Home care is when nursing care and medical treatment are delivered in a person's own home.
As part of the trend away from hospital admission, many people are now treated at home. Even when hospital treatment is unavoidable, time spent in hospital is kept to the minimum, and care is often transferred to the home. Depending on your circumstances, you may be cared for by visiting health-care professionals working with family carers or friends.
Apart from the comfort and convenience of familiar surroundings, one of the main advantages of home care is that it reduces the risk of infections that are sometimes acquired in hospital.
Home care may be required for only a short period of time, such as after minor surgery, or may need to be established on a long-term basis for a person who has a long-standing illness, such as multiple sclerosis or Alzheimer's disease. Some people with a terminal illness choose to be at home for the final weeks of their lives (see Caring for a terminally ill person).
Preparing the home
Depending on the severity of your illness and the extent of your disability, you may be advised to make practical adaptations to your home. Usually, an occupational therapist (see Occupational therapy) suggests which changes need to be made.
If you are only temporarily immobilized following an injury such as a leg fracture, you may need to have wheelchair ramps placed over steps. If you are likely to be permanently immobile, doorways can be widened and equipment, such as a lift to manoeuvre you from a chair to the bed or into the bath, can be installed to minimize the physical strain on your carer.
What home care can be provided?
A growing number of treatments can now be carried out at home, including drug treatments, basic and specialist nursing care, and rehabilitation. You or your carer can be shown how to manage many simple and some more complex procedures yourselves on a day-to-day basis, while remaining under the overall supervision of visiting professionals.
Drugs are usually given orally, but some are given as injections or using a nebulizer that delivers drugs in aerosol form through a mask. Some painkillers, anticancer drugs, and antinausea drugs may be given by continuous infusion using a syringe pump. Injected, nebulized, and infusion drugs are usually first given by a nurse, but you or your carer may be shown how to administer them.
Nursing care Nursing help at home may include help with washing and getting dressed, changing wound dressings, monitoring healing, and helping to prevent pressure sores in a person who is confined to bed. Specialized support may be needed. For example, a person with a stoma, an opening from the bowel that has been surgically created in the wall of the abdomen (see Colostomy), will be shown how to manage it by a visiting stoma nurse.
After major surgery or a disabling illness such as a stroke, you may need intensive rehabilitation to restore as much function as possible. A physiotherapist will arrange a programme of massage and exercise (see Physiotherapy). You may also have occupational therapy or speech therapy, depending on which skills you have lost.
Advances in technology have made some kinds of medical equipment much easier to use. As a result, treatments such as kidney dialysis can sometimes be carried out at home. If you are unable to eat, nasogastric feeding, in which liquid nutrients are pumped through a nasal tube to the stomach, may also be performed in your own home.
You as a home carer
As the partner, relative, or friend of a person who is ill, you may have made a conscious decision to become a carer. However, sometimes the role is taken on gradually as an ill, disabled, or elderly person becomes less able to cope. The role of carer can be physically and emotionally demanding, and you may find yourself neglecting your own health because of your other responsibilities. It is important that you do not ignore your own need for support. Joining a local support group to share experiences with people in a similar situation can make a difference. It may be possible to organise a period of respite care for the person you care for in a residential home, nursing home, or hospital.
Moving into long-term care
Eventually, long-term care may be needed for people with severe mental health problems, physical and/or learning difficulties, a degenerative disease such as multiple sclerosis, or a terminal illness. Elderly people who are physically frail or mentally impaired may also need to move into long-term care. The choice is usually between a specialist hospital, a hospice, a residential home, or a nursing home.
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