ESCANABA - "Our work doesn't stop when you go home" is a mantra of the OSF Home Care Services in Escanaba. Follow-up care is often required for patients who are discharged from a hospital. Home health care can last for days, weeks or even months until the patient is able to live safely and comfortably.
Cindy Plourde, Manager of Home Health and Hospice for OSF Home Care Services, oversees this type of care. Plourde has worked in home care services for 20 years, the past three as manager. "As soon as I started with OSF, I went into home care," she said.
Changes in Home Care and Patient Education
Dorothy McKnight | Daily Press
Cindy Plourde, manager of OSF Home Care Services, enters patient information into a computer data bank.
During those years, Plourde said she has seen many changes in the services offered. "Patients are often very sick when they are in the hospital, but their hospital stays are much shorter now than they used to be," she said. "With home care services, we are able to provide physical, speech or occupational therapy. We also provide wound care for patients who have gone through surgery or who suffered serious injuries."
Plourde said her staff is trained to stress the importance of follow-up care when needed.
"Too many people go home and don't follow their doctor's orders and don't take it as easy as they should," she added. "Then their condition becomes complicated and more difficult to manage." When home care is required for a patient, the length of care can often last as long as eight weeks.
Therapy and Wound Care
"We work toward the goal of getting the patient stronger and able to function on their own," Plourde said. "If they are able to meet the goals, they are discharged from the program early. If they still need help, they can remain longer."
Plourde said wound care is a considerably high need for home care patients.
"We have pretty high incidence of wound care in this area," she said. "That can include treatment of post-surgical wounds, bed sores and pressure ulcers, and diabetic wounds."
Individuals who have suffered a stroke or undergone orthopedic injuries or surgeries - particularly hip or knee - are evaluated by the home care team to make sure the patient has all the required home medical equipment related to their illness or injury.
The patient's ability is evaluated, as well as their living quarters, and recommendations are made to adapt the home to the needs of the patient whether it be a wheelchair, walker or a cane.
Physical therapy is available to help the patient to achieve better mobility. Occupational therapists evaluate whether the patient can function with the day-to-day routine of their home life. They check for things like steps inside or outside of the home or special equipment needs for bathroom safety. They can even help bring in items to allow for easy access to the kitchen appliances and cupboards.
"There is a difference between physical therapy and occupational therapy, but they frequently overlap," said Plourde.
Finding the Right Team
Balancing the needs of the patients and providing a sufficient staff is Plourde's focus. She has about 40 employees - full and part-time - all of whom have to be equipped with the skills and adaptability to manage the job.
"This is a very stressful job and our staff has to be very competent and able to work independently," Plourde said. "In home care, there's usually not someone down the hall to come and help in case of an emergency like there is in a hospital. If someone is way out in Rock and something comes up, they have to assess the situation themselves and rely on their own judgement and skills."
Plourde said many of her nurses possess special abilities that others don't have. "We have nurses who specialize in wound care and others are specifically skilled in IV's and infusions and frequently have to teach family members how to do it. Others are specially trained in hospice care. It's our job to find the best possible person to do the job that needs to be done," she said.
Today's challenges for health care providers are: providing affordable health care, increases in today's elderly population, and increases in government mandates regarding health care. This is especially challenging to providers with a mostly senior patient population.
"Health care has really turned into a business and it's very competitive," Plourde said. "There are three agencies in our area who provide home care assistance." She also said it is challenging to balance quality of care with the mandates that are required for reimbursement.
"It's obvious that something has to happen in this country because health care costs are out of control and abuse can be difficult to monitor," Plourde said. "The amount of elderly patients requiring care is going to cause the cost of caring for them to sky rocket."