About the SeniorAdvisor.com 2014 In-Home Innovation Scholarship: We started the scholarship program to bring awareness of the unique benefits and challenges of in-home caregiving for seniors to younger generations. The questions posed by the scholarship encouraged our nation’s future caregivers to present solutions for improving home care in the United States. College-aged students were required to answer one of the three essay topics below and provide a short bio as part of their scholarship application. Read the winning essays here.

What is the top challenge facing in-home care in your city, and what is your proposed solution?

Essay response by Donna Ruiz, Aurora University

Elderly patients who have impaired mobility, transfer and gait, living with their families or alone, have problems of getting to their doctors office for non-emergency doctor visits—primary care physicians, specialist or even for outpatient procedures. This decreases their chance to be evaluated and get treated before their health deteriorates. The current home health care services have been helpful but not applicable to every situation. The visiting doctors have been beneficial but not for the patients who prefer to keep their primary physician, patients who need to see specialists, and for patients that do not have Medicaid as well as a complete lack of transportation options. There are services such as dial-arrive and other transportation means provided by each county, but for the elderly who do not have means to pay transportation, it is not easy. My proposed solution to this is what I am going to call a “video care”. There should be a way to get a consultation with the physicians through a live video conferencing app, just like the FaceTime application in an iPad. These gadgets that will allow patients, doctors and the rest of interdisciplinary health team to interact with patients face to face.. In this gadget there should also be an attached auscultation device where patients can put the stethoscope to their lung fields, abdomen and heart for the doctor and nurses to hear the abnormal and normal lung, bowel and heart sounds. In addition to now available Telehealth systems, this will save transportation fees and will serve as an easy, quick and timely means of assessing patients. This should be billable and recorded so doctors and nurses can review the last assessment with their patients anytime they need to. Nowadays, not getting the face to face encounter with physicians in a timely manner will delay, and if not done, will disqualify a patient from getting home health services. This technology can also help nurses interact with their patients and assess the patient’s distress that they cannot visualize over the phone. This can help not only for assessment but also with medication management.

For patients that needs physical intervention from a physician, such as those needing procedures done, I am proposing a more broad mobile doctor services. For example, patients who need complex wound care would benefit from this service. In Illinois, we are lacking in-wound care specialists who visit patients at home. The “Woundcare on Wheels” program has been effective, but does not provide services to all places. Plus, the wait is too long because of there is only one company that specializes in this. Patient’s wounds have deteriorated before getting evaluated. Currently, patients who have difficulty ambulating have to be assisted to go the nearby hospital that has a wound care clinic. Bedbound patients have to be transported through a costly medivans or ambulance just to get to this specialty clinics. This adds burden to the working families and caregivers having to transport the patient and thereby, decreasing compliance to obtain the care they need. There should be more vascular doctors and wound care specialist nurses that can provide wound care at home equipped with a vehicle or any device that will enable patients to be treated at their homes.With the growing complexity in patients health condition, we need to use the latest technology to make more complex and broader healthcare services available to them in the simplest way.

About Donna

Donna is currently attending Aurora University. She is currently a Home-Health and Home-visiting nurse. She is attending university at this time, to increase her knowledge of nursing.

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