Our book should be of help to those who want to set up nursing care at home for a patient coming directly from the hospital or from a nursing home or rehabilitation facility that has served as an intermediate step. The patient has a severe and possibly chronic medical condition requiring skilled nursing care.
Basically, your choices are carrying out nursing care at home or putting the individual into a facility already set up to provide nursing care, such as a hospice, a nursing home, a long-term-care facility, but probably not an assisted-living community, as we are assuming that skilled nursing care will be required. We describe what we have learned by caring for two patients at home and what we have gleaned from our other experience and from the medical and nursing literature.
“In the United States, about 40 million people provide unpaid care to an ill or disabled adult. One quarter of those caregivers have been in their roles for five years or longer. And these loving helpers often go it alone. Only half of family caregivers say they get unpaid help from another family member or friend.” (AARP, 2015)
Nursing care at home can range from around-the-clock nursing for someone with a critical condition to regular or even intermittent visits by a nurse to care for someone who continues to live in the home almost exclusively.
Many people would prefer for themselves or their loved ones the option of nursing care at home rather than having to go live in a separate facility. Depending on the details of the situation, this can be significantly more, but sometimes less, expensive than being in a nursing facility. This option requires management, the primary focus of this book.
The patient in question is being released from the hospital under the condition that the next stop is either a nursing home, a hospice, or a suitably equipped home, yours. You have decided to take on the responsibility of having the patient at home. Now what?
We will show you how to plan for the patient’s homecoming, select where the patient will be cared for, and determine who will provide what care when, and how and with what equipment and material.
Douglas Winslow Cooper, PhD, is a writer, editor, and retired environmental scientist, who for over a decade has helped to manage continuous, at-home, skilled nursing care of his wife, Tina Su Cooper, quadriplegic and ventilator-dependent due to multiple sclerosis. For several years, he also managed the skilled nursing care at home of his nearly-100-year-old mother, bedridden, virtually quadriplegic, ventilator-dependent, medicated and fed through a gastric tube, and on a pacemaker.
Douglas earned his A.B., with honors, in physics at Cornell, served at the U.S. Army biological warfare laboratories at Ft. Detrick, MD, returned to school and obtained his M.S. degree in physics at Penn State and his Ph.D. in engineering from Harvard. His professional life centered on environmental issues.
He served as an Associate Professor at the Harvard Graduate School of Public Health, was Director of the Environmental Health Management Program, and subsequently conducted environmental studies as a Research Staff Member at
Yorktown Heights, NY, Thomas J. Watson, Jr., Research Center.
Dr. Cooper was the author or co-author of more than 100 technical articles published in refereed journals and was elected Fellow of the Institute of Environmental Sciences. He now does freelance writing, book coaching/partnering, and editing. He wrote Ting and I: A Memoir of Love, Courage, and Devotion, co-authored three other memoirs, coached for and edited three other non-fiction books. Most recently, he co-authored SOLVED! Curing Your Medical Insurance Problems, and Frustrated with Life? You Are Not Alone! and wrote Write Your Book with Me. He continues to work with would-be authors.
Douglas Winslow Cooper, PhD, LLC
264 East Drive, Walden, NY
Diane R. Beggin, RN: Originally hoping to become a veterinarian, but unable to finance achieving that goal, Diane R. Beggin’s earliest professional career was in the financial industry. She started working in a Dean Witter Reynolds branch office (now Morgan Stanley) in California and later transferred to the World Trade Center in New York, where she became a vice-president in operations. While a manager, she found that organizational skills and development of intra-departmental documentation proved vital.
Diane “retired” from this successful career to raise a family. When her children were young, she returned to school for a career in nursing. After graduating with her RN from Orange County Community College (SUNY Orange), winning the Spirit of Nursing Award from the Army Nurse Corps, and being recognized for her officer roles in the Nursing Club and Phi Theta Kappa, Diane began her career as a Professional Register Nurse [RN] directly in the critical care unit.
A disabling injury prevented her from continuing in hospital-based nursing. Soon afterward, in the fall of 2004, Diane began working for Dr. Cooper to assist in the skilled nursing care in their home of his wife, who was expected to survive only a few months, but who has survived for twelve more years.
Over these past twelve years, Diane has continued to work both part-time for the Coopers and in other nursing venues. Diane, as head nurse for Dr. Cooper, has used her training and experience to establish the documentation and protocols used in the daily practice of caring for two quadriplegic, ventilator–dependent patients in the home. She also completes the quarterly physician orders and extensive semi-annual insurance reports detailing the clinical status for Mrs. Tina Cooper to justify her continued medical insurance benefits.
Diane Beggin has collaborated in the preparation and writing of this book in hopes that it will prove of value to others seeking to manage nursing care in the home. She is currently available for consulting on such matters.
Diane R. Beggin, RN
40 Sycamore Drive
Montgomery, NY 12549
Available from Outskirts Press and from Amazon:
How to Manage Nursing Care at Home
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