Revitalize Your Care: The Home Healthcare Advantage

Nigeria

is a study in contrasts. This morning, I remember a senior colleague who recently passed away after spending many years in private medical practice. He was the first real doctor I knew who offered home services to patients he knew well.

However, one bad turn left a sad tale in his trajectory, and he probably never recovered his confidence after that. He answered a call early one evening to attend to the elderly mother of one of his acquaintances.

When he arrived at her home, he quickly determined that she was in need of some urgent medications, which he proceeded to administer through injections. After monitoring her for some time, he left.

The elderly woman passed away the following night. One of her daughters alleged later that she was not that ill, but that the injections she was given probably contributed to her early demise. There was a lot of trouble arising from that, and the doctor was broken.

Another encounter I can recall involves another colleague who was contacted to oversee an elderly man who had developed bedsores because he was bedridden and soiled the beddings constantly with both urine and excrement.

After a proper examination of the man, the doctor opted to insert a catheter into his bladder to help collect his urine. The stool would be collected in adult diapers. It looked like a reasonable plan, as these interventions should keep him reasonably dry.

In the dead of night, when nobody was watching, the old man pulled on the catheter with all his strength and began to bleed from the penis.

The doctor was called frantically, and he raced to the house. He had to remove the catheter and advised hospitalisation because the old man had damaged his urethra and could no longer urinate by himself.

Now, the attempt at solving one problem led to hospital admission. I do not know how that effort ended.

Home healthcare is a service that allows patients to receive medical care, therapy, and support in the comfort of their homes rather than in a hospital or nursing facility.

It is designed for individuals who are recovering from illness or surgery, managing chronic conditions, or needing assistance with daily activities due to ageing or disability.

This is how it should work: it should typically begin with a doctor’s referral. A physician will then assess whether a patient requires skilled nursing, physical therapy, or other medical services at home. Patients may qualify for home healthcare if they have difficulty leaving home without assistance and need intermittent professional care.

Once referred, a home healthcare unit of the hospital conducts an in-home evaluation. A nurse or therapist reviews the patient’s medical history, current condition, and home environment to create a personalised care plan.

This plan outlines the type and frequency of services needed, such as skilled nursing to ensure wound care, injections, and monitoring of vital signs.

Physical, occupational, or speech therapy may also be recommended by the primary care physician upon discharge from the hospital. Medical social workers will help with counselling or community resources, and personal care assistance involving bathing and dressing.

Feeding can be included as required. Trained professionals visit the patient’s home on a scheduled basis.

Services may include nursing care involving managing medications, intravenous fluids and drug therapy, or post-surgical care. Then there must be rehabilitation, which helps patients regain mobility or speech after a stroke or injury.

Chronic disease management is also an important component as it helps in educating patients on managing diabetes, heart disease, dementia, or chronic obstructive airway disease.

All these people do not have to be at the hospital. The home healthcare team communicates regularly with the patient’s doctor to update treatment plans and ensure progress.

Family members may also be trained to assist with care.

This is already the case in many of our public hospitals, which are struggling to cope with huge patient populations and overstretched manpower. The only difference is that such family members are not trained; rather, they are given simple tasks to perform, which do not require supervision, such as feeding their loved ones, assisting with bathing and grooming, and changing their beddings.

Home healthcare is a flexible, patient-centred solution that bridges the gap between hospital care and independent living, ensuring safety and quality of life for those in need.

Patients heal better in familiar surroundings. Home healthcare can be leveraged by poor countries such as ours in several ways. The obvious benefits include increased access to quality care. Home healthcare can reach patients in remote or underserved areas where hospital care is not readily available.

Home healthcare can also be more cost-effective than hospital care, reducing healthcare costs for both individuals and governments. Often, it turns out to be cheaper than hospital or facility-based care. It can lead to better patient outcomes by providing personalised care and support in the patient’s own environment, while also ensuring that patients retain their dignity and some level of autonomy, something they may not experience in a hospital. Moreover, home healthcare can help reduce the immense burden on hospitals, such as we have often described on this page, thereby allowing hospitals to focus on more complex cases. When a patient recovers or no longer needs skilled care, services may be reduced or discontinued. If ongoing assistance is required, the hospital may help transition the patient to community resources or long-term care options.

Strategies to achieve these goals include community-based care. This will not work without training community health workers to provide basic home healthcare services. It can be an effective way to reach more patients. However, just like the training and deployment of sanitation inspectors has been long discarded, this area of healthcare provision is no longer emphasised. Task-shifting of patient care to non-specialist healthcare workers or family members can help address the shortage of skilled manpower available to hospitals or the Ministry of Health for deployment as required.

However, without a strong digital presence in the modern world, even this aspect of service is doomed from the start.

The use of telemedicine technologies can also enable remote consultations and monitoring, expanding access to specialist care, even while the patient remains in their home. This is a service already being deployed in some countries that lack the kind of resources available to Nigeria. Yet, we have not embraced it.

The challenges are legion. Many poor countries lack the necessary infrastructure, such as reliable electricity, water, and transportation, to support home healthcare, all of which bedevil our country. In addition, there is a shortage of skilled healthcare professionals, making it difficult to provide high-quality home healthcare.

Of course, there is usually no money to fund these schemes. Home healthcare may require significant investment in training, equipment, and personnel, which can be a challenge for resource-constrained countries. The solution lies in exploring innovative financing models, such as public-private partnerships or mobile health financing, which can help address funding constraints. Furthermore, there must be investment in training and capacity building for healthcare workers to help address workforce shortages. These will take time, but Nigeria is always in a hurry, and the end result is often unsatisfactory.

Lastly, leveraging technology, such as mobile health apps or telemedicine platforms, can help overcome infrastructure challenges and improve access to care, particularly in the hinterlands where practically everyone owns a mobile phone.

Provided by SyndiGate Media Inc. (
Syndigate.info
).