This article has been written by Sonali Choudhury pursuing a Diploma in Content Marketing and Strategy from Skill Arbitrage.

This article has been edited and published by Shashwat Kaushik.

Introduction

Home and health are the two most precious assets one can possess in life. As much as we treasure and build our homes to give us comfort, rest and security, we should also treasure and take care of our health in order to feel healthy and fit. It is only then that we will be able to enjoy the gifts and possessions this life has to offer. An unhealthy body and mind will only rob us of the little and big pleasures that one can enjoy. Having said that, we should not rule out the fact that the human body can fall prey to unexpected internal and external attacks that take a toll on the patient and their loved ones. Very recently, I lost my father to serious health complications. He was hospitalised for 2 weeks after a massive heart attack and then he was under home care for a month, after which we lost him after his second stint in the hospital for a few days. This is when we understood the significance of home healthcare and nursing services and how this area needs serious attention from the government and/or the healthcare sector/ministry in our country.

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What is home healthcare

Home healthcare and nursing are the services and care that can be given to a patient at home. It can be for any illness or injury in the comfort of your home. It is less expensive and also more convenient, as it aims to provide all kinds of services at home, starting from doctor consultations to providing medications and other skilled facilities that one can only get in hospitals. For example,  my father was at home for a month after getting released from the hospital with a massive cardiac arrest, which led to many of his organs not functioning optimally. He was put on a catheter as his bladder was not functioning properly due to poor blood circulation. So we needed regular help from an expert nurse who would visit only when he was free from duty to come over and address issues leading to leakage, bleeding, infections, cleaning and disinfecting, etc. A doctor would also visit once a week, depending on his free time, to check on his vitals and get other updates on his well being. There would also be blood and urine tests done on a regular basis. So there was a lot of coordination that the family members needed to undertake in order to ensure that the patient was getting the right and timely treatment and attention.

Who all need care at home

So there are many aspects to providing home healthcare and nursing services to patients at home.

Kind and intensity of illness

The intensity and kind of the illness is important to understand the services required for home healthcare and nursing. In case of a patient recovering from an injury or a surgery, the patient will need assistance and care with regular dressing, bathing, movement and physiotherapy, medication, etc. 

However, a person with a critical illness or a chronic illness may need more assistance. It may be that the patient is bedridden or has restricted movement. So besides timely medication, that person may need assistance with sponging, eating with help, timely checking of vitals, cleaning after urination and/or defecation, ensuring that there are no bedsores formed, turning their sides from time to time, etc.

Age of the patient

The age of the patient is very important to understand the kind of healthcare and nursing services that have to be offered. In the case of a child, a lot of attention is required to be given, as they are very sensitive and scared when in pain or experiencing any discomfort. So besides the parents, the healthcare provider or nurse has to be very intuitive and establish trust with children in order to be able to administer any medication. This is also true for the elderly or geriatric people who need constant assistance for medical or age related issues. In addition, they also need constant supervision and a companion to communicate with for their emotional well being.

Country or region

In India, these services need to go a long way in order to be professionally delivered. Trained nurses in India mostly move out of the country in order to earn more. The rest are absorbed by public and private hospitals and nursing homes. They work in 12 hour shifts, which leaves them with hardly any time or energy to take up care services for home patients. India is also juggling with a shortage of these nurses and many issues like low skills, a lack of empathy, mistreatment and much more. Therefore, people are left with no option but to employ medically untrained nurses from remote areas with no or very basic skills (sponging, cleaning soiled patients, washing and cleaning the patients belongings). They also lack empathy towards the patients, as they find it to be a monotonous job. They are not educated enough to have meaningful conversations with patients.

Overall benefits of home care and nursing services

Working members and other members taking care of household chores and other family activities can get a sigh of relief when there are skilled people to take care of the patients. Sometimes the process of recovery is a time-consuming process and it becomes a tough exercise for any one or other family members to juggle between the caregiving activities for patients and other family responsibilities, along with jobs as well.

Sometimes the care is so complex and critical that it is not possible and also not advisable for a non medical practitioner, like a family member, to administer such care. For example Care for diseases and conditions such as Traumatic brain injury, Spinal cord injuries, Ventilator care, Monitoring vital signs, administering intravenous medications, osteomy/gastrostomy care, feeding tube care, catheter care, etc.

When it comes to home healthcare for differently abled individuals and/or elderly individuals, it definitely requires a long term arrangement where either a family member takes up the entire responsibility, which is not a very feasible option in nuclear families, or the best option is to hire services from healthcare professionals categorised under personal care and companionship services. The services include assistance with self-care, such as grooming, bathing, dressing, and using the toilet; enabling safety at home by assisting with ambulation and transfers (e.g., from bed to wheelchair, wheelchair to toilet); and fall prevention. Assistance with meal planning and preparation, light housekeeping, laundry, errands, medication reminders, and escorting to appointments Companionship and engaging in hobbies and activities, Supervision for someone with dementia or Alzheimer’s disease

Home healthcare services also include providing occupational therapies, physiotherapies, speech therapies, etc., which are long term treatments and can be easily done at home.

Conclusion

To conclude, I would like to emphasise the fact that India has a long way to go to be able to provide the best home healthcare services. My personal experience is that home healthcare and nursing services are still in their nascent stages. There are very few hospitals that are initiating such services. We had the privilege to avail such services during my father’s illness, but there is so much to improve in terms of professionalism, accountability, coordination, lack of expertise, lack of empathy, etc . Although we have the advantage of a huge population, a lack of knowledge and expertise is one of the key reasons that people are not able to perceive home healthcare and nursing services as a rising and prospering industry.

On the other hand, Western economies have already been working and developing home healthcare and nursing services by decentralising these departments and engaging local municipal bodies to provide effective and better healthcare services to patients with the aim of helping patients recover, become more independent and self-sufficient and, above all, bring stability and avoid any further deterioration in conditions. Also, depending on the kind of care needed, they have been providing customised care to patients. Western countries have a very holistic approach when it comes to providing healthcare services at home. They have been involving community services at local levels to identify patients and individuals who are alone and need someone to take care of them at home. The goal has been to give less stress to family members of patients and elderly people and increase quality of life in a holistic way. There are proper processes in place for providing awareness and facilitating their homecare and nursing services. Living an independent life is what everyone strives to achieve in western countries, and ensuring this life for all is what the homecare and nursing services aim to provide.

References

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