The transition from having around-the-clock care following surgery or serious illness in a hospital, rehabilitation center or similar facility can be very scary. You wonder how you and your loved ones can manage your recovery with limited experience with personal health care. The professionals with Banner Home Care Payson create the bridge from 24-hour care to family-assisted care in your home.
Tanya Schlegel and Mandy Johnson, LMSW, with Banner Home Care Payson, recently discussed the services they and their fellow professionals provide at a program at Banner High Country Seniors. Schlegel is director for home care services and Johnson is care coordination post-acute senior manager for Banner Home Care Payson.
With home care, patients of all ages, with a variety of illnesses or conditions, can receive quality care in the comfort of their own home. It is physician-driven skilled care that is based on an individualized plan.
To receive home care there must be written orders from the patient’s physician, a skilled nursing facility, hospital or rehabilitation facility. The care must be approved by insurance — whether through Medicare, the Arizona Health Care Cost Containment System, VA benefits or private insurance. Medicare pays 100 percent of home health benefits. Medicare Advantage plans also cover home health, many at 100 percent or with a small co-pay. The service is also covered by private insurance coverage, AHCCCS and VA.
The first visit to a patient is scheduled within the first 24 to 48 hours of their discharge from the facility where 24-hour care was provided. Banner Home Care services are available to residents living within a 50-mile radius of Payson.
The services are done in coordination with the patient’s physician. The services are based on a customized plan built by the patient, the home care team and the patient’s physician. The plan is tailored to the individual’s particular needs and their diagnosis. Home care services can be provided for up to 60 days.
With Banner Home Care, a patient can have services from an RN, a physical therapist, an occupational therapist, a home health assistant or telemonitoring or from a combination of professionals. These professionals can provide, as needed, wound care, IV management, pain and medication management, education on disease processes, education about a new diagnosis, and catheter care.
A patient working with either a physical therapist or occupational therapist can get a home exercise program for rehabilitation, strengthening, gait training, transferring techniques, mobility, prosthesis care and activities of daily living and personal care.
Telemonitoring is an additional service offered a patient on home care. It can monitor vitals, such as blood pressure, pulse and weight; allow the patient to input their temperature and glucose count. The patient and their care team can also keep track of medications and even program an audio reminder for taking the medications. Additionally activity can be checked when the patient enters therapy time or activity. The system even lets the care team ask the patient how they’re feeling with two to three questions specific to the individual’s diagnosis. The information through the telemonitoring system is reviewed by a nurse daily and someone can call the patient to address any red flags and coordinate with providers for necessary interventions.
The goals of home care is to reduce hospitalization or re-hospitalization; provide additional monitoring for a patient after their discharge from the hospital; provide virtual visits through telemonitoring as well as in-home visits by the clinical team; bring care to the patient; increase education about health and the individual’s specific condition.
About 80 patients have been enrolled in Banner Home Care’s telemonitoring program, which started in June 2018, according the service’s representatives speaking to members of Banner High Country Seniors. Over a 30-day period only five were readmitted to 24-hour care; over a 60-day period there were just three readmissions. There were also seven emergency department visits over a 30-day period among those in the telemonitoring program.