Healing At Home

Posted on: 7 May 2015

Home health care is widely recognized as being the provision of medical services to someone who is terminally ill or recovering from a major injury. Not meeting the criteria for inpatient hospitalization, the patient receives visits at home by medical professionals such as nurses, lab technicians, and occupational therapists (just to name a few). These services can mean all the difference to someone who needs care and assistance during a physically challenging time. However, a less recognized, but just as critical, component of home health is the provision of psychiatric services to those who are debilitated by mental illness. If you have a family member who does not meet the criteria for inpatient psychiatric hospitalization, but is nonetheless debilitated by emotional challenges, psychiatric home health may be the answer you've been seeking.

Why the need?

People with mental illness suffer daily from symptoms that others are unable to recognize. While hallmarks of physical illness are apparent to friends and family members, psychiatric illness is primarily one of internal symptoms. However, these symptoms can be just as crippling, rendering patients unable to function outside their homes. Some examples of severe psychiatric symptoms include:

• anxiety so severe that patients experience paralyzing panic attacks in public places

• post-traumatic flashbacks triggered by loud noises or crowded areas

• auditory hallucinations (hearing voices inside one's head) convincing patients that people are following or plotting against them

• sadness so profound patients have difficulty getting out of bed

• memory failure that makes independent trips to routine places no longer safe

Just a few diagnoses that can make patients homebound include schizophrenia, PTSD, dementia,  major depression, and many of the anxiety disorders.

Psychiatric home health help

Enter psychiatric home health care. Patients whose psychiatrists have recommended in-home services for them receive regular visits from psychiatric nurses, social workers, lab technicians, and occupational therapists. Here are some of the ways these professionals assist psychiatric patients:

• Psychiatric nurses assess the intensity of psychiatric symptoms, such as hallucinations, delusions, suicidal ideation, and anxiety. They offer reassurance, reality orientation, and encouragement. They consult with patients' psychiatrists for medication adjustment and the need for inpatient hospitalization if symptoms have worsened.

• Social workers assess family support systems and may conduct family meetings. These meetings may include the patient (for instance, to resolve a conflict) or may not (for example, to educate family members about their loved one's diagnosis and treatment options). They may do individual counseling with patients. They also coordinate community resources to help patients utilize practical resources applicable to their circumstances.

• Lab technicians draw blood so that patients' psychiatrists can determine whether therapeutic levels of medication are being achieved.

• Occupational therapists help patients set goals for reintegration into their communities. They may liason with patients' employers to arrange modified work schedules or responsibilities. They assist patients in identifying and building personal strengths, as well as encouraging them to take small steps towards improving areas of particular difficulty.

Paying for psychiatric home health

As you can imagine, these professional services, provided in patients' homes, are quite expensive. Your loved one's eligibility for psychiatric home health care will depend on his/her insurance coverage. While Medicare will cover home health if your loved one meets certain requirements, private insurances vary widely on what services they cover and for what length of time. You can contact the benefits department of your family member's health insurance company for more information.

Psychiatric home health services are essential for those who are homebound because of their symptoms. If your loved one has significant challenges that prevent him/her from successfully interacting with the world outside, talk to the doctor about this type of home health care.