As a case manager, you do your best to help your members to live independently. As many as 28 percent of those eligible for home health care turn down these services. By refusing needed services, the odds of being readmitted to the hospital within 30 to 60 days can double.
Home health care can be an integral part of a discharge plan for those returning home from the hospital. Caring for a loved one after a hospital stay can be complicated and confusing for an untrained family member. Complications may arise, and readmissions can occur with inadequate care. Readmissions can lead to increased cost for patients and financial penalties for hospitals.
Some reasons why seniors refuse home care services include:
- Don’t feel help is needed
- Invasion of privacy
- Previous negative experience
- Do not know about available services
- Fear of the unknown
Others may look at in-home help as a sign of weakness and remind them of their frailty and loss of independence. Many do not realize they have limitations and could be at risk for a fall.
Types of Home Care Services
It is important to verify with the individual’s insurance plan to confirm which services may be covered. Below are the most common services:
In-Home Nursing and Therapy – Many private insurance plans will pay for some part of the cost of a registered nurse and licensed practical nurse when prescribed by a physician. Typical services they provide including monitoring medications. Some health plans may cover the services of respiratory, physical, speech and occupational therapists in the home.
Home Health Aides – Some policies cover the services of individuals who help with personal care like bathing, dressing, exercising, and eating.
Hospice Care – Coverage typically includes hospice care at home and in other settings. Pain and symptom management, social services, emotional, and spiritual support is available for those facing a terminal illness.
Check with Medicare to see which services are covered for individuals with original Medicare coverage.
Case managers can help to guide and encourage older adults to take advantage of the services available. Questions such as “tell me more” and “what are you concerned about” after a patient refuses services can lead to an open dialogue. Explaining to members that home health care services can increase independence and help them to take care of themselves better can be positive statements to seniors.
Malnutrition Risk
One common condition after hospital discharge is malnutrition. Recently discharged patients may have difficulty preparing nutritious meals at home. Busy caregivers may not know what meals are best for their loved ones.
Seniors who are malnourished face several risks:
- Increased risk of pressure ulcers
- Decreased wound healing
- Higher rates of infection
- More hospital readmissions and higher healthcare costs
Several health plans offer home-delivered meals to their members after a hospital stay. These meals can significantly impact both short-term recovery and long-term health of seniors. Weight loss and poor nutritional intake can delay the healing and recovery process, resulting in longer, more challenging recoveries.
In fact, according to a recent study, those who received home-delivered meals after hospitalization showed a reduction in emergency room visits and hospital readmissions.
To learn more about choosing a home-delivered meal provider, download our resource guide below.
