From the Guidelines
Home-based care is a vital component of healthcare that prioritizes patient-centered care, aiming to increase survival, decrease morbidity, improve function and quality of life, and support independence and self-management, as evident from the American Thoracic Society's statement on home care for patients with respiratory disorders 1.
Key Aspects of Home-Based Care
When establishing home-based care, it is essential to begin with a thorough assessment of the patient's medical needs, functional status, home environment, and available support systems. This assessment should be followed by the development of an individualized care plan that addresses specific medical requirements, medication management, and necessary interventions.
- Medication management is crucial, and medications should be organized using pill organizers or blister packs to improve adherence, with clear written instructions for dosing schedules.
- Regular monitoring is essential, with vital signs, symptoms, and treatment responses documented during each visit.
- Effective communication between all healthcare providers, including primary care physicians, specialists, nurses, and therapists, ensures continuity of care.
Importance of Coordination and Training
Family members or caregivers should receive proper training on medication administration, basic nursing procedures, and recognition of warning signs requiring medical attention. This training is vital for ensuring that patients receive high-quality care in the comfort of their own homes.
- The American Thoracic Society's recommendations for consideration for home health care referral upon discharge highlight the importance of identifying patients who would benefit from home-based care, including those with complex medical needs, unstable or fragile medical status, and those requiring close supervision 1.
- The general goals of home care for individuals with respiratory disorders, as outlined in the statement, include increasing survival, decreasing morbidity, improving function and quality of life, and supporting independence and self-management 1.
Benefits of Home-Based Care
Home-based care offers numerous benefits, including comfort, reduced infection risk, and personalized attention, which can contribute to better psychological well-being and potentially improved health outcomes.
- By providing care in the patient's home, healthcare providers can promote optimal growth and development of children with lung disease and support patients with terminal illnesses to die at home with dignity.
- The use of home health services, including skilled nursing, physical and occupational therapy, and social work, can help reduce hospital readmissions and improve patient outcomes, as demonstrated by studies on home health care interventions 1.
From the Research
Knowledge, Attitude, and Practice (KAP) regarding Home-Based Care
- The KAP regarding home-based care is a crucial aspect of healthcare, particularly for older adults with complex chronic conditions 2.
- Studies have shown that home care services can be effective in managing polypharmacy, which is common among older adults receiving home care services 3.
- Comprehensive geriatric assessments (CGAs) are an essential component of home-based care, as they help identify older people's problems and care needs 4.
- CGAs can be conducted using various instruments and procedures, and their effectiveness can vary depending on the specific context and population 4.
- Acute Care at Home services have been shown to be a viable alternative to hospital care for older patients, offering benefits such as reduced length of stay, decreased escalation in domiciliary care packages, and prevention of functional decline 5.
Factors Associated with Home-Based Care
- Polypharmacy is a significant concern in home-based care, and is often associated with older age, female sex, increased frailty, living alone, and poor economic situation 3.
- The use of home care services can be influenced by factors such as the patient's functional ability, residence, and social support network 5.
- The effectiveness of home-based care can also depend on the availability of resources, such as healthcare personnel, equipment, and transportation 6.
Interventions to Improve Home-Based Care
- Interprofessional interventions, such as collaboration between healthcare professionals and home care workers, can help improve the quality of home-based care 3.
- Efficient use of home care workers and improved health literacy can also contribute to better outcomes in home-based care 3.
- The use of CGAs and other assessment tools can help identify areas for improvement and inform the development of targeted interventions to enhance home-based care 4.