Who Needs Home Care?
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1. |
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Patients who need
transitional or
short term (three to
six month) care to
recuperate from a
bad fall, major
surgery (e.g. open
heart, neuro and
orthopaedic surgery)
or stroke.
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2. |
Patients who are
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battling a
debilitating disease
such as Parkinson’s
or dementia that
requires more
substantial and
ongoing care; and
/or frail,
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immobile or
bedridden due to
sickness or old age
and require long
term and ongoing
care.
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3. |
Patients who are suffering
from terminal diseases and
wish to spend the last days
of their lives at home
instead of the hospital or a
hospice. |
What is Required in Home Care?
There are three main areas of needs
to consider: Home Readiness,
Medical Treatment and Daily Care
Giving.
1. Home
Readiness
The home environment may require
some adjustments to receive the
patient back home. For example
a patient who is wheelchair bound
may not be able to enter the
bathroom easily. Or grab-bars
may need to be installed to help the
patient sit down or stand up from
the toilet seat. An
occupational therapist can help to
make an assessment and guide the
family.
In addition, depending on the need
of the patient, the family also
needs to purchase Home Care
Equipment, Accessories and
Consumables such as
– Wheelchair
– Commode
– Oxygen Concentrator
– Suction Pump
– Nebuliser
– Hospital Bed
– Mobility Aid such as Walking Frame
– Thickener for Transitional Feeding
– Feeding sets and Milk Feeds
– Diapers
– Bandages and Dressing materials
2. Medical
Treatment
A skilled nurse may be needed for
dressing wounds, dispensing
medications and monitoring vital
signs. Patients with a larger budget
may even opt to have full time
nursing care at home. Doctors
may visit to review patient progress
and monitor medication or other
treatment. Following a stroke,
a physical or speech therapist might
visit the home to help your parent
learn to walk or speak again.
Patients who are receiving
Palliative care may also need pain
management medication and
counselling (for emotional pain).
If your loved one returns to full
health e.g. transitional care
patients who have recovered, home
health might be no longer needed.
For those with chronic conditions,
such as Parkinson’s disease,
dementia or a debilitating stroke,
the home care would be on-going for
the long-term. This is because
the elder requires ongoing skilled
medical care. In some cases,
24-7 assistance and more complex
levels of care are required, and
therefore, a registered nurse
visiting the home is the best
option.
There may also be instances where
patients need to be re-admitted to
hospital due to some complications.
The Home Care medical team should
make the assessment for re-admission
and provide records to assist
hospitals in caring for the patient.
One downside to note about Home Care
in Singapore is the lack of
co-ordination between the different
medical workers, which can
compromise the care outcomes for
patients and lead to confusion for
families.
3. Daily
Care Giving
Patients generally need help in
activities of daily living e.g.
eating, bathing, changing, moving
around.
In Singapore, families may employ a
domestic helper to assist or provide
in the care giving for the patient.
With the right training and
attitude, the domestic helper can
really add value to the patient’s
Home Care experience. The
extent of training required depends
on the level of care required by the
Patient (e.g. how acute the
condition) and the domestic helper’s
own competency level.
The level of supervision available
at home also makes a difference.
Regular Nurse Visits can also
augment the supervision especially
if more complex procedures such as
changing a colostomy bag, suctioning
secretions from a tracheostomy tube
or monitoring a ventilator are
required. Access to 24X7
nursing helpline also gives the
helper and families the assurance
that help is at hand.
How Much Would Home Care Cost?
The costs is largely dependent on
Patient Condition e.g. how acute the
patient condition is and level of
care required. The more acute
and complex the needs, the more
medical team visits would be
required.
Having a competent domestic helper
would also certainly help to
complement the services of visiting
nurses, doctors and therapists.
You should always invest in good
caregiver training and monitoring
for your helper to ensure that she
is confident to carry out her
duties. Some families may
consider respite care where a care
assistant takes over the duty of the
caregiver for a few hours or days to
allow for rest or vacation.
You may also need some help in
care-ordination e.g. sourcing the
right equipment or scheduling of
appointments with the different
medical workers.
All said, your Budget would also
determine the level of care you can
afford. Rule of thumb is to
budget from $120 for each visit by a
Registered Nurse, $200 for an allied
health worker visit and $350 for a
doctor’s visit. Depending on the
qualifications, nurses can charge
between $220 to $450 per 12 hour
stay at patient’s home.
What are Some Benefits of Home Care?
The number one benefit of home
health care is that it allows
patients to receive personal care in
the privacy and comfort of their own
homes. For aging and homebound
patients, in-home care facilitates
them in remaining as functional and
independent as possible. This
gives them a higher sense of
security and dignity.
Receiving home health care helps to
reduce unavoidable readmissions to
the hospital, and studies have shown
that patients recuperating from
illness, injury, or surgical
procedures heal more quickly and
more successfully when recovering at
home instead of a medical facility.
Home Care
Benefits for Caregivers & Loved Ones
Home health care provides assistance
to family caregivers, allowing them
to get back to their lives and enjoy
more quality time with their
homebound loved ones. Families
that are unable to serve as primary
caregivers e.g. children who stay
outside Singapore have the benefit
of knowing that their loved ones are
receiving professional,
compassionate, and personalized care
in the convenience of their own
homes.
The primary benefits of home health
care include:
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Delivered in the comfort of
the patient’s home |
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Easier for family and
friends to visit |
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Promotes healing and
provides more safety from
infections |
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Allows more freedom and
independence |
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More affordable than
inpatient care |
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Tailored to the needs of
each individual patient |
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Reduces re-hospitalizations |
Is Home Care Suitable for Everyone?
Depending on the condition of the
patient and the level of care
available at home, Home Care may not
always be practicable. A
patient who requires very intensive
medical attention and sophisticated
equipment would not function well in
a home environment. On the
other hand, a fairly stable patient
with very limited mobility but no
family nor domestic helper as
caregiver at home, will have issues
with daily living. They may
fare better in a nursing home or
medical facility with the
appropriate support.