Your sister calls you to inform you that your father, who is in the hospital for treatment of his heart failure symptoms and to patch him up after a fall at home, is coming back to his home. This is great news! However, neither you or Sis live in the same state as Dad and neither of you will be there for his arrival back home. You are both worried about your Dad and wonder if he will be okay by himself.
Dad’s doctor has referred him to home health care to see if they can help improve some of his heart failure symptoms and to change dressings on his wound on his arm from his fall that was stitched up at the hospital. The case manager at the hospital needs to know which home health company you want to use to care for Dad at home.
Getting Ready to Make the Right Choices
Here are some pointers to help you out, ensure that Dad gets the care that he needs and is safe at home, and to relieve some of the stress that you and Sis are feeling.
- By Medicare regulations, you must be given choices in home health providers that you will choose from.
- The selection is YOUR choice, not the doctor’s and not the case manager’s.
- The list of home health providers can be lengthy, so ask the case manager for a manageable number of agencies to consider who are best equipped to meet Dad’s unique needs, say 3-5 choices.
- Set aside a block of time to interview these home health agency choices (more to come on this!) and tell the case manager what times you have available to interview.
- Dad will have a list of needs in his recovery at home, make a list of those needs. For example.
- Wound care
- Dyspnea (shortness of breath or breathlessness) is a common symptom of heart failure, this needs improvement
- Edema (fluid build-up in his extremities (usually around the ankles, feet, lower leg) causes swelling, so Dad’s shoes may be tight and uncomfortable and his joints stiff, so this needs improvement too.
- Why did Dad fall? This needs to be addressed too.
- What about all of the medications that Dad is on? And now he has new prescriptions. This needs to be addressed also.
- What if Dad falls again and this time no one can help him. We need an answer to this need too.
- Based off of Dad’s needs, you and Sis need to get together and create a list of questions to ask your home health agency choices, so you can make apples to apples comparisons and choice the right agency for Dad.
- You can compare the outcomes of the home health agencies that you have been provided by going to Medicare’s Home Health Compare Website.
- The comparisons may give you additional questions to ask the agencies about their care and outcomes!
A List of Possible Interview Questions
You have your list of Dad’s needs, now make a list of questions to ask each home health agency representative, usually a nurse. Here are some questions you might ask of them.
- Dad has bruises and stitches. How will you manage his recovery? How often will you visit dad to change his dressings?
- Tell me about the nurse who will be tending to Dad’s wounds and his skilled nursing needs. How long have they worked for your agency?
- Dad suffers with shortness of breath with minimal exertion. What specifically will your agency do to help improve Dad’s breathing? How often will you address this symptom?
- Specifically, how will you treat Dad’s edema?
- Dad fell at home and we are concerned about his safety, what will your agency do to be sure that he is safe when you are not there? What will you do to make sure he won’t fall again?
- Tell me about your physical therapist that be visiting Dad. Are they full time therapists dealing largely with seniors?
- Tell me about your occupational therapist that will be helping Dad. Are they full time therapists dealing largely with seniors?
- We know Dad has quite a few prescriptions already and now he has new prescriptions from the hospital stay, what will you do to make sure Dad is only taking what he needs and taking those drugs at the right time?
- Dad may need some extra assistance now that he is all banged up and his heart failure symptoms seem to be worsening, what options do you offer around having someone there for certain times of the day to help with personal hygiene or preparing some light meals for him and to keep an eye on him when he is not receiving care?
- If Dad has some quirks, ask how the agency will deal with those too!
By asking each agency representative the same questions, you can make a good comparison and choose the agency that best meets the needs of your father and is most likely to give him the care that he needs to regain his independence.
Why All of the Fuss?
There can be large differences in care between home health agencies and similarly large differences in quality outcomes for their patients and most importantly for Dad. Investing this time up-front, can save you much time and grief on the back end by avoiding agencies that are not the best fit for your Dad’s unique needs.
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