Family Support
Projeto Home Care is committed with each of its patients in risk reduction and for this develops and trains caregivers and family members in prevention and actions that should be taken in case of any health events. In order to organize those processes some leaflets were produced with important pieces of information for home assistance.
Risk Prevention
Home Care Basics
Home care enhances the rescue of the principles of patient integration in their self-care or family bonding at the time of illness. It aims at educating the family on an educational basis, preserving the basic human needs and affective bond of the patient as a holistic being, as a practice focused on the person as the subject of their health-disease process.
The Home Health Care team has a supportive focus on family, caregiver and patient, having as their duty:
Respect the principles of home care, searching strategies to improve them;
See the person as a subject of the process of promotion, maintenance and recovery of their own health and view them as co-responsible agents for the process of balance between health-disease relationship;
Clarify and guide the patient, family and caregivers;
Monitor patient/client health status, facilitating communication between the family and the team;
Ensure recording in the home medical record;
Assess the condition and physical infrastructure of the house;
Keep up with the patient/client according to the care plan outlined by the clinical need;
Covenant family agreement for home care;
Aim at ensuring comprehensive, resolute and harm-free care to the patient/client;
Work family relationships seeking harmony, optimizing actions for a therapeutic family environment;
Guide general hygiene care with the body, food, environment and water.
It is considered deviation of the home health care team professional role:
It is forbidden for the professional to perform domestic services, banking, or any other activity that misrepresents their link to the activity proposed herein.
To ensure patient safety in home care, below are basic requirements:
Have physical infrastructure compatible with the performance of home care at home, such as adequate electrical installation, drinking water supply, media, ease of access to vehicles and fresh air environment, in cases where poor physical conditions imply increased risks for the user’s health, they should be evaluated by the multidisciplinary team;
Have the informed consent of the user (if conscious) and/or their legal representative;
Need care at a frequency of visits and competence activities of basic care;
The patient may be disconnected from the Home Care Project program in the following situations:
Change of coverage area, shall be transferred to the team responsible for the area of the new house;
Impossibility of the caregiver's stay at the house;
Non-acceptance of the home care program;
Clinic worsening that justifies hospitalization;
Improvement of health conditions that do not justify home care;
Cure;
Death.
The caregiver is the person who provides the care directly, continuously and/or regularly, and may or may not be a family member. It is understood that the figure of the caregiver is relevant to the performance of home care. For such activity, it is required full physical and psychological capacity, not indicated for people aged over 60 years.
Based on this principle and the fact that the team, depending on the home care program, shall not be with the patient at all times, family members/caregivers should be able to perform some less complex actions and procedures required in care, if necessary. To make this possible, the team will be guiding and validating caregivers to perform:
Sanitation;
Exchange of collecting bags;
Bed bath;
Administration of oral or enteral drug products.
Record of sleep schedules, frequency of diuresis and defecation;
Temperature measurement;
Notice of warning signs;
Change of decubitus position;
Administration of enteral diets and probe care;
Intermittent bladder catheterization
Clean technique;
Skin moisturizing.
Patient’s Rights and Duties Letter
Patient’s Rights:
1. The patient has the right to dignified, attentive and respectful care by all health professionals, with no prejudice of race, belief, color, age, gender, diagnosis or any other form of prejudice.
2. The patient has the right to be identified by the full name. The patient should not be called by generic or any other improper, disrespectful or prejudiced forms.
3. The patient is entitled to receive immediate and timely assistance from the employee present at the place to improve their comfort and well-being.
4. The patient has the right to identify the professional by visible badge, which should be kept in an easily visible place.
5. The patient has the right to demand that the professional comply with all standards of prevention and control of home infection, according to the regulation by the competent agencies, contained in the Home Care Infection Control Program.
6. The patient has the right to receive clear, simple and comprehensive information, adapted to their cultural condition, regarding the diagnostic and therapeutic actions, the duration of treatment, the location of their pathology, the instruments to be used and which body regions will be affected by the procedures.
7. The patient has the right to consent or refuse diagnostic or therapeutic procedures to be performed as part of treatment. The patient must consent freely, voluntarily, informed and with adequate information.
8. The patient has the right to see their medical record completed correctly and in readable conditions. This medical record should contain a set of standardized documents of the patient's history, onset and evolution of the disease, clinical reasoning, examinations, therapeutic conduct and other clinical reports and notes.
9. The patient has the right to receive all information about the drug products to be administered.
10. The patient has the right to receive prescriptions without codes or abbreviations. Recipes must be typed or legibly handwritten, and signed and stamped with the registration number of the relevant professional council.
11. The patient has the right to safety and physical integrity, respecting the established safety features and procedures and the facilities of the house.
12. The patient has the right to protection of their secrets by maintaining professional secrecy as long as it does not pose any risk to third parties or public health.
13. The patient has the right to maintain their privacy, with proper care and professional conduct that safeguards this privacy.
14. The patient has the right to respect for their spiritual and religious beliefs and to receive or refuse moral, psychological, social and religious assistance.
15. The patient has the right to a dignified and serene death, being able to give their own opinion (as long as the patient is lucid), the family or the person responsible for the follow-up, and whether or not to use painful and extraordinary treatments to prolong life.
16. The patient has the right to dignity and respect even after death. Family members or the person responsible should be notified immediately after death.
17. Patients have the right to have their image and identity preserved and their ethical, moral and cultural values respected, regardless of their state of consciousness.
18. The institution supports the patient's right to seek a second opinion regarding their diagnosis or treatment, inside or outside the institution, with the patient or family being responsible for the costs.
19. The patient has the right to be informed, oriented and, if necessary, trained on how to conduct self-care, receiving clear and readable medical instructions on the continuity of their treatment aiming at cure, rehabilitation and secondary prevention and its sequelae or complications.
20. The patient has the right to be informed of all rights mentioned above, the rules and regulations of home care and how to communicate with the authorities and leaders of the company for information, clarification of doubts, presentation and complaints.
Patient’s Duties:
1. The patient and/or legal guardian has a duty to give complete and accurate information about their health history, previous illnesses, previous medical procedures and other health related problems.
2. The patient has a duty to report unexpected changes in their current state of health to the professionals responsible for their treatment.
3. The patient has the duty to acknowledge the actions being taken or proposed to cure the health problems, prevent complications or sequelae, rehabilitate them and promote their health by asking questions whenever in doubt.
4. The patient has a duty to follow the instructions recommended by the assisting multidisciplinary team, being responsible for the consequences of their refusal.
5. The patient has a duty to participate in their treatment plan and discharge or indicate someone to do so.
6. The patient has a duty to respect the rights of the Institution's employees and contractors, treating each other with respect and courtesy, contributing to well-being as a human being.
The Patient and Family Rights policy in the Home Care Project is based on State Law No. 10.241, of March 17, 1999, which provides for the rights of health care users in the State of São Paulo; on Federal Law No. 8.060 of July 13, 1990, which enacts the Child and Adolescent Statute; and on the Patient Rights Manual of the São Paulo State Government.
References:
Constitution of the Federative Republic of Brazil
Brazilian Civil Code (Law 10.406 of 01.10.2002)
Consumer Protection and Defense Code (Law 8.078, of 09.11.1990)
Universal Declaration of Human Rights
State Law 10.241, of 03.17.1999 – Health Services and Actions Users Rights of the State of São Paulo
Elderly Statute (Law 10.741, of 10.01.2003)
State Office of Health – SP – Patient Rights
