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The Concept of Home Care
What is the meaning of the terms
"Home Care" and "Hospital at Home"?
Various definitions have been suggested for Home Care:
- "Paid or unpaid assistance provided to a person with a chronic disability or illness, living in the community".
- " A clinical NetWork made up of members who care for patients in the home or who have special interest in promoting the development of home care as a viable alternative to in-hospital care".
- "The provision of assistance to persons over the age of 16 in their home, according to an assessment of their needs. The assistance could be practical, financial (not advice), or help with day to day activities.
- "Home care, also known as domiciliary care, is health care provided in the home by healthcare professionals (often referred to as home health care or formal care) or by family and friends (informal care)".
- "The provision of comprehensive services, including health and social services by formal and informal caregivers in the home, in order to promote, restore and maintain a person's maximal level of comfort, function and health, including care towards a dignified death" (WHO) .
Home Care services can be classified in preventive, therapeutic, rehabilitation, care for chronic diseases and palliative. It is more than obvious than this term represents a wide spectrum of services, which are mainly for cronically ill patients, meals on wheels, home visits of family physicians, vaccinations, medications, supply of oxygen and other disposable material at home, consulting, logotherapy, ergotherapy, physiotherapy and more...Most frequently "home care" services have little, if any, relationship to nursing or medicine. Bathing, dressing, household, shopping, house maintenance, paying bills, visits of priests and social workers are some examples.
This leads to almost complete confusion. Although amost any country has reported the provision of home care services[9], the types of services offered are so dissimilar, that it is difficult to realize their classification under the same term.
For example: In the UK during a survey week for home care in September 2002 an estimated 2.98 million contact hours were provided to around 366,800 households (or 381,900 clients). Around 81,500 households (22% of households) received intensive home care in 2002 (defined as more than 10 contact hours and 6 or more visits during the week). However "Home Care" is defined as "services that assist the client to function as independently as possible and/or continue to live in their own home". Services may involve routine household tasks within or outside the home, personal care of the client or respite care in support of the client's regular carers [10].
Almost lately a new term has appeared: "Hospital at Home", which is defined as "a service that provides active treatment by health care professionals, in the patient's home, of a condition that otherwise would require acute hospital in-patient care, always for a limited period" [8]. This definition seems, at least, much more concrete than others.
All types of Home Care are of great help to patients and people with disability who stay at home. However the need for comprehensive classification is obvious. A lot of concerted work has to be done, towards a common understanding of terms