A long-term care nurse is available free of charge to persons who meet certain conditions. What is long-term home nursing care, who needs it, who can apply and is a referral necessary?

Contents:

  1. Long-term care nurse - who needs it?
  2. Long-term care nurse - what conditions must be met
  3. Long-term care nurse - referral
  4. Long-term care nurse - not en titled to care
  5. Long-term care nurse - costs
  6. Long-term care nurse - what does she do?
  7. Rehabilitation at home? Also possible, but as part of a different service
  8. Home hospice - possible in certain situations

Long-term care nurseis helpful when caring for an elderly or chronically ill person at home exceeds the capabilities of those closest to you. It does not have to be commercially paid.

The services of a long-term care nurse, under certain conditions, may be granted and paid from public funds: prescribed by a primary care physician and financed by the National He alth Fund.

Long-term care nurse - who needs it?

Under what circumstances can I apply for a long-term care nurse?

Oh, even if an elderly and / or chronically ill person is discharged from the hospital, because he or she no longer requires treatment in hospital conditions, but is not yet able (or will not be able to function at all), and therefore requires nursing care.

Also in situations where the loss of fitness and the need to provide care is not preceded by a stay in a medical facility, the use of this type of service may be indicated and granted.

The problem does not only concern people in very advanced stages of old age. Losing independence as a result of a stroke, stroke or long-term care for a severe chronic disease is an experience to which we are exposed at various stages of life, although, of course, adult age is a factor that increases the likelihood of such circumstances.

When reassurance is neededcare refers to an elderly person, difficulties with organizing and providing it fall on people from the environment, the closest family, and often they are also people of advanced age.

Worth knowing

The services of a long-term care nurse are different from the services of a he alth visitor. It is also different from the care services and specialized care services granted within the framework of social assistance.

There are many forms of caring support at home, and they all differ in terms of scope and principles of granting, financing and benefits. There are a number of forms of public services between the family and the marketplace to support those in need of care at home and their families.

The nursing and rehabilitation dimension of care is provided by long-term care nursing at home and home rehabilitation services, respectively. Both are free benefits, financed from he alth insurance contributions, collected under the National He alth Fund.

The rules for granting them as well as the time range are strictly defined in medical legislation. It is worth being aware of their existence and the distinctions between them (as well as between them and the aforementioned care services from social assistance).

Long-term care nurse - what conditions must be met

Many of the activities in question, especially in the first phase after the person requiring care loses independence, may be difficult only for those closest to them, as they are simply not prepared for it.

Many people also cannot afford the privately purchased services of nurses or babysitters. The help of a long-term care nurse (or nurse) is therefore worth its weight in gold, and in the light of the law, this support is not limited only to systematically performing certain nursing activities, but also to preparing the dependent person and their environment for care.

The benefits may therefore extend beyond the time for which such services are granted. To receive them, a number of conditions must be met, related to the he alth condition and, above all, the level of (in) fitness of the person under care and the completion of certain formal procedures.

This is specified in the Regulation of the Minister of He alth of November 22, 2013 on guaranteed benefits in the field of nursing and care services as part of long-term care.

This legal act is not extensive and complicated to read and it is worthwhile for people in need to consult it to know what rights they are en titled to.

Long-term care nurse - referral

The keyThe information is that the primary he alth care physician is authorized to refer long-term care nursing services, and the referral must be accompanied by appropriate medical documentation specified in the regulation.

The decision of the primary care physician is based on the diagnosis of dependency according to the so-called Barthel scale. This scale determines the degree of independence in performing specific activities of everyday life.

This includes eating meals, maintaining personal hygiene, using the toilet, washing and bathing, moving around, controlling physiological needs, getting dressed, etc.

In order to be able to use long-term care services (both in the stationary formula provided by care and treatment institutions and nursing and care institutions, and in the community formula, i.e. in the form of long-term care nurses' services at home), the patient must have awarded no more than 40 points out of 100 on the Barthel scale.

Long-term care nurse - not en titled to care

This requirement may be objectionable. Can a person whose independence will be defined at, for example, 45 points on the Barthel scale always be considered as not requiring this type of home long-term care nursing services, even if it is for a much shorter period of time?

It seems that not necessarily, but the law unfortunately contains a clear limit of 40 points here. Moreover, to a limited extent, this scale allows to capture the care needs of relatively physically fit people whose neurodegenerative diseases (e.g. Alzheimer's disease) also indicate the need for long-term care.

There are also prerequisites other than the result on the dependency scale, which exclude the granting of the benefits in question. The condition for granting them is:

  • not covered by home hospice,
  • not covered by another care institution providing guaranteed benefits in stationary conditions,
  • LTC team not covered by mechanically ventilated adults, children and adolescents,
  • not staying in the acute phase of mental illness.

The last of the above points in particular raises a question that goes beyond the scope of this article - what about people who require long-term nursing care, but are in the acute phase of mental illness? The situation for them and their relatives is also not easy.

Long-term care nurse - costs

However, it is worth noting the positive from the point of viewthe patient and his / her close aspects of granting and providing long-term home care as part of services financed by the National He alth Fund.

Once credited, the recipient and their loved ones do not have to pay out-of-pocket. By law, the nurse should come at least four days a week.

The principles of financing are therefore quite different here than in the case of care services and specialist care services allocated as part of social assistance. This is because they, for people exceeding the low income threshold entitling to social assistance benefits, may require co-payment by their recipients.

The more the income threshold is exceeded, the higher the out-of-pocket cost may be. In the case of long-term nursing care, the financial and financial situation of the patient, his family or the household in which he is staying is not taken into account. He alth and fitness criteria count.

Long-term care nurse - what does she do?

The catalog of activities of a long-term care nurse is specified in the aforementioned regulation. They are:

  1. services provided by a nurse,
  2. preparing the beneficiary and his family for self-care and self-care, including developing skills in coping with disability;
  3. nursing benefits in line with the nursing process;
  4. he alth education of the beneficiary and members;
  5. help in solving he alth problems related to independent functioning in a home environment;
  6. assistance in obtaining medical and rehabilitation equipment necessary for the proper care and rehabilitation of the beneficiary at home.

As you can see, among the tasks of a nurse, only some of them refer to strictly nursing activities, and the rest to education and preparation of the environment for care and support for a dependent person as well as help in solving he alth problems or obtaining material aids enabling the rehabilitation process.

It is worth emphasizing the educational dimension of long-term care nurse services, which not only provides some kind of care, but is designed to prepare and support the family and the person who requires this care in solving various problems that accompany the loss of independence.

To some extent, therefore, it is an institution that, at least to a small extent, fills the gap in the support system regarding information and training assistance for family members of thedependency.

Rehabilitation at home? Also possible, but as part of a different service

Coming back to the issue of nursing long-term care at home, let us pay attention to the last point of the calculation of activities that fall in this area, namely assistance in obtaining rehabilitation equipment.

It is worth mentioning here that although the nurse helps in obtaining support, she is not directly responsible for rehabilitation.

So if rehabilitation measures are needed (and these are, or rather should be, in fact an inherent feature of long-term care), separate services are provided for this purpose, the provision of which at home can also be applied for under the National Fund He alth Fund.

This is regulated by paragraph 6 of the Regulation of the Minister of He alth of November 6, 2013 on guaranteed benefits in the field of therapeutic rehabilitation. Such a referral can be obtained during the visit of a primary care physician, specialist physician or the physician responsible for the patient's discharge from the hospital.

It is also possible, in justified cases, to receive a referral for rehabilitation as part of a doctor's home visit (e.g. when the person requiring care at home is lying down).

The ordinance distinguishes between circumstances in which rehabilitation at home is limited in time and in which rehabilitation may be granted indefinitely.

In principle, rehabilitation under the National He alth Fund can be conducted for 80 days, but it is also possible to apply for an extension of this period.

Home hospice - possible in certain situations

In the context of home long-term care services, it is also worth mentioning the home hospice formula. The condition is, however, the presence of the terminal phase of the disease, which does not predict a cure.

There is a catalog of diseases strictly defined in the ministerial ordinance that may be the basis for hospice care. In practice, as the NIK report showed, almost 90 percent. people using this care are patients suffering from oncological diseases (of which over 83% are malignant tumors).

If the hospice has a contract with the National He alth Fund, using it is also free of charge for the patient and family.

  • Palliative care at home and in the hospital. Home and inpatient hospices
  • Care for the bedridden. Mental support for the bedridden
  • Care for the bedridden. Proper nutrition of the bedridden
  • Care for the bedridden. Problems with physiology and the daily toilet of a bedridden person
  • Care for the bedridden:bed, bedsores, chafing

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Patient's kit