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How to Keep Home Health Patients out of the Hospital?

Home Health Article   (787 Views 1 Replies 629 Words)

traumaRUs has 27 years experience as a MSN, APRN and specializes in Nephrology, Cardiology, ER, ICU.

15 Followers; 149 Articles; 187,533 Visitors; 20,805 Posts

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Home health patients are vulnerable to readmissions. Let's discuss how to keep them at home....

How to Keep Home Health Patients out of the Hospital?

Nearly 5 million people in the US receive home care at any one time. 

Home health patients receive care in their home for a variety of reasons including:

  • Recuperation from surgery or acute illness
  • Ongoing PT, OT, ST needs
  • Respiratory care
  • Need for nursing care oversight

The goal of home health is, of course, to keep patients at home and allow them to be as independent as possible. Home care might be short term or long term and might involve very in-depth technical care, i.e., ventilator, IV medication administration or it can involve the need for nursing oversight of other disciplines. Many aspects of care impact patients staying home and one of the sometimes overlooked issues is nutrition. Some patient populations that are at risk for malnutrition include:

  • Elderly living in their homes are often live more isolated from family and may not drive or have the ability to get to grocery stores
  • Low-income patients often do not have the financial resources to obtain nutritious food and transportation might also be difficult
  • Patients living in rural areas with grocery stores frequently miles away
  • Some patients experience dysphagia or difficulty chewing due to ill-fitting dentures or being edentulous
  • Patients that have a high medication burden sometimes experience issues with food not tasting palatable
  • Some patients do not cook or have the ability to stand for long periods of time to prepare nutritious meals

Issues resulting from malnutrition include:

  • Reduced muscle and tissue mass
  • Decreased mobility and stamina as a result of muscle wasting
  • Wounds take longer to heal and illnesses take longer to recover from
  • Lowered immune response which increases the risk of getting infections, and increases the length of time that it takes to recover from infection
  • Difficulty staying warm as a result of having less muscle and tissue mass, increasing the risk of hypothermia (the inability to maintain normal body temperature)

New research found that prioritizing nutrition care in patients at risk for malnutrition had a dramatic impact on keeping home health patients out of the hospital, but also helped save millions in healthcare costs. A study, published June 24, 2019, in the Journal of Parenteral and Enteral Nutrition, more than 1,500 home health patients were followed for 90 days. The study found that when patients at risk for malnutrition received a comprehensive nutrition care program, including nutrition drinks, to aid in their recovery:

  • Risk of being hospitalized was significantly reduced by 24% in the first 30 days, nearly 23% after 60 days, and 18% after 90 days.
  • Healthcare costs were reduced by more than $2.3 million or about $1,500 per patient at risk for malnutrition treated over the course of 90 days.

This study was from Advocate Health and Abbott and also found:

"As many as 1 in 3 home health patients are at risk of malnutrition, which can impact their recovery or cause further health issues.1,3 But malnutrition often goes unrecognized as it can be invisible to the eye and can occur in both underweight and overweight individuals. Therefore, more healthcare systems are starting to focus efforts on the identification and management of malnourished or at-risk patients through regular monitoring and follow up."

Does your home care agency employ dieticians to address the nutritional needs of your patients? Do you add supplements to your patient's diet plan? Do you provide a diet plan for your patient to optimize their recovery?

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15 Followers; 149 Articles; 187,533 Visitors; 20,805 Posts

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kat7464 has 5+ years experience and specializes in Hospice, home health, LTC.

2,736 Visitors; 64 Posts

I worked as a home health nurse for two years. You state that these patients don't have the funds for nutritious meals and yet many of the ones I treated had no problem spending their money on fast food. Given a choice, they would take their $1 and spend it on a liter of coke vs. a bag of beans or a dozen eggs. Don't tell me poor ppl can't afford healthy eating. This is a lie. My daughter has been just as impoverished but forgoes fast food to buy dried beans, eggs, day-old produce, whatever. It is about choice and the willingness to get off your butt and cook your meals, as well as take control of your health overall. I saw so many "frequent flyers" that would rather someone else take responsibility for their problems than they try to change their lifestyle.

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