1. 1. Explain the purpose of and need for home health care
Home health care exists because
Hospitals discharge earlier and patients still need care.
Patients need short-term care, which is less expensive in the home.

2. 1. Explain the purpose of and need for home health care
Home health care may be required because
Caregivers in the family now work.
Most people prefer care at home.
Longer lives increase chronic illnesses and need for care.
Medical advances mean people with chronic illnesses live longer and require more care.
Disabled people are more comfortable at home.

3. Define the following term:
Home health agencies
businesses that provide health care and personal services in the home.

4. 2. Describe a typical home health agency
Possible sources of referral to home care agency include the following:
Client’s doctor
Hospital discharge planner
Social services agency
State or local department of public health
Welfare office
Local agency on aging
Senior center
Client himself or family member

5. 2. Describe a typical home health agency
Home health agencies commonly provide the following services:
Physical, occupational, speech therapy
Medical-surgical nursing care
Intravenous infusion therapy
Maternal, pediatric, and newborn nursing care
Nutrition therapy/dietary counseling
Medical social work
Personal care
Homemaker/companion services
Medical equipment rental and service
Pharmacy services
Hospice services

6. Transparency 24-1: Home Health Agency Organization Chart

7. 3. Explain how working for a home health agency is different from working in other types of facilities
The following aspects of working in the home will differ from working in other settings:
You may provide housekeeping help
There is generally more family contact
More independence for the aide
Communication skills are essential
You are responsible for transportation to clients’ homes

8. 3. Explain how working for a home health agency is different from working in other types of facilities
Differences when working in the client’s home (cont’d.):
You need to be aware of safety issues
Every client’s home is different and you will need to be flexible
The working environment of a home is different from a facility
You must remember you are a guest in the client’s home
The client will be more comfortable in his or her own home than in a facility

9. 4. Discuss the client care plan and explain how team members contribute to the care plan
REMEMBER:
Each client care plan is different.
Activities not listed on the care plan should not be performed.

10. 4. Discuss the client care plan and explain how team members contribute to the care plan
The following factors are considered in formulating a care plan:
Client’s health and physical condition
Diagnosis and treatment
Goals or expectations
Whether other services and resources, such as transportation, equipment, and additional income are needed

11. 4. Discuss the client care plan and explain how team members contribute to the care plan
REMEMBER:
Input from the HHA is essential to the care planning process. The HHA can inform her supervisor if special equipment is needed or if care plan assignments would put the HHA or the client at risk of injury.

12. Transparency 24-2: Care Planning Process

13. 5. Describe the role of the home health aide and explain typical tasks performed
HHAs provide services to their clients by
Providing personal care or assisting with self-care
Reinforcing teachings of other team members
Promoting behavior that improves health, such as diet and exercise
Maintaining a safe, secure, and comfortable home life for clients and their families

14. 5. Describe the role of the home health aide and explain typical tasks performed
The following tasks may be included in a client’s care plan:
Bathing
Dressing
Grooming
Toileting
Assisting with ROM exercises, ambulation
Transferring from bed to chair or wheelchair
Measuring vital signs
Feeding
Reminding client about medications

15. 5. Describe the role of the home health aide and explain typical tasks performed
The following tasks may be included in a client’s care plan (cont’d.):
Giving skin care
Using medical supplies and equipment, such as walkers and wheelchairs
Changing simple dressings
Making and changing beds
Light cleaning, including dusting, vacuuming, washing dishes
Teaching home management

16. 5. Describe the role of the home health aide and explain typical tasks performed
REMEMBER:
HHAs are role models and can help promote clients’ independence.

17. 5. Describe the role of the home health aide and explain typical tasks performed
These tasks are outside an HHA’s scope of practice:
Administering medications
Inserting or removing tubes or objects in a client’s body (thermometer is an exception)
Honoring a request that is outside the scope of practice
Performing procedures that require sterile technique
Diagnosing or prescribing treatments/medications
Telling client or family diagnosis or medical treatment plan

18. 5. Describe the role of the home health aide and explain typical tasks performed
REMEMBER:
It is important to set and maintain boundaries in your relationships with clients and their families.
Be friendly, warm, and caring, but behave professionally and follow the agency’s rules and the care plan’s instructions.

19. Define the following terms:
Policy
a course of action that should be taken every time a certain situation occurs.
Procedure
a method, or way, of doing something.
Confidential
the legal and ethical principle of keeping information private.

20. 6. Explain common policies and procedures for home health aide
Home health agencies will have policies and procedures regarding the following areas:
Confidential information
Client’s care plan
Reporting to a supervisor
Personal problems
Dependability and punctuality
Following deadlines for paperwork
Delivery of care
Gifts from clients

21. 7. Demonstrate how to organize care assignments
Look at Fig on p. 413 of the textbook and think about these questions:
What is the value of making a list of tasks to be done?
How do you usually keep track of the tasks you need to complete in your daily life?

22. 8. Identify an employer’s responsibilities
It is an employer’s responsibility to
Provide a written job description.
Provide competency testing and skills evaluation before aides are sent to care for clients.
Provide initial training and continuing in-service training.
Provide appropriate and adequate preparation for each assignment.
Provide supervision.
Provide information about supervision.
Provide proper equipment and supplies for you to safely do your work.

23. 9. Identify the client’s rights in home health care
REMEMBER:
Home care clients have legal rights just as residents in long-term care do.

24. 9. Identify the client’s rights in home health care
Read the Client’s Bill of Rights on pp of the textbook and think about these questions:
What do these rights mean to HHAs?
How are they related to abuse?
What action should an HHA take if abuse is seen or suspected?

25. Chapter Exam
1. Which of the following reasons has led to an increase in the need for home care?
(A) People with chronic illnesses are living longer.
(B) There are fewer and fewer long-term care facilities.
(C) Home care is more expensive than care in a facility.
(D) Long-term care facilities do not want any new residents.
2. What happens after a doctor refers a patient to home health care and an agency has been chosen?
(A) The client checks into a LTC facility to be observed before home care begins.
(B) A home health aide visits to get to know the client and family.
(C) The home health agency arranges a welcome party for the client.
(D) The home health agency performs an assessment of the client’s needs.

26. Chapter Exam (cont’d.)
3. Which of the following best describes a difference between working as a home health aide and working in a long-term care facility?
(A) A home health aide has less independence.
(B) A home health aide has more independence.
(C) A home health aide does not have to worry about dealing with the client’s family.
(D) There is no difference between working as a home health aide and working in a facility.

27. Chapter Exam (cont’d.)
4. What is one of the challenges a home health aide might encounter in her work that would not be a problem in a facility?
(A) The home might not be organized in a way that makes caregiving easy.
(B) The clients will be in a familiar and comfortable setting.
(C) Clients’ homes are always messy.
(D) Family members will never be helpful.

28. Chapter Exam (cont’d.)
5. Which of the following statements is true of a home health aide’s responsibilities if a task is not listed in the care plan?
(A) The HHA should perform any task he thinks is best for the client.
(B) The HHA should consult other HHAs to see if they would perform the task.
(C) The HHA should not perform any task not listed on the care plan.
(D) The HHA should only perform the task if the client says she wants it performed.

29. Chapter Exam (cont’d.)
6. What is one reason an HHA’s observations are essential to the care plan?
(A) Observing a client is not a task that the HHA performs.
(B) The HHA can decide what medication to prescribe for the client’s current condition.
(C) The HHA can tell the nurse how and when to change the care plan.
(D) The HHA spends the most time with the client and can provide information nobody else will know.
7. Which of the following is a task an HHA typically performs?
(A) Changing a sterile dressing on an open wound
(B) Giving skin care
(C) Administering medication
(D) Prescribing treatments

30. Chapter Exam (cont’d.)
8. Which of the following tasks is outside the scope of practice for an HHA?
(A) Inserting tubes into a client’s body
(B) Giving a client a bath
(C) Helping a client eat dinner
(D) Transferring a client from bed to chair
9. Which of the following is a common policy or procedure at a home health agency?
(A) HHAs should discuss personal problems with clients.
(B) The HHA can choose whether or not to follow the care plan.
(C) HHAs do not give or receive gifts.
(D) HHAs can complete their paperwork whenever it’s convenient for them.

31. Chapter Exam (cont’d.)
10. Why is it a good idea to make a list of tasks to complete when you arrive at a client’s home?
(A) So you will have time to watch TV with the client later.
(B) Because you’ll have to leave things undone if you don’t finish everything before it’s time to leave.
(C) To make sure you finish all of your tasks and aren’t late for your next client.
(D) So you can decide which tasks you’d rather not do.
11. Which of the following is the responsibility of a home health agency as an employer?
(A) To only assign HHAs to work with pleasant clients
(B) To provide appropriate preparation for each assignment
(C) To guarantee that family members will never interfere with an HHA’s work
(D) To give HHAs company cars and cell phones

32. Chapter Exam (cont’d.)
12. Why do clients have the right to be involved in their own care planning?
(A) Because clients know better than doctors and nurses how to cure disease
(B) Because clients do not respect caregivers very much
(C) Because care planning is too complicated for the care team to do on their own.
(D) Because clients are more likely to continue treatment if they are involved in the planning