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Care and the Comforts of Home
Home Healthcare Services Provide Seniors with a Better Quality of Life During Recovery.

by Cheryl M. Keyser + Photos by Jamie Turner

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Just as with everything from music to fashion and car design, Baby Boomers are beginning to leave their mark on healthcare. Their influence might signify a return to healthcare being brought to one’s home — except this time, instead of the doctor with his black bag, it is the nurse with a laptop computer.

Around 8:30 a.m. every Monday for more than a year, Dick and Jane Forrest of Hagerstown have received a phone call from a nurse with the Home Health Care department of Washington County Hospital. “She tells me what time she is coming to the house,” explains Dick, caregiver for his wife, who has an inoperable brain tumor. “She takes my wife’s vital signs, examines her legs to ensure there are no blood clots, and draws blood, which goes directly to a lab.” The sample is analyzed and the results phoned into Jane’s oncologist.

Twice a week a nursing assistant visits the couple to help Jane with her bath. This requires a gentle touch as the medications Jane takes leave her skin thin and sensitive. A therapist also worked with Jane until she met the goals of the program. She was given a set of exercises that she continues to do faithfully. Dick is thrilled with the care his wife of 56 years receives. “A few months ago, I stopped by the home health office just off the Dual Highway to thank them in person for being one hell of a bunch of professionals.”

From Hospital to Home
Home healthcare is one of the fastest growing segments of the health industry; in the last decade it has jumped by 14 percent in Washington County according to Home Health Care Director Elise Culler, and Frederick Memorial Hospital’s Home Health services has experienced an 11-percent growth in the last year alone. Approximately eight million Americans require some type of in-home medical care, according to the American Association for Home Care (AAHC). And demand for these services will grow as new Medicare rules take effect in January 2010. Then Medicare will change its hospital reimbursement for three diagnoses — congestive heart failure (CHF), pneumonia and myocardial infarction (MI) — paying for the first episode of any of these three illnesses. If the patient is re-admitted within 30 days for any of these illnesses, however, hospitals will have to absorb the cost. “What home health agencies like ours are saying to hospitals is that we will work with [patients] over that 30-day period to make sure there is no need for the patient to be re-hospitalized,” says Elise. FMH Home Health Services is developing specific disease management programs, according to Community Services Liaison Jane Kinney. “We look at these as a way to decrease hospitalizations or readmissions.”

Also contributing to the growing home healthcare trend is the fact that, as AAHC points out, “virtually any medical procedure short of surgery can be performed in a patient’s home.” Regional home healthcare agencies like Home Health Care, Lutheran Home Care & Hospice — which serves areas in southern Pennsylvania and Western Maryland — and Frederick Memorial Hospital’s Home Health provide short-term, in-home skilled nursing care ranging from home infusion and oxygen therapy, to wound and catheter care, IV monitoring, venipuncture, physical, occupational and speech therapy and medical education. “We have registered nurses, licensed practical nurses, certified home health aides, non-certified homemakers, physical, occupational and speech therapists, social workers and dieticians,” says Elise.

Lutheran Home Care incorporates technology to its programs by giving patients a monitor about the size of a clock radio to take vital signs. This information is then transmitted via telephone to the home care office. “A nurse reviews this daily,” says Melanie Furlong, director of community relations for Lutheran Home Care. “It gives clients a sense of security and the audio system walks patients through the necessary steps. It will even tell them when to call their doctor.” And FMH Home Health offers Lifeline service — a device worn by an individual that provides direct access to help with the push of a button. “Medicare does not pay for Lifeline,” says Jane, “but we are looking at ways to cover the cost for high-risk patients who live alone”

An Array of Vital Services
Medical plans cover many home healthcare services, and organizations like Home Health Care and Lutheran Home Services will help patients determine coverage and work with them on non-covered costs. “We need an order from the doctor,” says Melanie, “however, if someone needs us they can call and we will arrange that.” The organization also does individual assessments to determine the type of care needed. “Most people call us because they don’t know what they need,” Melanie says. “Our admissions people spend a lot of time listening as people tell their stories, and then staff makes recommendations for help.”

In addition to skilled in-home medical care, many organizations offer home care services such as bathing or dressing, companionship and maybe light housework and meal preparation for patients who need additional help with everyday activities. Medicare Part A pays for 100 “medically necessary” home health visits after a hospital stay. Both Lutheran Home Care and Home Health Care provide non-medical services. In Hagerstown, the Care at Home program includes personal care. “However,” notes Elise, “as this is a non-skilled program, it is not covered by Medicare.”

Lutheran Home Care operates a similar non-medical service in Franklin County: Living Independence For the Elderly. Known as LIFE, the program provides transportation to its center on Fifth Avenue in Chambersburg where an interdisciplinary medical staff offers services including foot, eye, hearing and dental care. The center provides hot meals, activities, in-home care and even laundry. “LIFE provides a better quality of life for participants and helps avoid a drain on the health system,” adds Melanie.

Enhancing Quality of Life
For patients and their families, it is the overall increased quality of life that draws them to home healthcare. “No one wants to be in a hospital or where other people are in a similar or worse situation,” said Cynthia Eberhart, physical therapist with Lutheran Health Care. Being at home, outside the hospital or nursing home environment, can also help patients recover. “In a home environment, a patient can rest easier and do what they want within their own time frame,” says Cynthia. “From a caregiving standpoint, it helps us see what they have to deal with every day and we can figure out ways to help them continue their normal activities.”

Receiving home healthcare is the preference of 80-year-old George Schamel of Boonsboro, who has used home health services four different times over the past few years. Home Health Care provides twice a week therapy and bathing. “The best part is that the nurses are there when you need them, and they are very accommodating,” he says. Though his latest bout of illness required a five-week nursing home stay, George emphasizes, “It’s nicer to be in one’s own home.”

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Selecting Service
Follow These Tips when Choosing Home Healthcare

Elise Culler of Washington County Hospital’s Home Health Care department offers these tips for selecting a home healthcare provider:

• Look for a state licensed agency, accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and certified by Medicare and Medicaid
• Check that the staff is certified in CPR
• Consider the number of visits the staff makes each day
• Match the agency’s healthcare specialties with your needs
• Review references and criminal background checks of staff
• Ask for a written financial estimate before service begins
• Review the agency on the Medicare website. Visit www.medicare.gov and click on Home Health Compare.

To contact Home Health Care in Hagerstown, call 301-766-7800 or check the website at www.washingtoncountyhospital.com. For Lutheran Home Care Services, call 717-264-8178 or visit www.lutheranhomecare.org. To learn more about Frederick Memorial Hospital’s Home Health program, call 240-566-3222 or visit www.fmh.org.