Are We Expecting Too Much From Home Care Workers?
Perhaps out of fear?
Perhaps as a backlash to the bad press we regularly hear about nursing homes?
The popularity of home-care continues to expand as many people view such arrangements as a viable alternative to the skilled nursing care provided in nursing homes. For the the most part, these simply are not.
Unlike nursing homes which are medical facilities--- staffed by medical professionals, most home-based care is provided by staff who may not have the specialized training and credentialing of nursing home staff.
That's not to say that home-care (and even home-health care) doesn't fill and important role in providing needed assistance to people who are not capable of living independently, but it is important to remember that there are limits to the type of care that these people can provide.
I was remined of the increased reliance that we are consistently putting upon home-care workers and agencies when I read about a home care worker who was caring for a stroke patient who was completely reliant upon the worker for assistance with all daily living activities--- grooming, bathing, administration of medications and transportation to doctors' appointments.
Unfortunately, at some point the home care worker stopped attending to her patients care needs and simply allowed the patient to deteriorate to the point that the patient was allowed to remain confined to a reclining chair. Over the course of several months, the home care worker allowed the disabled patient to essentially sit in her own feces and urine because she was unable to move the patient without assistance.
Not surprisingly, the inattention to the patient's basic care needs resulted in the development of extensive decubitus ulcers--- and eventual death from a systemic infection known as sepsis. According to the coroner examining the body, the wounds were so advanced in nature that maggots had infested the wounds.
Now, the home care worker faces involuntary manslaughter charges for her extended inattention to the patient's needs.
As we await to see how the criminal matter progresses, I immediately began to consider why a single home care worker was allowed to single-handedly care for a patient with such obviously complex medical needs? Though I know no more about this incident than what has been disclosed in news reports, I would home that authorities would consider investigating to see if she was part of an agency or placed via a service.
Sadly, situations like this can--- and do occur in a variety of different contexts-- nursing home, hospital or assisted living, but I feel as though situations such as this simply set the patient and caregiver up for imminent failure with perhaps a combination of unrealistic patient expectations and a caregiver simply overextending themselves.
Home Care Services
For patients and families considering a home-based care arrangement, it is important for families be realistic about their loved one's personal care and medical needs. As opposed to assuming that all needs can be achieved, it is crucial to understand that there are limits to the type of care that can be realistically provided.
From a legal perspective, when a home care agency fails to uphold their end of the bargain, a cause of action may be pursued to recover damages related to their negligence or neglect. In a civil lawsuit against these providers, damages can theoretically be recovered for all of the patients injuries and accompanying medical care.
Related Nursing Homes Abuse Blog entries:
At Fraud Trial Involving A Home Health Agency, The Real Losers Are The Patients Who Miss Out On Care
I've come to accept that the physical responsibilities placed upon nursing home staff are completely unrealistic. The desire of management and administrators to maximize the individual productivity of nursing home workers may appear to be an admirable proposition on paper--- yet, fails when it comes to providing quality care for patients. 
