

Patient records and other record

In House Phase

Termination Phase

Home Based Care

Documents

Transcript of Home Based Care