Home health care allows you or a loved one to receive essential medical services at home. Since not every one has a family caregiver who can provide the needed assistance, receiving professional wound care services in your own home can be more affordable than wound care management provided in an out-patient or in-patient clinical setting. Home care also helps prevent future hospitalizations.
If you can't afford to pay the expense out of pocket, you must qualify for Medicare or other insurance coverage of home health care. But qualifying for coverage is just the first step. There are numerous other factors to consider when hiring a wound care specialist to provide in-home treatment.
Who Needs Wound Care Provided In the Home?
A wound that doesn't heal is considered to be a chronic wound that may require care provided by a professional. Individuals with diabetes or poor circulation, which can interfere with the body's healing process, are at particular risk. Other people who are confined to bed can develop pressure sores that may require wound care. If left untreated, open sores can lead to complications including serious infection, gangrene, amputation, or even death. Surgical wounds and wounds caused by cancer tumors that break through the skin also may require home health or palliative services.
What to Consider
If you need wound care in the home, consider whether the professional providing the wound care will:
Communicate with your primary care provider. A physician's plan of care is required, especially if you are a Medicare beneficiary. The plan of care must explain what clinical findings support the need for home health care and include specific instructions on how to treat the wound.
Get you and your family members involved in your care by educating you about wound healing and applying sterile dressings. Helping a chronic wound care patient and his or her caregivers understand how to prevent complications and recurrences helps improve the individual's quality of life.
Make your home health aide aware of the difference in the types of products and dressings available for wound care. A wound care specialist also can educate your home health aide on how to prevent problems such as pressure sores from occurring or becoming worse.
Come equipped with the supplies he or she needs to take care of the wound and prevent infection. In some cases, you may be responsible for making certain that you have all the supplies on hand the wound care nurse will need. The home care agency may not provide supplies that do not require a prescription by your physician and are not covered as part of the home health care services you receive.
Paying For the Cost of Wound Care
The cost of wound care is another key factor to consider. Although a private insurance carrier may not require that you be homebound to receive home nursing care, the rules for Medicare differ. If you receive home care through Medicare, you must be homebound, which means your medical condition prevents you from leaving your home to get the medical services (including wound care). You also may qualify for home care under Medicare guidelines if leaving home for medical appointments takes a significant amount of physical effort on your part.
Medicare also requires that any care you receive in the home be medically necessary. Circumstances for which Medicare covers home health for wound care include:
Wounds that cannot be safely self-treated, but must be treated by a licensed nurse
Post-operative wounds that led to complications
Wounds that require irrigation to clean the area and packing to prevent bleeding and absorb drainage
Open wounds that become infected and are draining pus and require the use of antibiotics
Ulcers or wounds that require care following debridement to remove dead tissue
Contact a service like Neighbors Home Care Services for more information.