Types of Home Care Aid – Part Three

Jean S. writes in:   “Does having home health care mean I am required to hire a private duty nurse or therapist?” 

The short answer is that Home Health Care does not automatically require skilled services.  Skilled care, depending on the needs of the individual can be quite complex, specialized and comprehensive.  Last month the discussion centered on the responsibilities of Personal Care/Home Health aides and that they are trained to provide more assistance for individuals requiring an increased level of personal care.  As in the cases of companion and personal care, an assessment of the client in their home by the agency’s Clinical Services Director is part of the process in developing the plan of care.   Additional instructions for skilled care in the home include physician orders and/or other healthcare professionals.   Part Three and the final of this series focuses on Skilled Care.

What is Skilled Care?

Skilled care is a type of health care given when individual circumstances dictate that   an individual requires skilled nursing or rehabilitation staff to manage, observe, and evaluate his or her care. Nursing, physical therapy, occupational therapy, and speech-language therapy are considered skilled care and the most frequently utilized. In addition to providing direct care these professionals manage, observe, and evaluate the individual person’s care.  Any service that can be safely done by a non-medical person (or on your own) without the supervision of a nurse is not considered skilled care. 

Skilled services are typically prescribed by physician order and are of relatively short or intermittent duration compared to employment of companion or home health aides.

Discharged hospital patients who have relatively short-term needs as well as those with chronic medical conditions are the primary recipients for skilled care.  Depending on the individual plan of care both skilled and unskilled services may be necessary.

Skilled Nursing care is care given or supervised by licensed nurses.  Nurses provide direct care, manage, observe, and evaluate a patient’s care and teach the patient and his or her family caregiver. Examples include: giving IV drugs, shots, or tube feedings; changing dressings; and teaching about diabetes care.  Skilled nursing includes a number of highly specialized treatments (which may require additional accreditation and licensing) that focus on care for more critical medical conditions or age groups such as pediatrics.

Speech Therapists specialize in the study and treatment of communication problems. These licensed therapists assist with problems involving speech, language, and swallowing. Communication problems can be present at birth or develop after an injury or illness, such as a stroke. 

Occupational Therapists are trained and licensed to specialize in providing services to help the individual return to usual activities (such as bathing, preparing meals, and housekeeping) after illness either on an inpatient or outpatient/home based basis. 

Physical Therapists are trained and licensed to specialize in the treatment of injury and disease by mechanical means such as heat, light, exercise and massage.  Depending on the condition of the patient, treatment can be done at a rehabilitation facility or at home.

Counseling Services are available when counseling may be beneficial to the overall health and well-being of a client and are also provided under the care and direction of a physician.  The availability of these services may depend on state and local regulations and may include:

• Medical Social Services
• Dietary Counseling
• Psychiatric Nursing
• Advocacy and Case Management

Skilled care plans vary greatly for each individual.  Like the aides, skilled care professionals may either visit multiple clients daily or work solely with one client.  

  

                                            Warmest Regards and a Happy Spring at Home,

                                               

                                                Catherine Stelianoudakis Prochaska, CSA 

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