A Closer Look

House Calls: Providing Health Care in the Patient’s Home

The biggest growth of jobs in health care is projected to occur in the home health arena, which is a natural outgrowth of the trend to be proactive in managing chronic disease outside of acute care.

What types of jobs will experience this huge increase? Patricia Donehower, RN, retired vice president for Clinical Services at the Visiting Nurse Association of Chittenden and Grand Isle Counties (VNA) in Colchester, can list quite a number of them.

“There is a wide range of professions that provide service in home health, including registered nurse, licensed practical nurse, licensed nursing assistant, occupational therapist, physical therapist, speech therapist, social worker, personal care attendant, and nurse specialists such as wound care/incontinence nurse, psychiatry nurse, maternal-child nurse, and diabetes educator. In addition, there are specialized programs that function in the home, such as palliative care, hospice, and bereavement.”

“The benefits of working in home care are numerous,” says Pat. “You’re part of a team of people who enable recovery and/or adaptation to chronic illness in patients’ homes, and that’s a great feeling. You get to know the patients and their families because you see them over time and the rewards of developing a relationship with a patient are very substantial.”

Home health care also presents opportunities for using many skills, such as clinical decision-making, communication, patient assessment, and for registered nurses who guide and direct licensed practical nurses and licensed nursing assistants, management and team building skills. The challenges presented are in finding the patient’s home and establishing a relationship with new patients balanced by a degree of independence for workers to schedule their patient visits within the day, and a supportive work environment.

Typical employee benefits in home health care include car allowance reimbursements, cell telephone expenses, a pension and an investment savings program, says Pat. There are also tuition reimbursement funds available and in-house and external continuing education provided.

When asked how to know if home health care is the right setting for an employee, Pat suggests summer employment at an agency to get a closer look at the environment. Those interested in being a licensed nursing assistant can attend an LNA course, a job shadowing experience, and for other new employees, there is an extensive orientation program that is customized for each learner.

“Home health care allows you to truly understand the patient in their environment, and challenges you to call upon community agencies and resources who should be involved to help make the patient as independent and comfortable as possible,” Pat comments. “It is a health care setting where you can see the difference you make each and every day.”