Show Wednesday March 2 1931 THE RICHnPLD REAPER 5-- Home Care — Then And Now In the 1800s physicians and nurses cared for the ill at home because it was a time when travel was difficult Medical personnel were some of the only people to have transportation As transportation has become available to more people the tables have turned with patients traveling Hearing Loss May Cause A Personality Change ogy have enabled these providers to return to patient’s homes to deliver high quality care Helen Keller both deaf and blind said that hearing loss was a much more difficult handicap than to health care providers Current hospital cost and improved technol- blindness Physicians seldom travel to the home but are consulted by members of the home care team nurses aides physical therapists medical social workers speech therapists occupational therapists and personal care aides arc what HomcCarc Of Utah offers to Sevier Wayne and Piute counties Although the majority of home health patients are elderly and home bound people of all ages benefit from home health "Blindness" she said "separates us from things but hearing loss separates us from people" Because of the difficulty participating in conversation people with hearing problems may withdraw from social groups church friends and even family members Sometimes they become irritable or embarrassed because they arc afraid of asking others to repeat or of giving care Medicare has encouraged ing home health care costs in an effort to reduce hospital and nursing utiliz- home costs Insurance companies have followed Medicare's lead rec- ognizing the savings by treating qualifying patients at home HomcCarc Of Utah Richfield Office has been open since April 1993 Cathy Blood RN Director of Nursing explained "Home health is a good service we can meet a patient's needs more com- a umm liatcd Other offices arc also in Salt Lake CUy and where the bathroom is Family and neighbor visits arc comforting and they can visit whenever it is convenient Patients often feel as though their home care providers are part of the family medication instruction catheter carcchangcs tube feeding colostomyilcoslomy care bowel care — impaction removal pain and symptom management and blood draws Physical therapists provide gait training bed mobility transfers strengthening and therapeutic exercises and assess home environment for possible need of durable medical equipment Speech therapists provide language and communication retraining and dysphagia Occupational therapists provide activities of daily living retraining dressing eating and use of special equipment Home health aidcspcrsonal care aides provide complete bathing care and assistance oral and hair care range of motion exercises meal preparation shopping and errands laundry and light housekeeping We continuously strive to provide high quality care with a personal touch By combining the skill and experience of carefully selected health care professionals and the familiar surroundings of a person's home HomcCare of Utah offers the best of both situations HomcCare of Utah Richfield Of-- I R M 0 I! N T A I II N A I I ID I OQBQ o II ( A R I Rural Health Care? Patients appreciate the little things associated with being at home Patients sleep better at home and appetites improve There is no confusion about where they arc or care T N 0 O0 0 ment with the audiologist call What Can Be Done to Reform taught and accurately evaluated Suggestions can be made that the patient or family never would have thought of HomcCarc Of Utah provides a full range of home care services designed to meet the needs of both the patient and physician Some of the services provided arc: skilled nursing for diabetic tcachinginsulin administration IV therapy continuous antibiotic TPN wound caredrcssing changes ventilator life support — tracheostomy care bum 896-541- ID Clinical Audiologist If hearing loss is found a comprehensive hearing evaluation may be recommended to determine the type and extent of the loss For an appoint- Families and friends can help however by realizing how frustrating a hearing loss can be and by adhering to the following suggestions when speaking with someone with hearing loss 5 There is a registered at nurse on call 24 hours a day seven days a neck Tooele Utah For more information concerning homo health services call car office I Teaching in the home is effective Home safety diet medication effects and side effects arc widely Home health care can also be the most humane and compassionate form of health care Whether the individual is a child or an aging adult home care allows that patient to receive care in his or her own home Home care personnel keep in close contact with the patient’s physician in order to provide the proper medical attention and treatment of each patient's needs be- problems This impatience is understandable but only makes the hearing loss a greater handicap Carl Parsons IIIIA Bottom row Larel McCay Human Resource Director Cathy Blood RN Director of Nursing Richfield Office Kim Steadman Administration Pat Lee RN SLC Office o Q)OQO0(bPQ QQi "The home nurse is challenged by the 'detective work' required in developing nursing diagnoses and plans of care also in providing the good quality nursing care the patient desires and needs" she said one-to-o- rong answer to a question Spouses or children often of Utah staff includes: back row left Pamela Peterson Office Mgr Julia Chappell RN Cynthia Avery IIIIA Codi Cook IIIIA Klysta Garcia IIIIA Dave Britsch RN DON fice is located at 840 North Main w 4 Try to reduce background or in noise and speak small groups 5 Include your listener by asking for comments or opinions A person with hearing loss should be evaluated by an audiologist Some types of hearing loss can be treated medically The Sevier Valley Hospital offers free initial hearing screenings for adults by C Brent Fox MCH come very impatient and angry with a family member who has hearing I IomeCare pletely in the home We realize the needs and problems and can take the lime to address each of these needs and coordinate other services and resources Not only arc families and health providers finding home health to be a comfortable cost effective option but government and state officials are also supportive of home health care the Get the listener's attention 1 first 2 Face the person you are speaking to and slay within a few feet of them 3 Speak naturally but a little more slowly and with a few more pauses Don’t shout Speak at normal levels or slightly louder Politely ask if you arc being heard Smi komrRi S' m k 1 IMi'l ll i i il H M lilt Rural health earc is not just eoneem of rural residents Most of us who live m the larger cities of the Intermountam West travel through rural areas often in n pursuit of business or recre-atioTounsm mining ranch- existence of rural health and these businesses suppon many jobs in cities as well as in rural areas scr-vic- Competition w ith urban hospitals Lack of competition propo-d- s -- com-jx'tuio- 1 arc suspicious of participating in health sv stents where hosservices pitals physicians and care plans managed sikh as HMOs join (USD together to provide a o full range ol eost-effee- health ices Although ser- - ramia 'turns it seiiKn uinn region needs to accomplish two goals Define essential health services 1 com- - 5200215 should be located in rural areas w hieh The most effective way to accomplish these goals is undoubtedly through a combination ol public and private initiatives In the Intermouniun region there are already nunv examples of successful partnerships between rural facilities health systems and where transport services outreach programs and other services are brought to rural areas These rural providers benefit from integration while per-fon- greater difficulty in covenng their costs 4 Labor shortage Physicians nurses technicians and other clinical and non-chmc- We believe our 2 Identify a structhe efficient assure to ture of these services in deliver)rural areas tend to see a higher percentage of Medicare and uninsured patients compared to urban hospitals Since hospitals receive lower reimbursement for treating Medicare patients — and often no reimbursement at all when treating the uninsured — this means that rural hospitals have QEIIOJIB) In dollar terms most health care to residents of rural areas ts delivered in the cities Rural hospitals often lose patients and rev- - 1 Mo a reform Reluctance to align w ith s) stems Some rural hospitals 4 Payment problems Rural hospitals o CURRENT CONCERNS 1 rely on which managed competition depends on a mixture ol go n eminent regulation and between health care prov tders T hese models ma not work well in rural settings hecause a community can only support one hospital OBSTACLES TO RURAL RETORM system is vital to our regions citizens and economy Intermountam lealth Ore with 12 rural hospitals and numerous dimes is committed to providing rural health care heart oi managed competition reform proposals 3 remains a nagging question that has often been given inadequate attention in public policy debates about reform because rural health issues are different m many ways from urban health issues 1 lere are some thoughts on the special nature of rural care and how HEALTHCARE sometimes it is not necessary 2 Lack of economics of scale It's hard to maintain low pnccs w hen you're dealing with relatively small numtx'rs of patients Imagine for example that a rural hospital and an urban hospital each invest in identical S 7 5 000 mammogra-physystem- s The urban hospital has 10 mammogram Readers of this column have asked how health care reform will affect rural care Indeed the impact of reform projvsals on rural care ABOUT RURAL cians— half us medical stalf mammography patients a day hut the rural hospital only has three Because of the higher volume the urban hospital can charge less for each ing transportation and many other mdustnes depend on the we might approach issues of reform enues to urban hospitals Sometimes this is necessary as when a rural hospital lacks the capability to treat a patient hut staff members are often diflieult to recruit and retain tn rural areas One rural hospital in this region recently lost two of its physi 2 Cost versus access C ost is the pnrnarv problem with health care in urban areas hut access to services is the primary problem in rural areas Managed competition is designed pnmanly to control cOst Low managed care pene3 tration Currently most rural residents in the Intermountam area are not enrolled in HMOs and other managed care plans and managed care is at the petition between these integrated sv stems is the cornerstone of most retorm proposals some rural hospitals may new such integration as a threat to their autonomy and another wav to lose revenue and patients to urban areas I retaining significant local representation If you have a question related to health care please call or write IHC DIALOGUE ON HEALTH CARE 36 South State Street Salt Lahc City Utah 84111 1 A RURAL AGENDA The lirst step in bnngtng the benefits of health care reform to rural areas is to recognize that a strong rural health care SEVIl R VALLEY HOSPITAL I HC A i Srrk d Hmi’: ( ar toll-fre- e |