In today’s fast-paced world, and with the increasing costs of hospital care generally, many individuals and families are turning to home nursing care and support as a preferred alternative to traditional hospital settings for those who are elderly or health-challenged. This is not a selfish choice by any means, but rather a considered decision to allow for personalised, safe and cost-effective care in a familiar environment, but are unable to provide themselves. Home nursing care offers numerous benefits, including maintaining a degree of independence, improving quality of life, and providing an individually suited approach to health needs. The significance of home nursing care extends beyond the physical aspect of treatment, as it also contributes to the emotional well-being and overall quality of life of individuals requiring specialised care.
What is Home Nursing Care?
Home nursing care encompasses a range of healthcare services aimed at addressing the needs of individuals who require medical attention but prefer to receive care in a familiar and supportive environment.
This care is provided by licensed healthcare professionals, such as registered nurses (RNs), private nurse practitioners (PNPs), and licensed practical nurses (LPNs), who are trained to manage various medical conditions and assist with daily living activities. A Professional Nurse is registered with the South African Nursing Council and provides nursing care on a fee-for-service basis and is therefore reimbursed directly or indirectly by the patient or their family.
Home nursing services typically include:
- Medical Care: Administering and checking medications to ensure an uninterrupted supply and expiry dates, wound care, IV therapy, and monitoring vital signs.
- Personal Care: Assisting with bathing, dressing, grooming, and mobility.
- Rehabilitation: Providing physical, occupational, and speech therapy.
- Education and Support: Advising patients and their families about disease management, medication administration, and important aspects of home safety.
It should be noted that, according to Health SA Gesondheid, “No nurse or a person registered under the Health Professions Act, 1974, other than a medical practitioner or dentist, may prescribe a medicine or scheduled substance unless he or she has been authorised to do so by his or her professional council concerned.” Whilst nurses and nurse practitioners may administer certain medications, they cannot, and should not, be expected to prescribe any medicines. They can certainly offer suggestions regarding OTC medications, but even those should be carefully considered as some could negatively impact prescribed medicines and should be double-checked with the client’s doctor. Having said this, employing professional nursing care for your family member offers many benefits and peace of mind for all concerned.
Benefits of Home Nursing Care
- Personalised Attention: Home nursing care allows for individual attention, focused on the patient’s needs. This personalised approach ensures that care is tailored to the individual’s health condition and preferences.
- Comfort and Familiarity: Receiving care at home means patients can stay in a familiar environment, surrounded by cherished belongings and where they feel most comfortable, either with family members or independently. This usually results in reduced stress and improved emotional well-being. For those suffering from dementia, the home where they have probably lived for many years offers a sense of comfort and familiarity in an otherwise confusing world.
- Enhanced Independence: Home nursing care promotes a greater sense of independence by allowing patients to perform those daily activities within their ability with the necessary support, thus preserving their independence and mental welfare as much as possible.
- Family Involvement: Families can be more involved in the care process, receiving guidance and support from healthcare professionals on how to best assist their family member. They can also be assured of the standard of care being provided and build up a good working relationship with the nursing professional. Open and honest lines of communication between the nursing professional, patient, and family members create a trusting and reliable relationship and environment, which is a positive outcome for everyone involved.
- Cost-Effective: Home care is often more affordable than hospital stays or long-term care facilities. It eliminates the need for costly hospital overheads and provides a more relaxed and peaceful environment for the patient. These factors can significantly reduce the need for emergency room visits.
- Reduced Risk of Infection: Remaining in a home environment reduces the risk of exposure to infections and diseases that are naturally widespread in healthcare facilities.
A Brief Overview of Basic Home Care Services
Home care services, where professional nursing qualifications are not required, are generally limited to personal care, administering certain medications, mobility assistance, light household tasks like vacuuming, making beds, changing linens, laundry, cooking, companionship, and assisting with or accompanying clients on errands or outings. Home carers refer to those they support as clients rather than patients. They may offer full live-in services or domiciliary care, where they spend set hours with clients each day, often rotating with other carers or providing cover during a live-in carer’s daily break. Live-in carers are legally entitled to two hours off-duty each day and remain responsible for their client’s well-being, even overnight, requiring stamina and strong listening skills.
In the UK, for example, a home carer must complete rigorous training before offering services and must have a clean Disclosure and Barring Service (DBS) clearance. This check allows clients or families to review the carer’s criminal history to determine their suitability for working with children or vulnerable adults. A DBS is not a lightweight clearance, as it exists to prevent various types of abuse – including physical, emotional, mental, financial, and psychological – and is a critical measure to ensure client safety, especially as carers often play a central role in the lives of elderly, mobility-impaired, frail, or mentally disabled clients, including those with dementia. This role is especially important when clients’ families live at a distance.
The Difference Between Home Nursing Care and Basic Home Carer Services
To provide nurse specialist care services in private practice, one must be registered with the South African Nursing Council (SANC) as a nurse specialist, following the Scope of Practice amendment (June 2022). It is essential to distinguish between those offering comprehensive nursing services and those providing basic home care, as home carers are neither qualified nor permitted to perform many of the specialised nursing tasks that require formal training. When seeking care services, it’s crucial to assess the client’s specific needs and the level of care required. It is unrealistic to expect a carer without formal nursing training to perform the advanced, complex tasks reserved for licensed healthcare professionals.
In Summary
Home nursing care offers a compassionate, effective alternative to traditional healthcare settings. Delivering personalised, patient-centred care in a familiar environment enhances the patient’s quality of life and promotes independence. To make the most of home nursing care, it’s essential to thoroughly assess individual needs, select qualified providers, and maintain open communication. With careful planning and the right resources, home nursing care can be a valuable and fulfilling choice for managing health and well-being.
