The Future?

I have to admit, I am a HUGE nerd! As a kid I was Princess Leia every Halloween. I love science and geek out often with sci-fi movies and tv shows. Lately I have gotten hooked on a new show on AMC called Humans. The show is all about humanistic androids living amongst us.

While to purchase your own "synth" (what they call the androids) is very expensive and something reserved mainly for the wealthy, they have medical synths that are loaned out to patients needing home health care. As a MOM that relies HEAVILY on nursing care for my daughter, this really gets me thinking.

Now I know, the chances of this type of advancement ever- much less in my lifetime- is slim to none. It is fun to think about though. The insurance companies send out a synth to the patients home. This synth then does EVERYTHING. They have built in technology to monitor vitals, change diapers, suction, do the feeds, push meds, monitor vents, help with baths, do some range of motion, ,they can drive the patient to appointments, they can go the grocery store, they clean the house, cook dinner, they really do everything. The best part- they don't need time off!!!

We LOVE our nurses and honestly I would be lost without them. They all have their own lives though- and that's a good thing. They need time to go home and sleep, see their own families, cook their dinners, take care of their own needs. They also need a break from time to time- AKA- vacation. While we totally understand that this is something they need, we miss them so much while they are gone. If I was working out of the home and had a healthy child, I would take time off and vacations too. I never get angry about this; I really do understand and know I would do the same if I were in their shoes. That being said, I do dread when they take time off.

Many of my friends and family look forward to the weekends, holidays, spring break, etc. I dread them! I know that a holiday means that most likely some if not all of our nurses will take time off. This means that for 24- however many hours until they return it is just my husband and I taking turns sleeping and taking care of our daughter. She requires someone to be alert and watch her 24x7. Usually if there is not a night nurse I stay up all night and then drag my husband out of bed around 6 to take over while I get some sleep. We love our daughter and this is not intended to sound like I am complaining. I am just fantasizing about having a "synth" of our very own.

On nights that the night shift call outs I could charge the "synth" all day and then get some sleep while it takes watch. If my husband is traveling for work and I need to run to the store, but there is not a nurse here to watch my daughter I can either send the "synth" to the store or have it watch my daughter while I go. I would not have to feel guilty about it missing out on it's families events in order to help us celebrate ours.

We have recently been in the process of finding a new night nurse. We have 2-3 nights a week covered consistently, but since May I have been staying up the other 4-5 nights and then sleeping all day. We hope to soon find a good fit to fill these night shifts so that we can get back to living our lives. Sadly I feel we have missed most of our summer already. I sleep all morning while the day nurse (luckily our day nurses have been picking up a lot of extra hours and shifts and our remaining night nurse picks up that extra night as often as she can) is here then get up just in time to shower, eat and do the "must do" items on my list before the day nurse has to leave. We have missed out on lots of swimming, play dates, outings, and even doctor appointments have been getting canceled and rescheduled. On my long night shifts I spend a lot of time fantasizing about having a "synth". Oh to dream! Heck, since I haven't been sleeping much I guess daydreaming is the closest thing I get to real dreams.

So you know what this tired MOM wishes exists to help make my life easier, what types of things to you imagine/fantasize about to help you and your child get through the day?



NOTE- I should point out that in the show they use "synths" for many other non-medical related tasks as well- some that are not appropriate for this blog. So, if you do decide to watch this show and fantasize about your own home health "synth" just a heads up/warning it may not be a show to watch with the kids.

What is Home Health?

Short answer –
Home Health is ANY medical service provided in one’s home. Home Health can be all types of things. Therapy services, nursing services, aids and attendants and hospice are some common forms of home health.

Therapy Services

Therapy services done in the home are pretty common, especially with children under 3 (still in some sort of early intervention program). Home therapy services can be physical, occupational, speech, vision, development and even play therapy.

Nursing Services

In home nursing services are typically what people think of when they hear the term “Home Health.” Nursing services done in the home vary from patient to patient.

There are different levels of nursing as well. Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) is the first level. A LVN can provide most at home care. In most areas LVNs are not able to start an IV and they are not licensed to write the Plan of Care (POC). The next level of nursing is Registered Nurse (RN) or Bachelors Science Nursing (BSN). An RN can do all of the things an LVN can, with the addition of IVs and writing the POC. The next level is Nurse Practitioner (NP). An NP can do all that an RN can do. In addition, an NP can also write orders and prescriptions and see patients.

• The most basic form of home nursing is home visits. Home visits are when a nurse comes to the patient’s home and basically just checks in. They take vitals, check that the patient has been getting their medications, and visits with the the family to see if there are any medical needs not being met, questions that need to be answered, or if there is anything that the family needs help doing. Some home visits will include help with some chores around the house. The nurse may help with cooking, cleaning, or even running some errands. Home visits may occur daily, weekly or even monthly. The schedule is determined based on the patient’s needs and doctor recommendations.


• Another form of home nursing is Private Duty Nursing (PDN) or Skilled Nursing. Private Duty Nursing is a little more involved than home visits. Instead of the nurse checking in on the family, the nurse is scheduled for a shift at the patient’s home. PDN can be as few as 4 hours a week to 168 hours a week (24 hours a day- 7 days a week). The number of hours that are approved will depend on child’s medical needs, the doctors’ recommendations and the individual family’s ability to care for their child.


• Respite is another use of home nursing. Respite can often be confused with PDN as often it is the same nurses filling the role. Respite is a little different however. PDN can be used when the primary caregiver is working, at school, sleeping, or tending to daily activities. Respite is supposed to be used to provide the primary caregiver with a break. Respite in many states can NOT be used if the primary caregiver is at work or school. Each respite provider and state will have their own guidelines. The best way to think of respite care is to ask yourself, will the primary caregiver get some respite (a break) during this time? If they chose to use their break to clean the house or go to the store, thats up to them, but are they getting a break?

Some nursing agencies offer all types of nursing, while others may only offer one. In addition, some agencies serve only infants and children (pediatrics), some only adults, and some cover the entire population. Each agency is different. It is recommended that before selecting an agency for your home health needs that you research the areas they cover and determine who will best be suited to fit your needs.

Aids & Attendants

On occasion a patient will need help, but may not medically qualify for nursing services. In this case, a family usually relies on aids and attendants. Unlike nursing that requires a license, aids and attendants do not require any type of certification. Aids are typically used to help with Assisted Daily Living (ADL) skills and tasks and administer some medications.

Hospice

Hospice can be found in some nursing agencies or in hospice agencies. Hospice combines Private Duty Nursing with pain management, family counsel, and palliative home care. Hospice used to only refer to patients at the end of life. However, with medical advances it is not uncommon for people to move in and out of hospice programs.

Questions to Ask When Choosing Home Nursing Care

• Will the nurses assigned to my child’s care all have pediatric nursing experience? What is the skill level I can expect from assigned nurses?


• Are the nursing hours scheduled according to the needs of my child and my family? How much input do I have regarding the scheduling of hours? Note: Most nursing shifts are based on the timing of the child’s skilled care needs.


• Does the company guarantee shift coverage? Will I be able to have the nurses that I want? Note: Nursing is usually not a guarantee and there may be unfilled shifts. Therefore, it is important for families to train as many people as possible in your child’s care. Hospital nursing staff or the nursing agency can provide training for family members and friends.


• How long will my insurance company / Medicaid pay for skilled nurses?


• Who is available during and after business hours should I have questions or concerns?


• What happens if I do not want a nurse to return to my home because of personality conflict or problems with the nursing care?


• Will I be expected to train nurses in the care of my child or do the nurses familiar with the care do that?


• Will the nurse be able to accompany my child to physician appointments?


• Will my child be assigned a primary nurse, or do nurses rotate and if so how often?


• How do nurses communicate with each other about my child’s health status and the nursing care goals?


• How will my family’s privacy be maintained?

Questions provided by: Cincinnati Children’s Hospital Medical Center’s Special Needs Resource Directory: Home Healthcare.