Coping with the aftermath of a diagnosis, extended hospital stay or sudden injury can be daunting and requires many decisions to be made about how to meet daily needs as well as the doctor's treatment plan. It is important to consider the age; physical and emotional strength and abilities; location; and health of both the patient and the caregiver(s) when deciding the next phase of care. Many options are available at home and in facilities devoted to the well-being of individuals unable to care for themselves during recovery or at the end of their lives.
Most people want to remain at home while recuperating from surgery, an illness or injury, or while facing the end of their lives. Attempts at reducing healthcare costs have resulted in hospital stays being kept to a minimum, with patients being discharged to recuperate fully outside the hospital. Elderly patients often cannot adequately be cared for by their spouse, and their grown children often live out of town or have physical limitations of their own.
In-home sitting services, medical equipment rental, home health nursing and hospice care allow patients and their caregivers to stay in a familiar environment.
Sitting services offer a variety options based on the degree of need. "We are the hands and feet when their hands and feet aren't working," said Rhonda Perez, RN, owner of Angel Care Sitting Services. "We help clients and their caregivers manage staying at home by helping with daily chores and activities, as well as medical needs."
The daily tasks of dressing, bathing, food shopping and preparation, cleaning house, doing laundry and receiving visitors can be too much for those in medically fragile conditions. "We provide ongoing, necessary physical and emotional support for as long as it's needed," Perez said.
Moving adult patients can be difficult, but is essential for daily bathing and dressing. Equipment such as hospital beds, wheelchairs, oxygen tanks and bath chairs often aids in home recovery. Medical equipment rental provides easy access for short- or long-term use, as well as offering training on how to use the equipment properly. "We give instructions and make sure the primary caregiver feels comfortable operating the equipment before we leave," said Medico Home Medical Equipment owner Nina Howard. "We also use a safety checklist and a 24/7 on-call service to answer any questions." When the equipment is no longer needed, return pick-up is handled through the service.
Home health services supply nurses who visit on a scheduled basis to check vital signs, start and maintain intravenous tubes, administer medications and monitor the overall health and progress of the patient. They can also provide therapy or rehabilitation after a hospital discharge or ongoing assistance with daily living activities, working in conjunction with sitting services to complement care during recuperation. "We give intermittent care and education for a recent diagnosis, as well as durable medical care and medical management for a prescribed course of treatment," said Missy Wilbanks of Mid-South Home Health.
When curative treatment is no longer an option, hospice care is recommended to provide supplies, medications, nurses and support during the end-of-life transition. "Doctors need to be thinking about hospice care when their patients are presenting frequently to their offices or the emergency room, complaining of pain more often than usual and showing decline," said Missy Fields, area director of sales for Wiregrass Hospice, a Gentiva Company. Social services, spiritual and bereavement support, counseling and nursing services are all part of hospice treatment, focusing on patients' and families' wishes.
Hospice representatives communicate with attending physicians regularly regarding the patient's status. "Doctors don't turn over control, just because their patient is in hospice," said Craig Greer, program director of Community Hospice of Alabama. Hospice workers also spend time with the patients' caregivers, understanding that medical conditions place great stress on these loved ones, as well.
"Our goal is to keep people comfortable and let God be God," Greer said. "When they're comfortable, they often live longer and better; or they are more comfortable and find it easier to let go." Hospice also provides grief support for families after the death of a loved one.
When staying at home is not an option, nursing home services are preferred. Short-term and long-term stays are available depending on the need and urgency of the medical condition. "We have all-over care that gives rehabilitative, complex medical or specialized services, as well as Alzheimer's care," said Sherrie Taylor of Golden Living Centers Nursing homes. "We offer programs that help with movement and function, balance, and coordination, which, in turn, helps with independence."
Communication with family members and healthcare providers is essential during times when medical conditions impact lifestyles temporarily or permanently. Resources to smooth the transition can be located through social services at hospitals and doctor's offices, publications, the phone book, Web sites and the Internet, and support groups through churches and community centers. Asking questions while researching services and facilities empowers families to make the best decisions during stressful times. Just as cures are expected every day, new technologies and treatments emerge to enhance the quality of life while recovering or letting go.
