The Reform of Home Care Services in Ontario: Opportunity Lost or Lesson Learned?

2007 ◽  
Vol 74 (3) ◽  
pp. 208-216 ◽  
Author(s):  
Glen Randall

Background. With the release of the Romanow Commission report, Canadian governments are poised to consider the creation of a national home care program. If occupational and physical therapists are to have input in shaping such a program, they will need to learn from lost opportunities of the past. Purpose. This paper provides an overview of recent reforms to home care in Ontario with an emphasis on rehabilitation services. Method. Data were collected from documents and 28 key informant interviews with rehabilitation professionals. Results. Home care in Ontario has evolved in a piecemeal manner without rehabilitation professionals playing a prominent role in program design. Practice Implications. Rehabilitation services play a critical role in facilitating hospital discharges, minimizing readmissions, and improving the quality of peoples' lives. Canadians will benefit if occupational and physical therapists seize the unique opportunity before them to provide meaningful input into creating a national home care program.

2019 ◽  
Author(s):  
Yara Cardoso Silva ◽  
Kênia Lara Silva

Abstract Background: to analyze the process of development of the caregiver in a home care program, focusing on the attributes, feeling and needs of those individuals. Methods: regarding our method, we made use of a qualitative research, which has been carried out at the Home Care Service of Belo Horizonte. The data has been collected through interviews performed with all the 7 caregivers and 6 healthcare practitioners. All the info has been analyzed under the scope of the the discourse analysis research method. Results: the caregiver acts with his/her heart, he/she listens and looks very carefully and attentively. Care is characterized by an intense and permanent process of conflict between the duty due to the assingned functions and the moral desisre of taking care of other human beings. Those two dimensions can be expressed sometimes by affection, gratitude and solidarity, but, in other times, it is guided by duty, resulting in work overload and concerns that make the caregiver unique in his/her moral condition. Conclusion: the person in charge of being a caregiver finds himself/herself surrounded by feelings and responsibilities, in a heavy load of relationships that are shaped by the subjective and subjectfying experiences, which makes critical the implementation of supportive social networks to aid the caregivers. keywords: Caregiver; Home Care Services; Home Care.


2019 ◽  
Vol 10 (3) ◽  
Author(s):  
Daniel Vinícius Alves Silva ◽  
Júlia Rocha Do Carmo ◽  
Monique Évellin Alves Cruz ◽  
Carolina Amaral Oliveira Rodrigues ◽  
Edileuza Teixeira Santana ◽  
...  

Objetivo: caracterizar clínica e epidemiologicamente os pacientes atendidos por um programa público de atenção domiciliar na cidade de Montes Claros, Minas Gerais, Brasil. Métodos: Estudo transversal e exploratório, realizado entre junho de 2017 e janeiro de 2018, com 131 pacientes cadastrados e atendidos pelo Serviço de Atenção Domiciliar - Melhor em Casa. Para o levantamento dos dados utilizou-se um instrumento contendo variáveis sociodemográficas, clínicas e funcionais. Os dados foram analisados por estatística descritiva. Resultados: A maioria dos pacientes eram idosos (67,9%), do sexo feminino (55%), pardos (47,3%), casados (31,3%) e/ou solteiros (31,3%), restritos ao leito (71%) e alimentavam-se via oral (68,7%). As doenças vasculares (42%) foram as mais prevalentes, 45,8% dos pacientes apresentavam lesão por pressão e o atendimento domiciliar foi realizado principalmente pelo enfermeiro (83,2%) e médico (82,4%). Conclusão: A identificação do perfil clínico e epidemiológico é fundamental para planejar e implementar cuidados adequados às necessidades específicas dos pacientes.Descritores: Pacientes Domiciliares; Serviços de Assistência Domiciliar; Perfil de Saúde; Idoso.CLINICAL AND EPIDEMIOLOGICAL CHARACTERIZATION OF PATIENTS TREATED BY A PUBLIC HOME CARE PROGRAMObjective: to characterize clinically and epidemiologically the patients attended by a public home care program in the city of Montes Claros, Minas Gerais, Brazil. Methodology: A cross - sectional and exploratory study was carried out between June 2017 and January 2018, with 131 patients enrolled and attended by the Home Care Service - Better at Home. Data were collected using an instrument containing sociodemographic, clinical and functional variables and were analyzed by descriptive statistics. Results: The majority of the patients were elderly (67.9%), female (55%), brown (47.3%), married (31.3%) and / or unmarried to bed (71%) and were fed orally (68.7%). Vascular diseases (42%) were the most prevalent, 45.8% of the patients had pressure lesions, and home care was performed mainly by the nurse (83.2%) and the physician (82.4%). Conclusion: The characterization of the profile, besides describing problems, contributes to patient care, impacting on the planning and implementation of appropriate interventions.Descriptors: Homebound Persons; Home Care Services; Health Profile; Aged.CARACTERIZACIÓN CLÍNICA Y EPIDEMIOLÓGICA DE PACIENTES ATENDIDOS POR UN PROGRAMA PÚBLICO DE ATENCIÓN DOMICILIARIAObjetivo: caracterizar clínica y epidemiológicamente a los pacientes atendidos por un programa público de atención domiciliaria en la ciudad de Montes Claros, Minas Gerais, Brasil. Metodología: Estudio transversal y exploratorio, realizado entre junio de 2017 y enero de 2018, con 131 pacientes catastrados y atendidos por el Servicio de Atención Domiciliar - Mejor en Casa. Para el levantamiento de los datos se utilizó un instrumento que contenía variables sociodemográficas, clínicas y funcionales, analizados por estadística descriptiva. Resultados: La mayoría de los pacientes eran ancianos (67,9%), del sexo femenino (55%), pardos (47,3%), casados (31,3%) y / o solteros (31,3%), restringidos al lecho (71%) y se alimentaban vía oral (68,7%). Las enfermedades vasculares (42%) fueron las más prevalentes, el 45,8% de los pacientes presentaban lesión por presión y la atención domiciliaria fue realizada principalmente por el enfermero (83,2%) y médico (82,4%). Conclusión: La caracterización del perfil, además de describir problemas, contribuye al cuidado del paciente, impactando en la planificación e implementación de intervenciones adecuadas.Descriptores: Personas Imposibilitadas; Servicios de Atención de Salud a Domicilio; Anciano.


Author(s):  
Chien-Yi Wu ◽  
Yu-Hsuan Wu ◽  
Yi-Hui Chang ◽  
Min-Shiow Tsay ◽  
Hung-Cheng Chen ◽  
...  

Hospitals have played a leading role in providing palliative care in Taiwan as its care model has developed over the past few decades. However, earlier local studies in Taiwan showed that terminal patients prefer to die at home, highlighting the need to promote community-based palliative care instead of hospital-based care. Along with this shift, how community nurses provide palliative home care merits further exploration. This qualitative descriptive study aims to understand (1) how community nurses implement community-based palliative care, (2) what preparations are needed, and (3) what challenges they may face. Purposive sampling was used for recruiting nurses. We conducted one-on-one, in-depth, semi-structured interviews. Interview recordings were transcribed verbatim and analyzed using thematic analysis. Eight community nurses with a range of experience in palliative home care were interviewed. Four major themes emerged: (1) Opportunities, (2) Qualifications, (3) Support, and (4) Commitments. Psychological preparedness, well-developed professional capabilities, external assistance, and peer support motivate community nurses to offer community-based palliative care. As the requests for palliative home care services increase, community nurses play a critical role in palliative home care. Although the sample size is small and the findings retrieved from a small number of experiences might not be generalized to every region, the study results could inform future experience-sharing and workshop sessions to train more nurses for community-based care, expanding service coverage, and providing optimal palliative care.


2018 ◽  
Vol 23 (4) ◽  
pp. 440
Author(s):  
Janno Sinaga ◽  
Amila Amila ◽  
Evarina Sembiring

AbstrakTujuan jangka panjang pelaksanaan program Mutiara Home Care adalah menciptakan akses bagi terciptanya wirausaha baru, menunjang otonomi kampus perguruan tinggi melalui perolehan pendapatan mandiri. Bagi pasien program ini membantu meringankan biaya rawat inap yang makin mahal, karena mengurangi biaya akomodasi pasien, transportasi dan konsumsi keluarga. Dampak ekonomi nasional home care bagi pasien dan keluarga adalah semakin pendeknya hari rawat, sehingga jumlah klaim rumah sakit ke BPJS semakin rendah, sehingga berdampak bagi penurunan anggaran biaya perawatan masyarakat secara nasional. Produk Jasa Layanan Mutiara Home Care memiliki keunggulan dibandingkan home care lain. Pertama, Mutiara Home care akan dikelola dan diorganisir secara profesional oleh tenaga dosen profesional dibidang kesehatan dan keperawatan. Selama ini, home care dilakukan secara individu atau berkelompok tanpa wadah atau organisasi yang jelas. Tenaga kesehatan yang akan ditempatkan di komunitas atau di rumah telah terlatih dimulai sejak masa pendidikan dan tersertifikasi dari USM-Indonesia. Kedua, menyediakan layanan antar jemput pasien yang membutuhkan perawatan rumah sakit atau pemeriksaan khusus, seperti radiologi dan laboratorium. Layanan Mutiara Home Care pada tahap awal melayani pasien paska stroke dan perawatan lanjutan jantung, perawatan pasien DM dengan atau tanpa luka dan perawatan pasien lanjut usia. Secara bertahap akan dilakukan pengembangan serta layanan terhadap berbagai penyakit yang membutuhkan jasa perawatan profesional di rumah.Kata Kunci: Home care, MutiaraAbstractThe long-term goal of the Mutiara Home Care program is to create access to new entrepreneurs, to support college campus autonomy through the acquisition of independent income. For patients this program helps alleviate the cost of increasingly expensive hospitalization, as it reduces patient accommodation costs, transportation and family consumption. The national economic impact of home care for patients and families is the shortening of day care, so the number of hospital claims to BPJS is lower, thus impacting the reduction of national community maintenance budget. Products Care Services Pearl Home Care has advantages over other home care. First, Mutiara Home care will be managed and organized professionally by professional lecturers in the field of health and nursing. During this time, home care is done individually or in groups without a clear container or organization. Health workers who will be placed in the community or at home have been trained since the education and certified from USM-Indonesia. Secondly, it provides a shuttle service to patients who require hospital treatment or special examinations, such as radiology and laboratories. Pearl Home Care Services in the early stages of serving post-stroke patients and advanced heart care, treatment of DM patients with or without injuries and care of elderly patients. Gradually will be developed as well as services against various diseases that require professional care services at home.Keywords: Homecare, Mutiara


2019 ◽  
Vol 25 (3) ◽  
pp. 212-228
Author(s):  
Ma'mur Haswira ◽  
Wahidin Wahidin ◽  
Syarif Ahmad

Home care services at midnight many residents complained and there is no distribution of home care officers at the Bara-Baraya Public Health Center in Makassar. The focus of research in this study is the evaluation of the implementation of home care programs at the Bara-Baraya Public Health Center in Makassar City. This study aims to evaluate the implementation of home care programs at the Makassar City of Bara Baraya Health Center. The approach used in this study is a qualitative approach that describes and observes deeply the evaluation of the implementation of home care programs at the Makassar City of Bara Baraya Health Center. This research also uses applied research design. The data source in this study was taken from four home care officers at the Bara-Baraya Public Health Center in Makassar City and four people who use home care services. The results showed that the input sub-variables can be quite good. Medical devices such as thermometers, tensimeters, and stethoscopes function properly and are suitable for use in home care health services. Then operational funds such as staff salaries are paid according to the number of visits to the community. The doctor for Rp. 100,000 / visit and nurses 75,000 / visit. But in the aspect of home care officers is still inadequate. Home care workers have a dual role between serving the community at the puskesmas, as well as serving the community at the residence. In the process sub-variables, it can be quite good. In the call center aspect, people can easily call the call center because this service is toll free. Home visits and observations have been carried out carefully. But the division of duties of home care officers is not optimal. In the output sub-variable, it can be said to be good because the public can directly benefit from home care services.


2006 ◽  
Author(s):  
Janice D. Crist ◽  
Humberto Velazquez ◽  
Ian Durnan ◽  
Diana Ramirez Figueroa

2019 ◽  
Vol 8 (6) ◽  
pp. 823
Author(s):  
Hsiao-Fen Hsu ◽  
Chia-Chan Kao ◽  
Ti Lu ◽  
Jeremy C. Ying ◽  
Sheng-Yu Lee

The current study explored the differences in the effectiveness of first and second generation long-acting injections and orally administered antipsychotics in reducing the rehospitalization rate among patients with schizophrenia receiving home care services in a medical center in Southern Taiwan. Longitudinal data between 1 January 2006, and 31 December 2015, were collected retrospectively. Patients were classified into three treatment groups: First generation antipsychotic (FGA) long-acting injection (LAI), second generation antipsychotic long-acting injection (SGA) (LAI), and oral antipsychotics. The primary outcomes were the rehospitalization rate and the follow-up time (duration of receiving home care services) until psychiatric rehospitalization. A total of 78 patients with schizophrenia were recruited. The average observation time was about 40 months. The oral treatment group tended to be older with a higher number of female patients and a lower level of education. The FGA treatment group tended to have a higher frequency and duration of hospitalization before receiving home care services. We found no significant differences in the follow-up time or psychiatric rehospitalization rate after receiving home care services among the three treatment groups. We propose that oral and LAI antipsychotics were equally effective when patients received home care services. Our results can serve as a reference for the choice of treatment for patients with schizophrenia in a home care program.


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