INTRODUCTION TO

CAREGIVING
OBJECTIVES:
1. EXPLAIN THE PURPOSE AND ORGANIZATION
OF A HOME HEALTH AGENCY
2. BECOME AWARE OF THE CHANGES IN
HEALTH CARE THAT AFFECT HOME HEALTH
CARE
3. DISCUSS THE PLACE PF CLIENT’S
SATISFACTION IN PRESENT HEALTH CARE
OBJECTIVES:

4. IDENTIFY THE RESPONSIBILITIES OF

MEMBERS OF THE HEALTH CARE TEAM TO
EACH OTHER, THE CLIENT, AND THE AGENCY
5. DISCUSS THE ETHICS ASSOCIATED WITH
WORKING AS A HOMEMAKER/HOME
HEALTH AIDE.
OBJECTIVES:
6. BECOME FAMILIAR WITH THE VARIOUS
AGENCIES AND REGULATORY BODIES
WHICH CREDENTIAL YOUR AGENCY
7. DISCUSS VARIOUS METHODS OF PAYING
FOR HOME CARE SERVICES.
INTRODUCTION: HOME HEALTH CARE
DURING ORIENTATION PERIOD:
The agency will give you the names and
titles of personnel in key positions in your home
health care agency.
A home health care agency---is one that
delivers care and services to people within
their homes.
INTRODUCTION: HOME HEALTH CARE
There are many types of home health care
providers:
1. Delivery of services to people
2. Delivery of equipment to be used in the home
3. Deliver specialized care such as respiratory
services or IV THERAPY.
INTRODUCTION: HOME HEALTH CARE
NOTE:
It is important to know what you as a member
of the health care team can expect from each
type of agency and what your responsibilities
are.
FUNCTIONS OF HOME CARE AGENCIES
1. TO PROVIDE CARE FOR THE
ILL/DISABLED/INJURED OR DYING WITHIN
THEIR HOMES AND COMMUNITIES
2. TO BECOME INVOLVED IN PREVENTIVE
COMMUNITY CARE
3. TO PROVIDE AND OPPURTUNITY FOR THE
FURTHER EDUCATION OF HEALTH WORKERS
FUNCTIONS OF HOME CARE AGENCIES
4. TO PROMOTE INDIVIDUAL AND
COMMUNITY HEALTH
5. TO PROMOTE RESEARCH IN THE HEALTH
CARE PROFESSIONS
WHO USES HOME HEALTH CARE?
1. People of all ages and economic
capabilities – who require both short term
help and long term assistance
2. People who are in active rehabilitation
programs and those who are on maintenace
regimes
WHO USES HOME HEALTH CARE?

3. People who will recover from their

illness
4. People who will die.
HOME CARE SERVICES HAVE INCREASED
IN RECENT YEARS BECAUSE:
1. People prefer to be cared for at home in
familiar surroundings, rather in institutions
2. Hospital stays are continually getting shorter
3. Home care is usually less expensive than
hospital or institutional care
4. Sophisticated services, once available only in
hospitals are now available at home
HOME CARE SERVICES HAVE INCREASED
IN RECENT YEARS BECAUSE:
4. As people live longer and the elderly
population grows, the number of people
requiring some type of assistance is increasing
CHANGES IN HEALTH CARE
1. Various groups have streamlined and tried
to control cost by making changes== these
changes have affected the way people get
health care, as well as how they use it and
pay for it.
2. Different people are now involved in clients
care
CHANGES IN HEALTH CARE
3. The way in which people get health care has
also changed.—insurance managed care
company may have identified
doctors/hospitals/and vendors to whom the
client is referred for care and equipment.
4. Client is obligated to use the designated
vendors – to continually receive coverage of
the needed services
CHANGES IN HEALTH CARE
NOTE: do not suggest that the client go to
another , more familiar doctor or vendor
without first consulting your supervisor. Some
insurance/managed care companies also
designate hospitals and rehabilitation services
for use. ( only in emergencies can a client go to
another facility)
MANAGED CARE
Managed care: this is the term to describe many of
the insurance industry’s different payment options.
Usually the client prepays the company providing
care a sum of money each month.
When care is needed, the company provides the
care the already paid. Client has agreed to pay--
MANAGED CARE
In the coming months.
1. Each company has a clear and strict rules to
each insurance option.
2. Assist your client in following these rules.
3. If there are questions call your supervisor or
advise the client to call the insurance company
directly.
MANAGED CARE
4. Be sure to let your agency know if the
insurance company calls the client/ask to
visit/or send papers for the client to
complete.
5. If an insurance company asks you direct
questions, be polite and refer them to your
supervisor.
CASE MANGEMENT
CASE MANAGER- is employed to review the care
provided by all members of the health care team,
ensure there is no duplication of services and
ensure that the client is progressing according to
the original plan of care.
6. If changes occur in the client’s status , the case
manager will change the plan of care.
CASE MANGEMENT
7. Your supervisor will discuss changes with
the case manager. The case manager may or
may not visit the client.
CORPORATE COMPLIANCE
1. Regulatory agencies such as the federal
and state governments and the joint commision
accrediting hospitals and organizations inspect
several documents throughout the year to be
sure the agencies are delivering care
according to the law and regulations. ---this
means that the organization delivers care
according to policies -
CONT….
And that no one receives special care because
of their status either within the community or the
organizations, the promise of money or whom
they know.
CUSTOMER
Customer – is a term that means one person
receives service from another person for some sort
of payment.
Health care agency has many customers--- the
client/the doctor/the insurance/managed care
company and you. – each has different
expectations of the agency all of which must be
met.
CONT….
Ask your agency whom it list as its key
customers.– if you do not agree discuss it with
your supervisor.
CUSTOMER SATISFACTION
One of the big changes in health care is that the
payor and health care agency are all interested in
what the clients think of their service.
All agencies are aware that the public has many
choices for health care.
Most agencies will have a special program to
teach employees techniques and behaviors that
contribute to high patient satisfaction.
PATIENT RIGHTS
SHARE THEM WITH THE CLIENT WHEN YOU
FIRST MEET.
The right to civil and religious liberties
The right to voice complaints without fear
The right to refuse care
The right to be treated with respect
CONT…
The right to have an active part in establishing an
individualized appropriate care plan.
The right to be free of physical and mental abuse
The right to be free of chemical or physical
restraints
The right to privacy
CONT….
The right to communication with family, friends
and medical care providers.
The right to have competent personnel caring
for them.
AGENCY CREDENTIALS
NOTE: all states require health care agencies
to conform to standards and submit to periodic
inspections and surveys. This process assures the
public and agency’s employees that the agency
is operating within minimum standards. The
documents indicating that the agency has
achieved these standards are called
credentials.
PAYMENT FOR SERVICES
1. There is a charge to someone or some
insurance/managed care company for your
services. These charges are collected by the
home health agency and eventually make up
your salary.
2. Payment for home health care services can
come from many sources- medicare/medicaid
CONT…
Private insurance companies are all sources of
payment.
3. Your client or his family may pay the
agency directly for your service. Your agency
has a protocol (set of plans or procedures) for
deciding the method of payment that clients
will use.
CONT…..
As you learn more about the agency, ask for the
agency’s credentials. The following are some
agency credentials that may be displayed.
1. Licensure – the agency has met minimum
standards set by the state.
2. Certification – all states must certify that
medicare and Medicaid minimum standards
CONT….
Have been met so they are eligible for
medicare and Medicaid reimbursement.
3. Accreditation – several professional
organizations will investigate and accredit an
agency. This a voluntary process and indicates
that the agency has met the standards of the
organization.
CONT…
4. Bonding – the agency pays a bond or
insurance policy, so that if it sued due to
employees’s actions, any damages can be paid
to the consumer.
SOURCES OF PAYMENTS
ELIGIBILITY SERVICES
COVERED
Medicare: 65 yrs old; Nursing/PT/OT
federally disabled more /ST/MSW/HHA
financed health the 2 yrs.; /
plan homebound; Some supplies
under medical and equipment
supervision
CONT…

ELIGIBILITY SERVICES
COVERED
Medicare Eligible for All necessary
hospice medicare; 6 services with
federally months some co -
financed prognosis. payment
program Terminally ill
CONT…

Medicaid- for Services must part time

low income be provided nursing/caregi
persons under MD vers /medical
supervision supplies and
equipments.
PT/OT/ST/aud
iology/person
CONT…

Health Individually as per policy

insurance: purchased
private coverage
Special Workers As per
compensation. situation
Auto insurance
CONT…

HMO Pre payment As per plan

health
HOME HEALTH AGENCY PERSONNEL
The home maker/home health aide: part of the
team.
1. The goal of the health care team is to provide
care so the client can function optimally- to
help client be the best he can
2. If he is ill – assist him with recovery
3. If he is disabled- the team will assist him with-
CONT…
Adapting his everyday needs so that he can
function in society and his own home
environment.
4. As a homemaker/home health aide, you
are an important member of the health care
team.
HOME HEALTH CARE AGENCY
PROFESSIONAL PERSONNEL:
1. Community health nurse/public health nurse
2. Registered nurse
3. Licensed practical nurse/or licensed
vocational nurse
4. Physical therapist
5. Occupational therapist
CONT…
6. Speech pathologist
7. Respiratory therapist
8. Nutritionist
9. Social worker
10. caregivers
TEAMWORK
1. Teamwork means that everyone knows what
he is supposed to do and does it to the best
of his ability with a spirit of cooperation.
2. Teamwork means that you are concerned
about the effect of your actions upon other
members of the team.
YOUR JOB AS A HOMEMAKER /HOME HEALTH
AIDE
OBJECTIVES:
1. List behaviors that will help you and the
clients be more comfortable at your first
meeting
2. Be familiar with qualities that are desirable
in a homemaker/home health aide.
CONT…
3. Become familiar with activities that
contribute to teamwork
4. Become comfortable with the legal and
ethical rules that govern your activities.
INTRODUCTION: TASKS AND
RESPONSIBILITES
1. Responsibilities – are trust that are
expected of you
2. Be familiar with the responsibilities and
expectations employers, clients and team
members have of you- you will be able to
act in the proper manner and feel more
comfortable.
CONT…
3. Everyone you work with will have a set of
responsibilities and expectations.
4. Your role will be slightly different in each
house, but your overall function will be spelled
out in the job description.
NOTE: Job description it’s a written document listing
the parts of employment such as the tasks for which
one is responsible.
CONT…
RESPONSIBILITIES: those tasks one has to
execute and for which one is held accountable.
ROLE: one’s function
PRINCIPAL CARE PERSON: that person
designated to be in charge of the client’s care.
WORKING IN A CLIENT’S HOME
PRINCIPAL CARE PERSON: this is the person in the
family who has been designated as “being in
charge” of the client’s care. Here are some helpful
hints to decrease the fears clients may have about
you as a new person;
1. Wear your uniform- be sure it is neat and
clean . It identifies as a member of the health care
team. A uniform indicates that you are focused -
CONT…
On the job and your role as a homemaker/home
health aide and separates this role from other
roles.
2. Wear your name pin and any identification
your agency requires. This tells the client you
are who you say you are.
3. Introduce yourself immediately in a clear, quiet
voice. Identify your agency and your job title.
CONT…
Look at the client when you speak. Write down
the information if the client asks you to.
4. Discuss with the client your responsibilities,
tasks and hours of work. Assure the client
you are there to work in his home in a
manner that is comfortable for him. You are
not there to change everything.
CONT…
5. Ask the client if he has any questions. If you
cannot answer his questions, refer him/her to
your supervisor.
RESPONSIBILITIES OF THE HOME CARE AGENCY
TO ITS EMPLOYEES:
When you are given a job, the employer
assumes responsibilities of:
1. paying you for your work
2. providing a safe and meaningful working
environment
3. Providing supervision
CONT…
4. Providing periodic evaluations of your work
5. Treating you with respect
6. Policies: health
examination/salaries/uniforms/evaluations/
documentations/communication/vacations/
assignments/hours of work.
7. You will always work under the supervision -
CONT…
Under the supervision of a registered
professional nurse or other health professional.
It is that person’s responsibility to plan the
client’s care and to assign taks to you in an
understandable manner.
EMPLOYEE’S RESPONSIBILITIES:
1. It is your responsibilities to do only those tasks
that are assigned and to do them to the best of
your ability.
2. You are expected to care of your clients with
thought, consideration and respect.
3. You are expected to care for your client as is
appropriate for his age. This means you must
be age competent.
CONT…
4. If you do not know of a procedure , ask!
5. If a procedure must be adapted due to the
age of a patient , discuss this with your
supervisor.
6. It is also your responsibility to be a contributing
member of the health care team, share your
ideas, your thoughts, and your knowledge. –
the clients will benefit/your fellow employees
and the agency will benefit
EQUIPMENT:
It is always necessary to have the proper supplies
and equipment to perform your tasks. When you
accept your assignment, ask your supervisor:
1. What equipment is needed for the client’s care
2. Who will obtain the needed equipment? Will
the family buy it? Will the nurse bring it? Will it
be delivered?
CONT…
3. Are the necessary tools and equipment to
keep the house clean available? Can they be
borrowed from neighbors? Will the family
purchase the needed equipment?
MOST EFFECTIVE QUALITIES TO SUCCEED:
1. You are a person who can be trusted
2. You are a person upon whom others can
depend.
3. You enjoy working with others
4. You get along well with others
5. You are sensitive to the feelings and needs of
others.
CONT…
6. You are a good listener
7. You try to be courteous
8. You get satisfaction from helping others
9. You show sympathy and patience with others
10. You always try to control your temper
11. You believe you are doing important work
CONT...
12. You want to improve your skills
13. You try not to let your private life interfere
with your work
14. You are comfortable meeting and working
with people from cultures different from
yours
DEPENDABILITY:
1. Your agency is organized to function efficiently
when a certain number of people are on the job. If you
are not there, a client may be deprived of needed
care. – your absence may cause your fellow workers to
have an overload of work. – it is very important that
you arrive promptly everyday when expected. – if you
are sick call your office as you have been instructed by
your agency. – your clients can be be
Assigned to another homemaker/ home health
aide.
DEPENDABILITY: means more than coming to
work everyday and coming in on time. It means
that your supervisor can rely on you to do
things at the proper time and in the proper
way.
ACCURACY :
1. as part of the health care team, you will be
concerned with human lives and feelings.
2. What might appear to you to be a tiny mistake
or oversight could affect the recovery of your
client.
3. It is important for you to follow your
supervisor’s instructions exactly.
4. Be accurate when recording a temperature etc.
5. Be careful in making a bed
6. If you make a mistake, report it.
7. If you do not understand something ask again.
8. Always remember: there is a reason for every
step of the client’s care.
FOLLOWING DIRECTION:
1. Everybody follows instructions and goes by
rules, otherwise, jobs would never get done.
2. Even supervisors and administrators have rules
to follow. These rules – policies and protocols
are made to give everyone guidelines for their
work. They are made up with professional,
ethical, legal and practical relationships in
mind.
CONT…
Good rules which can help to make you a
better homemaker/home health aide and can
help you in your relationships with your fellow
health care workers:
1. Be accurate to the best of your ability
2. Follow carefully the instructions of your
supervisor.
3. If you do not understand something ask your
supervisor
4. Report accidents or errors immediately to your
supervisor.
5. Keep information about clients to yourself
except when it might affect the client’s health
6. Do not waste supplies and equipment.
7. Be ready to adjust quickly to new situations
8. Try to get things done on time – use a
systematic work schedule.
9. Report all complaints no matter how small, to
your supervisor
10. Perform all your duties in a spirit of
cooperation and teamwork.
11. Keep personal problems out of the
workplace.
 ETHICS
Ethics:
1. Is a code of rules set up to govern behavior.
2. These behaviours always take into
consideration the feelings and needs of all
concerned.
3. These behaviours are based on the respect of
individuals and their rights.
CONT…
4. It is assumed homemaker/ home health
aide also work within as accepted set of rules.
DO NOT DISCUSS CLIENT INFORMATION
WITH:
1. One client about another client
2. Relatives and friends of the client
3. Representatives of news media
4. Fellow workers, except when in conference
5. Your own relatives and friends
DO NOT:
1. Read clients personal papers
2. Solicit financial information
3. Share your opinions with other agencies.
LEGAL CONSIDERATIONS
1. Laws concerning clients and workers in the
health care system are written to protect both
the client and the worker.
2. You should be familiar with the laws and how
they affect you and the clients under your care.
3. Clients must be cared for properly and within
the law.
CONT…
4. Your agencies has policies and procedures
to guide you and your co- workers in your
jobs.
5. Negligence is a legal term meaning the
failure to give proper care, when you know
how to do so, which results in physical or
emotional harm to the client.
 INCIDENTS
An incident is an event that does not fit the
daily routine of the home or agency where you
are working. It may be an accident or an
unusual happening. Types of incidents are:
1. client, visitor, or employee accidents
2. Accidents that happen to you anytime while
you are on the job.
3. Accidents occurring on the outlying property of
the client’s home, such as sidewalks, parking lots
or entrances.
NOTE: whenever an incident occurs, a report must
be made. Careful prompt reporting is important to
the safety program of the agency and for the
protection of all health care workers. -
For the agency to be prepared for possible
liability suits or damage claims, report
promptly all facts related to any incident or
accident.
PERSONAL PRACTICES
All members of the home health team are
teachers by the example they set. They
influence each other, their clients and their
families.
THINGS TO REMEMBER:
1. Dress properly and neatly. Follow the dress
code of the home health care agency where
you work.
2. Bathe daily
3. Use an unscented deodorant
4. Keep your mouth and teeth clean and in good
condition.
CONT…
5. Keep your hair clean and neat
6. Wear clean clothes everyday
7. Wear comfortable low heeled shoes with
nonskid soles and heels that can be wiped
clean frequently
8. Repair rips and replace missing buttons on your
clothing.
9. Do not wear jewelry such as earrings,
bracelets, pendants or large rings
10. Keep your nails short and clean
11. Wear conservative make up
12. Do not use perfume, scented sprays or after
shave lotion.
13. Keep yourself in good health by eating
properly.
14. Get plenty of sleep – be alert when you come
to work.
15. Polish your shoes – be sure the laces are clean
16. Always wear a wristwatch with a second hand
17. Always carry a pen and a pad of paper.