HOME NURSING

AND CAREGIVING
 Home care helps people who need
acute, end-of-life, rehabilitation,
maintenance and long-term care to
remain independent at home. Home
care encourages and supports
assistance provided by the family
and/or community.
HOME NURSING
HOME NURSING

 Specialized
nursing care services in
the home health care settings.

 Visiting sick people at their home.

 Helpclients who are recovering after a
hospital stay to remain safely at home
and avoid unnecessary hospitalization.

a private institution providing

residential accommodations with
healthcare, especially for elderly
people.
What Is Home Health Nursing?

 Home health nurses provide one-on-

one care for patients in their homes.

 Patients who need home health

nursing may be elderly, disabled, or
terminally ill, but they may also be
recovering from an injury or accident
or living with a chronic disease.
 Some home health nurses also work with
pregnant women and new mothers to
provide ongoing care, education, and
support.
 may involve assisting patients with basic
needs such as bathing and dressing, as
well as more specialized services such as
wound care, medication management, and
IV therapy.
QUALIFICATIONS:
 The requisites of a good nurse are
good health, common sense, and
the power of improvising.
A nurse is called to work under
varied conditions.
The good nurse must be kind; but
firm
 Should
be sympathetic without being
emotional.

 Should at all times be cheerful , patient

and even tempered, remembering that
the possible irritability and fretfulness
of a patient is a part of his disease.
A home health nurse job description
may include any of the following:

 Make an initial health evaluation and

individualized plan of care
 Administer
medications and assist with
pain management
 Clean and dress wounds
 Document symptoms and vital signs
 Monitorpatient health and update care
plan accordingly
 Instruct
patients and their families on
proper home care
 Provide suggestions to improve safety at
home
 Detectearly symptoms that could lead to
a hospital visit
Supervise home health aides
Communicate with physicians,
social workers or other health
advisors
Provide encouragement and
support
Duties to her patient

The home nurse should do her best

for her patient under all
circumstances, and should do it
cheerfully. She should never worry
the patient by any discussion of her
own troubles, her lack of sleep, her
weariness, or anything of the sort.
She should shield the
patient from all domestic or
household worries, and
should keep away from the
patient everything that
might in any worry or disturb
him.
Duties to her doctor
 The home nurse should accept and carry out as
far as possible the doctor’s orders and wishes.
This point ca not be too greatly emphasized. If
you call in a doctor follow his directions
absolutely.
 Make a written notes of his directions concerning
food , medicine, stimulants, etc.. in order that
there may be no chance of your forgetting any
part of his directions. Make a written notes also
of anything important regarding the patient that
may happen between his visits.
 Never attempt of your own accord any
treatment of any sort without consulting
the doctor. Giving an enema has been
known to kill a patient, and there are
cases where giving so simple a medicines
as castor oil at the wrong time may result
fatally.
 The nurse should always have everything
in readiness for the doctor’s visit. She
should have the patient washed, the bed
made, and the room cleaned.
Duties to herself
 The nurse must try to keep up her general health,
and must keep herself in good mental condition.
The nurse’s health should be maintained:
1. By taking sufficient plain, good food regularly.
2. Byhaving sufficient sleep and rest, so far as is
possible. The nurse should have six or eight
hours sleep out of each twenty-four hours.
3. Bygetting into the fresh air daily, even if only for
a short time.
4. By wearing proper clothing
-the nurse must keep herself clean and
neat. Care of the teeth, hair, nails,
person and dress are all of the utmost
importance. There should be no
personal odor. A sick person is usually
more susceptible to odors than a well
person.
Dress
 The most important article of dress so far
as the nurse is concerned, are
comfortable shoes. Good feet are
absolutely essentials to the nurse, and
she cannot keep good feet without proper
shoes. The nurse’s dress should be
comfortable, loose enough to make lifting
the patient easy, and of washable
material, so it may always be clean and
fresh, and easily disinfected if necessary.
Types of Home Health Nursing
1.Gerontology- the scientific study of
old age, the process of aging, and the
particular problems of old people.
 Geriatrics-
relating to old people,
especially with regard to their
healthcare.
 Geriatriciananexpert in the branch
of medicine or social science dealing
with the health and care of old
people.
2.Pediatrics- the branch of medicine
dealing with children and their diseases.

 Pediatrician-a medical practitioner

specializing in children and their
diseases.
3.Community/public health -the health of
the population as a whole, especially as
the subject of government regulation and
support.

 "chlorine
has been used to disinfect
water supplies to protect public health"
 the
branch of medicine dealing with public
health, including hygiene, epidemiology,
and disease prevention.

 "these diseases are of great interest in the

field of public health"
4.Psychiatric/mental health- relating to
mental illness or its treatment.
"a psychiatric disorder”

Psychiatrist- a medical practitioner

specializing in the diagnosis and treatment
of mental illness.
5.Medical/surgical- practice primarily on
hospital units and care for adult patients
who are acutely ill with a wide variety
of medical issues or are recovering
from surgery.
 Home healthcare can also result in greater
patient satisfaction and encourage people to
comply more readily with treatments,
helping to improve overall health outcomes.
CAREGIVING
What is Caregiving?
Caregiving- is providing care for the
physical and emotional needs of a
family member or a friend at home.
Caregiving may involve:
 assisting
with meals, personal care and
transportation

 helping with medical procedures and

therapy

 devoting
just a few hours weekly or
many hours each day
What should I learn to become a
Caregiver?
 Physically – The proper lifting and
transferring techniques and equipment can
make some of your tasks easier.
 Mentally – Giving care demands a lot of
thought. Learning to plan ahead and use
your time is very important and vital to your
well-being.
 Emotionally– Caregivers can easily feel
isolated and frustrated. Understanding the
challenges of caregiving is the first step in
meeting them.
The Many Roles of the Caregiver
 Caregivers can be spouses, partners, adult
children, parents, other relatives (siblings,
aunts, nieces/ nephews, in-laws,
grandchildren), friends, neighbors. Whatever
your relationship with the person you’re caring
for, it’s important that you add the title
caregiver to the list of things you are. Without
identifying yourself as a caregiver, you won’t
know to search for resources that can help
you navigate this new role.
Here are some of the common tasks caregivers do: ƒ
 Buy groceries, cook, clean house, do laundry,
provide transportation ƒ
 Help the care receiver get dressed, take a shower,
take medicine
 ƒ Transfer someone out of bed/chair, help with
physical therapy, perform medical interventions—
injections, feeding tubes, wound treatment,
breathing treatments
ƒ Arrange medical appointments, drive to the
doctor, sit in during appointments, monitor
medications ƒ
 Talk with doctors, nurses, care managers,
and others to understand what needs to be
done
 ƒ Spend time handling crises and arranging
for assistance—especially for someone
who cannot be left alone ƒ
 Handle finances and other legal matters
 ƒ Be a companion
 ƒ Be a (usually) unpaid aide, on call 24/7
 Being part of the overall Health Care Team
 Caregivers are part of this team that includes:
♦physicians and nurses
♦physical, speech and occupational therapists
♦home health aides
♦social workers
♦hospice volunteers
♦other health professionals
 ProvidingEmotional Support- can greatly
affect the physical health of your loved
one. One of the greatest gifts a caregiver
can provide is the human contact and
loving support.

 Helpmake Decisions – You may assist

your loved one and health-care team with
decisions on care and other issues.
 Encouraging your loved one – Allowing
them to do as much as possible for
themselves helps them feel valuable
and in control.

 Takingcare of you – Caregiving can be

an exhausting job. It’s very important for
caregivers to maintain their own mental
and physical health.
First Steps for New Caregivers
It’seasy to become overwhelmed as a
new caregiver. Here are some steps
that can help:
 ƒIdentify yourself as a caregiver
ƒ Get a good diagnosis—from a
specialist or geriatrician if necessary—
of your loved one’s health condition ƒ
 Learn what specific skills you might need to
care for someone with this diagnosis (Caring
for someone with Frontotemporal dementia,
for example, is different from caring for
someone with chronic heart disease)
 ƒ Talk about finances and healthcare
wishes
 ƒ Complete legal paperwork, e.g., Powers of
Attorney, Advance Directives ƒ
 Bring family and friends together to discuss
care ƒ
 Keep them up to date on the current situation
ƒ
 Identify resources, both personal and in the
community
ƒ Find support for yourself and your loved one
ƒ Remember, you are not alone
Making Home
Modifications
General Precautions
 Firesafety-Install smoke alarms and check
fire extinguishers. Make escape plans that
the patient can manage. Hold fire drills to
make sure everyone is aware of what their
own responsibilities are.
 Emergencies-Keep numbers by the phone.
 Mobility-If
needed, install ramps
over stairs and check door widths
to allow for a wheelchair. Remove
throw rugs that slip. Keep
walkways open and move furniture
that might tip easily if used for
support.
Considerations for the Bathroom:
a raised toilet seat
 grab bars near the toilet and tub
 nonskid
mats to prevent falls in the tub or
shower and elsewhere
 lowerthe water temperature on the hot
water heater to prevent burns
 other
items to consider include a bath seat
and hand held shower head
a intercom communication system
hospital or special bed
an over-bed table for eating, reading,
etc.
a night light in the room and in the
hallway
Other Areas to consider:
handrails in hallways
special handles for cups, pots,
silverware, brushes, etc.
levers for doors instead of knobs
walkers, wheelchairs, canes, reaching
devices, etc.
Good Mental Health for Everyone
No matter his or her physical condition, every
patient needs:
 Privacy-Allow you’re loved one time alone and a
spot for private visits and conversations.
 Self
Respect-Treat your loved one as an
important and capable human being.
 Giveas much responsibility as possible-Even
small and simple tasks can help a person feel
needed and competent
Adjusting to new situations-For many,
accepting the need to learn new
physical skills or adapt old ones is a
process that takes time and energy
Caregiver Emotions-Caregiving can
mean a major change in your life.
 Accept your new Caregiving role-Keep a
positive attitude. Providing care can be a
great gift to a person in need.
 Gethelp from others-Try and get a group of
others to help in giving care, caregivers
can relieve one another from duties from
time to time.
 Talk with Friends-Sharing thoughts and
feelings are an important way to stay in
touch with others and avoid caregiver
burnout and feeling isolated.

 SeekingProfessional Help-Caregiving is
bound to cause stress. If the stress seems
overwhelming, don’t hesitate to seek help.
Long Distance Caregiving
 Hereare some tips to help ease those feelings
of despair:
Observing your loved one during visits are
they:
♦eating properly
♦taking medications properly?
♦able to get out and about to do their errands?
♦is the house messy and unorganized?
♦increased confusion?
 Hiringa Care Manager Care managers act
as a substitute family member to your loved
one and can arrange for services such as:
 visiting nurses
 care providers
 home delivered meals A
Creating a support system of others
People living near your loved one may be
willing to help. Consider the following:
friends
relatives
church or community service groups
THE SICK ROOM
CHOICE , FURNISHINGS,
VENTILATION,
TEMPERATURE, AND CARE
OF THE SICK ROOM
Choice of the sick room
 Depend largely upon the nature of the
patients Illness.
 Thetwo important things to consider are
the good of the patient, and the
convenience of the nurse.
 Thepatient in a dark, poorly ventilated
room has a harder battle to fight than the
patient in a properly selected room.
Sunshine and fresh air are nature’s best
remedies.
 “where the sun never enters, the doctors will”
 The model sick room is a light, quiet, airy easily
heated room on the south or east side of the house,
convenient to the bathroom.
 Bearing the model sick room in mind, the nurse
should make the best of what she finds the house.
 If the patients is an elderly person or is a chronic
invalid, and the nurse is also the home keeper, the
sick room should be as near as possible to the room
in which the nurse must do her daily work, that is ,
it should be near the kitchen.
In such case, the selection of a room that is
satisfactory according to medical standards
may work injury both to the patient and to
the nurse. For example, suppose the patient
to be in a model room on the third floor,
removed from the noises of the house, etc.,
with the nurse compelled to do the
household work for her family.
Either the nurse will wear herself cut
climbing stairs, or the patient will suffer
neglect. To step from one room to the next
to give a drink of water, or to give the
bedpan, is no great tax on either the time
or energy of the nurse. To go up two flights
of stairs for the same purpose is a quite
different matter.
Ifthe patient is a child with measles,
chickenpox, or any other contagious
diseases, the sick room should be the room
in the house that is most easily isolated, in
order to keep the disease from spreading to
the other members of the family.
In such cases one member of the family must
act as nurse , without any household duties,
regardless of the hardship to the rest of the
family.
 The bathroom used for the patient suffering from
contagious disease, must not be used by any other
member of the family.
 Itis desirable that the sick room be conveniently
near the bathroom, or where water is handy.
 The nurse uses water frequently about her
patient- giving medicines, cleaning articles used
by the patient, for hot water bags, for cold
compresses, for drinking purposes, etc.
Then the nurse , in treating many
diseases, should thoroughly wash her
hands every time she touches the patient.
It can readily be seen that the selection of
a sick room is more a question of common
sense than of fixed medical rules.
Furnishing the sick room
 Depends upon the patients illness. The import
thing to consider here are cleanliness and
simplicity.
 Inthe case of an elderly person or of a chronic
invalid it is desirable that the room should look
homelike to the patient.
 Inthe case of contagious diseases, it is desirable
that there should be as little furniture as possible
to disinfect or burn after the illness, consequently
in such cases the room should be stripped of
everything except bed, chair and bedside table.
 In
any case of the illness , it is desirable that there
should be as few things as possible in the room to
catch dust, because dust is one of the great
enemies to the recovery of the patient.
 Dust under the microscope resolves itself into
particles of soot, sand, iron and steel , glass, lime ,
woody fibres of vegetables, dried sputum, shreds
of linen and wood from soiled bedding, pieces of
hair, dried particles of pus , blood and human
tissue, dried animal waste, fragments of food,
many of which may bear disease germs.
The essential furnishings of the sick room
are a bed, a chair and a bedside table.
Whatever other furniture is in the room
should be selected with some definite
purpose in mind. Thus , if curtains are
hung at the windows it should be because
curtains will tend towards the patient’s
recovery, or peace of mind, by making the
place seem homelike.
 The BED should be a single, iron bed, 26 inches high. In case such a bed is not
at hand the nurse must make the best of what she finds.
 If the bed is too low the castors may be removed and the bed raised to the
proper height by means of wooden blocks or of bricks.