Home Care to Fit Your Needs
As a Home Care Service, Green Meadows provides non-medical services in nature:
- Assistance with household chores, including cooking and meal preparation, cleaning and laundry.
- Assistance in completing activities such as shopping and appointments outside of the home.
- Companionship and Emotional Support
- Assistance with activities of daily living and personal care.
To delineate the types of services that can be provided by a home services worker, the following are examples of acceptable tasks and limitations when a more medical model of assistance would be needed to meet the higher needs of the client:
Skin Care
A home services worker may perform general skin care assistance. Skin care may be performed by a home services worker only when skin is unbroken, and when any chronic skin problems are not active. The skin care provided by a home services worker must be preventative rather than therapeutic in nature and may include the application of non-medicated lotions and solutions, or of lotions and solutions not requiring a physician’s prescription. Skilled skin care must be provided by an agency licensed as a home health or home services agency. Skilled skin care includes wound care, dressing changes, application of prescription medications, skilled observation and reporting.
Ambulation
A home services worker may assist clients with ambulation. Clients in the process of being trained to use adaptive equipment for ambulation, such as walkers, canes or wheelchairs, require supervision by an agency licensed to provide home health or home services during the period of training. Once the prescribing individual or the health care provider responsible for training the client is comfortable with releasing the client to work on his or her own with the adaptive equipment, a home services worker may assist with ambulation.
Feeding
A home services worker may provide assistance with feeding, food preparation, and special diets. Home services workers can assist clients with feeding when the client can independently swallow and be positioned upright. Assistance by a home services worker does not include syringe, tube feedings, and intravenous nutrition. Whenever there is a high risk that the client may choke as a result of the feeding, the client will be in the care of an agency licensed as a home health or home services agency to fulfill this function.
Dressing
A home services worker may assist a client with dressing. This may include assistance with ordinary clothing and application of support stockings of the type that can be purchased without a physician’s prescription. A home services worker may not assist with applying an elastic bandage that can be purchased only with a physician’s prescription (the application of which involves wrapping a part of the client’s body) or with applying a sequential compression device that can be purchased only with a physician’s prescription.
Exercise
A home services worker may assist a client with exercise. Passive assistance with exercise that can be performed by a home services worker is limited to encouraging normal bodily movement, as tolerated, on the part of the client, and to encouragement with a prescribed exercise program. A home services worker will not perform Passive Range of Motion.
Hair Care
As a part of the broader set of services provided to clients who are receiving home services, home services workers may assist clients with the maintenance and appearance of their hair. Hair care within these limitations may Include shampooing with non-medicated shampoo or shampoo that does not require a physician’s prescription, drying, combing and styling hair.
Mouth Care
A home services worker may assist in and perform mouth care. This may Include denture care and basic oral hygiene, including oral suctioning for mouth care. Mouth care for clients who are unconscious will be performed by an agency licensed as a home health agency or home services agency.
Nail Care
A home services worker may assist with nail care. This assistance may Include soaking of nails, pushing back cuticles without utensils, and filing nails. Assistance by a home services worker will not Include nail trimming. Clients with a medical condition that might involve peripheral circulatory problems or loss of sensation will be under the care of an agency licensed as a home health agency or home services agency to meet this need.
Positioning
A home services worker may assist a client with positioning when the client is able to identify to the personal care staff, either verbally, non-verbally or through others, when the position needs to be changed, only when skilled skin care, as previously described, is not required in conjunction with the positioning. Positioning may include simple alignment in a bed, wheelchair, or other furniture.
Medication Reminding
A home services worker may assist a client with medication, reminding only when medications have been pre-selected by the client, a family member or a pharmacist and are stored in containers other than the prescription bottles, such as medication minders. Medication minder containers will be clearly marked as today and time of dosage. Medication reminding includes inquiries as to whether medications were taken; verbal prompting to take medications; handing the appropriately marked medication minder container to the client; and opening the appropriately marked medication minder container for the client if the client is physically unable to open the container. These limitations apply to all prescription and all over-the-counter medications. The home services worker will immediately report to the supervisor, or, in the case of a placement worker, to the client or the client’s advocate or designee, any irregularities noted in the pre-selected medications, such as medications taken too often or not often enough, or not at the correct time as identified in the written instructions
Toileting
A home services worker may assist a client to and from the bathroom; aid with bed pans, urinals, and commodes; provide peri care; or change clothing and pads of any kind used for the care of incontinence.
A home services worker may empty or change external urine collection devices, such as catheter bags or suprapubic catheter bags. In all cases, the insertion and removal of catheters and care of external catheters is considered skilled care and will not be performed by a home services worker.
A home services worker may empty ostomy bags and provide assistance with other client-directed ostomy care only when there is no need for skilled skin care or for observation or reporting. A home services worker will not perform digital stimulation, insert suppositories, or give an enema.
Shaving- A home services worker may assist a client with shaving only with an electric or a safety razor.
Bathing
A home services worker may assist clients with showering, tub and sponge bath, and bed bath, when a client has skilled skincare needs or skilled dressings that will need attention before, during, or after bathing, the client will be in the care of an agency licensed as a home health agency or a home services agency to meet those specific needs. Home services workers may assist individuals who are unable to be bathed in a tub or shower only when the following requirements are met:
—The home services worker will have been trained in the particular methods required to perform a bed bath
—The client or client’s representative will be able to participate in or direct the bathing process and provide ongoing feedback to the home services worker; and
—Green Meadows Home Care Inc. will have conducted a competency evaluation of the home services worker’s ability to employ the methods required to perform a bed bath.
Transfers
A home services worker may assist with transfers only when the client has sufficient balance and strength to reliably stand and pivot and assist with the transfer to some extent. Adaptive and safety equipment may be used in transfers, provided that the client is fully trained in the use of the equipment and can direct the transfer step by step. Adaptive equipment may include, but is not limited to, wheelchairs, tub seats, and grab bars. Gait belts may be used as a safety device for the home services worker as long as the worker has been properly trained in their use. A home services worker will not assist with transfers when the client is unable to assist with the transfer. Home services workers may assist clients in the use of a mechanical or electrical transfer device only when the following conditions are met:
—The home services worker must have been trained in the use of the mechanical or electrical transfer device by the licensed agency.
—The client or client representative must be able to direct the transfer step by step.
—Green Meadows Home Care Inc. must have conducted a competency evaluation of the worker using the type of device that is available in the home.