older people’s health issues
Care of Older People in the Home
Introduction
Older people may need care in their home when they are frail or weak, particularly after they have been discharged from the hospital or a rehabilitation facility. Simple care is usually provided by family members, friends, or both. More complex care may require health care practitioners (such as registered nurses and therapists) and others (such as home health aides and social workers) to come to the home. Such care is usually coordinated by a home health care agency and supervised by a doctor. Care may be needed only briefly or for a long time. Medicare provides services for people who are considered homebound, which typically means that they are able to leave their home only for doctors appointments or emergencies. A nurse may be needed to change dressings or give injections of medications. A physical therapist may be needed to help people regain strength and balance or recover from a stroke. A home health aide may be needed to help people with shopping, preparing meals, going out in a wheelchair, taking a walk, or bathing. A social worker can determine whether people are receiving the services they need and recommend additional services if needed. A social worker may also help arrange for rides to and from medical appointments. With home health care, communication between all of the people involved is important. Any changes in the person's condition should be promptly reported to the person's nurse or doctor. Sometimes the primary care practitioner coordinates a team of health care practitioners who work together to provide better care for people who live at home and have a chronic disorder or disability. This arrangement is called a patient-centered home. In some situations, a care manager of another member of the team may be responsible for coordination of care. Care in the home can reduce placement in a nursing home by 23% and is less expensive when visits by home health aides and nurses are scheduled appropriately. 