What to expect from home health

Home health is unlike most healthcare people have experienced, because it happens in your house on a schedule that changes as you improve. Knowing the shape of it in advance makes the whole thing easier.

The first visit

The longest visit you will have — usually an hour or more. A nurse reviews your medical history and every medication in the house, examines you, asks a great many questions about how you manage day to day, and looks at your home itself: stairs, bathroom, lighting, trip hazards.

It can feel intrusive. It is not idle curiosity — a plan of care built without knowing that your only bathroom is upstairs is a plan that will not work.

The plan of care

This is the governing document. It states which services you receive, how often, what the goals are, and what your medications are. Your physician signs it, and it is revised and re-signed as your condition changes.

Ask for a copy and read it. If it says three nursing visits a week and you are getting one, that is a conversation to have immediately.

Visit frequency

Set by clinical need. Intensive at first — sometimes daily — and tapering as you improve. A reduction in visits usually means you are getting better, though it rarely feels that way at the time.

Your rights

• To be told, in advance, what care you will receive and what it will cost you.
• To participate in planning your own care, and to refuse any part of it.
• To be treated with respect and to have your privacy protected in your home.
• To know who is coming, when, and what their role is.
• To complain without any effect on your care. How to raise a concern.
• To change agencies.
• To have your health information kept confidential. Our privacy practices.

Your part of the bargain

• Be there for scheduled visits, or give notice when you cannot.
• Follow the plan of care, including the exercises between visits.
• Tell us about changes — new symptoms, a fall, a hospital visit, a new medication.
• Keep the home safe enough to work in, including containing pets during visits.
• Tell us if something is not working, early rather than late.

How it ends

Home health is designed to stop. It ends when the skilled need resolves, when goals are met, or when progress has plateaued — and by design, not by abandonment. You should have advance notice, written discharge instructions, and a clear account of what to keep doing.

Ask two questions before discharge: what should I watch for? and what happens if I still need help afterwards? For many people the honest answer to the second is ongoing personal care, and that is a conversation worth having before the last visit rather than after it.

See the CDS program →