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School of Medicine
Dome - Private duty
Date: April 11, 2012
Home Care offers a new service to improve patients’ quality of life at home.
Tracey Bagwell and the Home Support division give patients extended private care in a setting that’s familiar and comforting to them.
For three years, the woman had spent every day caring for her father, who was in poor health and could no longer fend for himself at home. She wouldn’t let anyone else help and it was exhausting. The daughter reached the end of her rope when, as she was trying to help her father move from one place to another, he fell on her, and they were both injured.
The woman turned to Johns Hopkins Home Support—a new division of Johns Hopkins Home Care—which helps patients and families who need assistance with a range of personal care services, from medication compliance to cooking to companionship.
A daughter taking care of an elderly parent in failing health is typical of the kinds of cases handled by Home Support, notes Tracey Bagwell, the division’s nurse manager. “Now,” says Bagwell, “we’re helping to provide personal care for her father, and it allows her to be the daughter again.”
The services offered by Home Support often follow those provided by home-based nursing services. These patients need more than medical assistance—they need help with even the most basic functions of daily living, such as grooming, meal preparation or housekeeping. Some may live alone, without family or friends who can assist them. In some cases, Johns Hopkins Medicine International patients, discharged from the hospital, may need these services until they’re well enough to travel home overseas.
“We’re able to provide these services at home, in a setting that’s familiar to our clients,” Bagwell says, “which gives peace of mind to their children or other loved ones who can’t be there all the time.”
“We built the company because there was a need for this,” says Angela Saquibal, an administrative resident with Johns Hopkins Home Care, who, along with staff education specialist Lou Ann Rau, played a significant role in launching and organizing the Home Support Group. “Whatever our clients want, from skilled nursing services to personal care and housekeeping duties, we should be able to facilitate it.”
Officially launched in November 2011, the program is a direct outgrowth of feedback received from home health care patients and their families about a need for private-duty services. Then there were concerns about patients who struggled to comply with discharge plans—including properly taking medications—an issue that can ultimately lead to readmissions and poorer outcomes.
Unlike home nursing care after hospitalization, which is covered by health insurance, Home Support services are paid for out of pocket by patients or their families. But for many clients, without someone to help, the only alternative would be assisted living.
According to Bagwell, a typical request is for services covering four hours a day, three days a week. “It gives the family caregiver a break or a chance to return to work,” she adds. Most of the care is provided by certified nursing assistants (CNA) whose duties require physical contact with the patient. They received clinical orientation and cultural training through Home Support. Some of the CNAs also are certified medication technicians and assist patients with maintaining their medication schedule. Additionally, home support associates provide patients with light housekeeping duties, transportation, shopping and other non-physical contact services.
All services are performed under the supervision of a registered nurse, and, because of the group’s association with Johns Hopkins Home Care, Home Support staff members have ready access to a large pool of R.N.s, should a need for higher-level care arise.
Home Support Services received its state certification this past January. Bagwell notes that the surveyors praised the division for its diligence in screening employees. Although there are many private-duty service companies in Maryland, Home Support has the important distinction of being part of Johns Hopkins Medicine. “Not only do we get clients who have come through our clinical system, we also get them through word-of-mouth association with the Hopkins name,” she says.
By the numbers
20 patients on service
20% are pediatric cases
16 certified nursing assistants (4 are also certified medication technicians)
2 home support associates