HOME HEALTH CARE
Private Duty An Essential Role During COVID-19 BY AARON STROMLEY
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he world has experienced huge disruptions in this time of COVID19, and in no arena more so than healthcare delivery. Parts of it, like hospitals, are under strain as they heroically act to meet the pandemic challenge. Others, like private duty home care, are stepping up to fill new needs created by the pandemic. Minnesota is one of the states with the highest number of private duty home care agencies, and these providers are a valuable part of responding to this challenge.
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What does private duty mean? There are significant differences between home health care and private duty care. Home health care visits are coordinated by a patient’s physician and typically covered by Medicare. Home health care provides a wide range of skilled health care services. Visits typically do not last long (under an hour) and treatment is typically complete within after 30-60 days. Examples of Home Health Care Services • Wound care for pressure sores or a surgical wound • Patient and caregiver education
• Monitoring serious illness and unstable health status Home health care services are typically offered just during 8-5 business hours, not early mornings, late evenings, overnight or on weekends. They also do not offer ‘same day starts’ in those crucial first 24 hours after a patient release. Once discharge orders are given to home health groups, it can take 72 hours just to get out and see the patient for a first-time visit. Private duty care is a service available for individuals of any age who require assistance with their day-to-day activities. Private duty aides can assist with tasks such as housekeeping; meal preparation and offering companionship to those who need additional assistance to remain safe and comfortable in their own home. Private duty care is not covered by Medicare and is typically paid for by the client. The goal of private duty care is to help maintain a client’s ability to stay in their home comfortably, offer a respite care to other caregivers or to provide an extra level of care in long-term care facilities or even in hospice. Examples of private duty care services • Personal care – bathing/dressing, hygiene, transfers, and ambulation. • Homemakers & Companions • Meal cooking and preparation • Medication reminders • Transportation for doctor’s visits, shopping, etc.
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OCTOBER 2020 MINNESOTA PHYSICIAN
• Care giving for specialized conditions such as Alzheimer’s disease, Hospice, or other comfort needs. Patients or their loved ones hire their own private duty provider and use the service for the short term or for long stretches. It is often a preferred choice when there is no immediate family to care for a recently released patient and it also fills the care gaps when home health care is available for only one or two visits per week. Private duty home care is being tapped more and more for medically complex cases including those that require overnight assistance. Private duty agencies can get an inquiry at noon and have a highly trained professional on site that evening.
Additional benefits This March, Governor Walz’s executive orders postponed non-elective surgeries to reserve hospital beds and staff for caretaking potential overflow COVID patients. A key concern now that those regular hospital procedures have resumed is re-hospitalization. Nationally, typical re-admission rates are more than 15%. When patients receive post-hospital home care, however, readmission rates can drop to 4-5%. With the aid of dedicated private duty agencies, this rate may be even less than 3%. Statistically, the first 48-72 hours after discharge are the most crucial to prevent complications. Private duty home care is especially valuable in the first 72 hours after a hospital discharge. Studies show that it more than pays for itself during this time period and many hospitals in the U.S. are willing to pay for it for 3-5 days.
