CHAPTER 1 WHY HOME, NOT A NURSING HOME,
OR HOSPICE?
Why would your patient
rather be at home?
The people, places, and things are familiar.
It’s comfortable. Why do you want to care for the patient at home?
You want to be together. You distrust care given by others, especially at a
distance. In some cases, home care is less expensive.
In a nursing home, there is a community
of patients, some whom your patient would like and some less attractive. There
are schedules with limited flexibility and personnel with limited time to
provide care. The nursing home is
generally at a significant distance from the patient’s friends and family,
inhibiting visiting and monitoring the care, as will the rules of the facility.
Physicians may visit, reducing the need to travel, a plus.
In a hospice, it is acknowledged
that the illness is terminal, and the goal is patient comfort, an advantage.
However, some families and some patients may well not want to accept this
prognosis, and there is always a concern that being labeled as “terminal” may
lead to receiving poorer care.
Home care can be a blessing. As
written about my [DWC’s] wife’s situation seven years after choosing to be home
rather than in a hospice (Cooper, 2011):
“…Tina was very fragile
when she first came home. Her needs were many --- ventilator-dependent, unable
to speak, tube-fed, unable to eat or drink by mouth; physical therapy to keep
her joints pliable, causing pain no matter how gently it was done, and
medication being given on schedule day and night, interrupting the little sleep
she was able to find amidst all the new noises and activity in her room.
While her body remained fragile, Tina’s
spirit grew strong. (Her complaining consisted of a frown on her face.) She
withstood the changes in her health condition with the attention she received
from the nurses, each one caring for her as a friend as well as a
patient." [Terry
Bush, LPN.]
She’s been home for
seven years since then. Through my IBM
retirees’ medical benefits, we have had round-the-clock nursing, first through
an agency and then from nurses we have obtained on our own. Most of our nurses
have been with us for years, as Tina is a cooperative and cheerful patient,
always appreciative of the care she receives. Here, "TLC" is
"Tina-Loving Care." There have
been some scary times, including several bouts of pneumonia, and many trips to
the doctor in our special van. There have also been lovely times. We say,
“every day is a blessing.” Every day is
Valentine’s Day….
Tina still cares about
her friends, her family, her nurses, keeps up with the news, and relishes the
documentary and music channels on TV. She chats on the phone, spends an hour or
two out of bed in her wheelchair daily, and provides an inspiration to those
who know her. She is our heroine.
Now, 2016, five years
after that was written, Tina’s condition is somewhat worse, with significant
losses in cognition and ability to communicate, but she still usually indicates
she enjoys her life, and we are still happy that she continues to be with us.
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Contact information:
Contact information:
Diane R. Beggin, RN
40 Sycamore Drive
Montgomery, NY 12549
http://managenursingcareathome.com
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