"There's no place like home." I can still hear my 76-year-old grandmother saying these words as we sat on her back porch, begging for a cool breeze on a hot Mississippi summer afternoon. As grandkids go, we were pretty useful in the pinkeye, purple hull pea-shelling business; we all tried to keep up with her, but to no avail. She worked ferociously as she postured herself erectly in one of her lawn chairs—the uncomfortable, black wrought-iron lawn chairs, where the top connection would sometimes pop off and the entire backside collapse, requiring an immediate zip-tie repair. There really wasn't anything special or extraordinary about my grandmother's house. It was neither lavish nor huge, nor filled with expensive furniture or antiques. She only had one small Magnavox television; it was in the den where everyone gathered. So, what was it about grandmother's house that made it so special? The answer is simple. It was her home. It was where the grandkids wanted to be. But, more importantly, it was where she wanted to be.
There are so many sayings about the word "home" that there is no way to count them all. But I am certain that just the thought brings a few to mind. There's just something so special, magical and therapeutic about home. Home—that safe place where we find shelter, solitude, security. Home—that perfect place for physical relaxation, emotional tranquility and mental serenity. Home—a unique place where we are the most content, comfortable and cozy. Even with the anticipation and excitement of going on a long-awaited trip or vacation, there is, likewise, an ironic anticipation and excitement about going back home. Granted, no two homes are alike, but it is undeniably uncanny how occupants always seem to "fit" their abode.
I began my nursing career in home health care when I was 25 years old. While I had not amassed an abundance of hospital-related experience at that time, still I did understand the concepts of hospital care. Thus, when I began working with home health care, it did not take long for me to realize that these patients—homecare patients—held a different perspective and mindset. Though home health care is not designed to meet the needs of all patients, it does address a specific need for a large number of easily identifiable patients in any given population. Also, the financial comparison between a hospital stay and home health care costs makes the latter the better choice when possible. Furthermore, the patient who benefits the most from home health care does so not only because of what home health care offers, but also because of the setting in which it is offered.
I can testify to the product and practicality of both the service and the setting of home health care. On a personal level, my own grandmother was a blessed recipient of such care with assistance from a supportive family. However, as a professional, I have also sadly witnessed how the involved family seems to disappear after a patient is discharged from the hospital. I have also observed a patient who nods with confidence in agreement with every word spoken by a doctor, nurse and discharge planner, only to stare in complete confusion during the subsequent medicine review at homecare admission.
Yet, on the other hand and much more often, I have been privileged to be a part of many homecare discharges, at which the clinician hugs the patient and family, all parties jointly understanding that this kind of goodbye is their ultimate goal—for the patient to get better. It leaves the patient with a viable venue for maintaining health because his or her home has been and will continue to be the comfort zone. This is where home health care has an enormous responsibility and opportunity to bridge the unaffordable gap between a hospital stay and a return to health; it is the best means by which and through which a patient can get home and stay there because "there's no place like home."
Tips for Aging in Place Caregivers
- Plan ahead. Talk with your loved one and facilitate a decision for where they want to age. Research available options.
- Learn what Medicare will pay for with the home health benefit. Should you supplement with a long-term care policy?
- Educate yourself on the health issues and diagnoses of your loved one. The more you know, the better care you will be able to provide.
- Have a back-up plan. Contingency plans help avoid stress.
- Keep an easily accessible list of family, friends and paid caregivers that you can call for help when needed.
- Take care of yourself. To be the best caregiver, stay on top of your game. Eat well, exercise, do something fun and get enough rest.
- Give medications exactly as they are ordered. Many re-hospitalizations are traced back to inaccurate medication management.
- Have Advanced Directives in place. Have your loved one's wishes in writing so there is no confusion when the time comes for difficult decisions.
