I can see the obvious good sides of this kind of program: a familiar setting; fewer noises; less driving and parking for family; less chance of getting an infection (superbug!) from being in a...
I can see the obvious good sides of this kind of program: a familiar setting; fewer noises; less driving and parking for family; less chance of getting an infection (superbug!) from being in a hospital.
But a big question looms: What about the family? Are unpaid, untrained family caregivers ready to take on the responsibility of overseeing a critically ill person at home. [...]
What does being in a hospital actually entail, and is what they are offering a good match up?
twice-daily nurse visits
daily telemedicine sessions with a doctor
services like physical therapy or blood tests
[Tele] nurse
30 minutes for paramedica and nurses request
[Equipment like] Oxygen machines, drugs and infusions
Wi-Fi enabled pill box that dispensed painkillers and other meds
Frozen meals
mobile X-ray machine (and others, I assume)
What about a wheelchair and walker and handrails around the entire house and bed pan and beds that go up/down and incline? Help going up and down stairs? The overnight shift? Why are they being paid the same to offer barebones services?
Are the doctors in the hospitals getting the same amount of time to read the patients' chart and vitals as if they were in the ward, or is this just extra work they now have to also do in addition to a still full ward?
"CMS makes it very clear that during the hospital-at-home stay, hospitals are not to use family members, support persons, or caregivers to provide care that would otherwise fall to nurses or other hospital staff during an inpatient admission,"
I didn't see cleaning and laundry and lifting help listed. And all those people doing visits and delivery better be paid for their time and gas milage.
I think this is a great program.... IF they won't use it as a cost saving and load increasing and buck passing measure.
They're being paid the same but it's obvious that they're off loading a ton of care to the families without passing the money to them. I'm also very concerned about the "freed up hospital bed": are they leaving them empty so the doctors can provide same level of care to the at home person? Or are they simply going to fill it up with the next in line? Doctors and nurses are already super over worked: are they somehow magically going to find extra time to commute twice a day to how many patients, without cutting into their own rest time and add to their work load?
I'm just very deeply suspicious about hospital administration in general, I think .
Sounds like they have the same sorts of concerns that you do, and are working to make sure it doesn't shake out that way. Practically, if there's minimal expectation that something could go...
The Centers for Medicare & Medicaid, which oversees these programs, is considering adding rules to clarify caregivers' responsibilities. "CMS makes it very clear that during the hospital-at-home stay, hospitals are not to use family members, support persons, or caregivers to provide care that would otherwise fall to nurses or other hospital staff during an inpatient admission," said CMS chief medical officer Lee Fleisher in a statement provided to NPR. "Caregivers should have time to focus on a patient's emotional needs and overall well-being throughout the healing process."
Sounds like they have the same sorts of concerns that you do, and are working to make sure it doesn't shake out that way.
Practically, if there's minimal expectation that something could go drastically wrong any moment, I'd prefer to be ill at home and have nurses visit rather than having to be in a hospital all the time. Hospitals are full of sick people and they take away your pants.
And your dignity. Hospitals are no good place to be sick. Having been a caregiver for my mom in her last days, I honestly wish we would have never taken her for that last trip to the emergency...
And your dignity. Hospitals are no good place to be sick.
Having been a caregiver for my mom in her last days, I honestly wish we would have never taken her for that last trip to the emergency room. She never made it home and saying goodbye in an ICU was brutal.
It sounds like this is for low risk and stable patients, not hospice-with-doctors-and-drugs. But you're absolutely right that it sounds like pushing care onto the shoulders of family members. Some...
It sounds like this is for low risk and stable patients, not hospice-with-doctors-and-drugs.
But you're absolutely right that it sounds like pushing care onto the shoulders of family members.
Some of those hospitao tasks take two people together to lift the patient....home care givers won't have the ergonomic gear or training to do this without hurting themselves. And most of the time it's going to be the patient's same-aged elderly partner trying to do the literal heavy lifting. Most homes don't have the same shower facilities. Most homes don't have cabinets to keep a rotation of blankets warm 24/7, or the laundry capabilities to keep up with the bedding and soiled garments.
Most people have full time jobs so folks might be left alone at home for extended periods of time with zero help if they, say, fell or had a sudden event or even a toileting accident.
From experience, it's nearly impossible to lift a fallen adult with just one other untrained adult.
Family also doesn't come in shifts to cover 24 hours.
I can see the obvious good sides of this kind of program: a familiar setting; fewer noises; less driving and parking for family; less chance of getting an infection (superbug!) from being in a hospital.
What does being in a hospital actually entail, and is what they are offering a good match up?
What about a wheelchair and walker and handrails around the entire house and bed pan and beds that go up/down and incline? Help going up and down stairs? The overnight shift? Why are they being paid the same to offer barebones services?
Are the doctors in the hospitals getting the same amount of time to read the patients' chart and vitals as if they were in the ward, or is this just extra work they now have to also do in addition to a still full ward?
I didn't see cleaning and laundry and lifting help listed. And all those people doing visits and delivery better be paid for their time and gas milage.
I think this is a great program.... IF they won't use it as a cost saving and load increasing and buck passing measure.
They're being paid the same but it's obvious that they're off loading a ton of care to the families without passing the money to them. I'm also very concerned about the "freed up hospital bed": are they leaving them empty so the doctors can provide same level of care to the at home person? Or are they simply going to fill it up with the next in line? Doctors and nurses are already super over worked: are they somehow magically going to find extra time to commute twice a day to how many patients, without cutting into their own rest time and add to their work load?
I'm just very deeply suspicious about hospital administration in general, I think .
Sounds like they have the same sorts of concerns that you do, and are working to make sure it doesn't shake out that way.
Practically, if there's minimal expectation that something could go drastically wrong any moment, I'd prefer to be ill at home and have nurses visit rather than having to be in a hospital all the time. Hospitals are full of sick people and they take away your pants.
And your dignity. Hospitals are no good place to be sick.
Having been a caregiver for my mom in her last days, I honestly wish we would have never taken her for that last trip to the emergency room. She never made it home and saying goodbye in an ICU was brutal.
It sounds like this is for low risk and stable patients, not hospice-with-doctors-and-drugs.
But you're absolutely right that it sounds like pushing care onto the shoulders of family members.
Some of those hospitao tasks take two people together to lift the patient....home care givers won't have the ergonomic gear or training to do this without hurting themselves. And most of the time it's going to be the patient's same-aged elderly partner trying to do the literal heavy lifting. Most homes don't have the same shower facilities. Most homes don't have cabinets to keep a rotation of blankets warm 24/7, or the laundry capabilities to keep up with the bedding and soiled garments.
Most people have full time jobs so folks might be left alone at home for extended periods of time with zero help if they, say, fell or had a sudden event or even a toileting accident.
From experience, it's nearly impossible to lift a fallen adult with just one other untrained adult.
Family also doesn't come in shifts to cover 24 hours.