The VNA Gave Dad Medical Support at Home After His Hospital Stay.
Organizations with the title ”Visiting Nurse Association” (VNA) are one of many nonprofit, mission-based Medicare certified home health agencies that provide physician-prescribed medical services, along with home care and caregiver assistance services. (Jump to Lessons Learned)
There is no singular “Visiting Nurse Association”. In fact, nonprofit agencies that follow the same general model may not call themselves VNA or Visiting Nurse Association.
Medicare requires that patients have a choice in which home health agency they use for services. Being able to specify the exact agency is key if there is one in particular you want to use. Otherwise, simply saying “VNA” may result in an agency that is other than the one you had in mind.
Home heath agencies like the VNA, are county based and offer the same Home Health Care and Rehabilitation services. Services that are consistent across Medicare certified home health agencies include:
- Skilled Nursing
- Physical Therapy
- Occupational Therapy
- Social Work
The differences between home health agencies are found in service offerings like Hospice, Adult Day Club/Care facilities, and Respite programs for caregivers. Program such as these may have qualifying income limits and require a medical waiver. Many are publicly funded through block grants.
Examples of Home Health Agency Programs:
Chronic Disease Care Management Programs – Dad’s stay in the hospital was the “event” that kicked off our participation in this program.
The focus of Chronic Disease Care Management Program is on patient well-being, quality of life and working to keep the patient from another hospital stay. This program is designed for individuals 60 and older who have been diagnosed with Diabetes, Congestive Heart Failure or Chronic Obstructive Pulmonary Disease. Or, those who have been classified as “at risk” for these diseases. Along with education, this program provides: Registered Nurse assessment, visits and case management; medication management, nutritional counseling, physical therapy at home, Telehealth monitoring as appropriate, and social worker evaluation to name just some of the services available.
Telehealth Monitoring – Dad participated in this program after his hospital stay and it brought some peace of mind knowing how closely he was being monitored. The goal is early detection and monitoring of conditions in order to prevent or reduce the need for emergency medical visits or hospitalization.
Telehealth monitoring starts with bringing a unit into your home. Every morning at the same time, it obtains patient blood pressure, pulse, glucose level, oxygen saturation and weight. In addition, the unit asks questions related to management of your symptoms – in dad’s case Congestive Heart Failure (CHF). The gathered data is transmitted over a phone line to the home health agency office where a specially trained nurse reviews the data and contacts you and your doctor if there is a concern. Monitoring CHF is closely tied to weight gain (water retention). Since it records your weight and oxygen saturation levels each day, weight gains of two pounds or more, or low oxygen levels, are picked up immediately and can be acted upon. We woke up each day to the Telehealth monitor announcing it was time to take measurements – the announcement a comfort and not a bother.
Respite Care Giver
In New Jersey, this service has been in place since the mid-80’s, offering respite care to non-paid family caregivers. Every county in New Jersey has a grant for Respite programs, but the sponsoring agency will be different. Caregivers do not have to be live-in to qualify, but it must be non-paid, done on a routine basis and there are income limits. Respite options are flexible in design to ensure it meets family needs. (e.g. a set number of hours or days a week; social or medical day care; coverage during work; vacation coverage.) For details on a program and who qualifies, contact your county Office on Aging. They will help you identify the organization that runs your county respite program.
Adult Day Club/Care Programs
These programs offer a home away from home for seniors that need companionship, and caregivers an opportunity for respite. Different recreational activities including music, art and pet therapy are structured and offered on a weekly schedule. The set schedule can help you decide which days to participate. In addition, these programs offer nutritious meals and snacks, and services such as health monitoring, maintenance and medication assistance. Adult day club / care programs can serve as transitional care and support following a hospital or nursing home discharge.
- If you come to home health services as we did after a hospital stay “e.g. event”, the discharge planner is the individual that puts the agency in contact with you. There may be multiple home health agencies that service the county you live in, so the discharge planner should give you a choice. Since services offered by home health agencies may differ, you will want to research them before you make a selection.
- Difference between Physical and Occupational Therapy
- Physical Therapy – is the physical rehabilitation of people recovering from injury or disease. The goal is to restore mobility and to teach patients how to prevent or manage their condition so that they can attain long-term health benefits. (Source: Occupational Therapy vs. Physical Therapy)
- Occupational Therapy – also considers the physical aspects of rehabilitation and motion, but is focused primarily on enabling the patient to engage in meaningful activities of daily life through therapeutic adaptations and modifications to their environments. Simply said, Occupational Therapy helps you in those all-important “Activities of Daily Living”- the ADL’s that are measured when qualifying for home health care and financial help.
NOTE: Thank you to the VNA of Somerset Hills for allowing me to speak with the managers of their Respite Care program, Adult Day club, telehealth program, and media relations. www.visitingnurse.org
Disclaimer: The material in this blog is for educational purposes only. It is not intended to replace, nor does it replace, consulting with a physician, lawyer, accountant, financial planner or other qualified professional.