Founded in 1999,  Dimensional HomeCare Services, Inc. is striving to be the premiere homecare provider in the Philadelphia area and across the nation.  We are a State-Licensed/Medicare Certified agency committed to providing the people we serve the highest quality of service available.  To find out more about the services we offer click here More

What is homecare?

Home health care involves providing people with health care and health-related services in their own homes. As a result, many people can lead healthier, happier, more independent lives.

A treatment plan is developed for each individual patient. All services are provided under the direction of the patient's doctor. Services are provided by trained professionals such as:

 Client and family education is an important part of home health care. The involvement of the client and family members in the treatment plan often improves the effectiveness of the plan.

What's more, by working in the client's own home environment, the health care provider can gain valuable insights to improve treatment and help the client live a healthier, more independent life at home.

While the home has been a primary site for care giving for ages, home health care as we know it now had its beginnings in the 1880s. Today, home health care is the fastest growing segment of the health care industry, providing an ever-growing list of services to people of all ages and walks of life.

Why homecare is so popular?

An estimated 3.5 million Medicare beneficiaries received fee-for-service home health services in 1997, twice the number of home health recipients in 1990.  For the period 1994-1997, Medicare home health expenditures increased from $12.7 billion to 16.7 billion.  Most of the rise in spending occurred as a result of the increase in visits, from 70 million in 1990 to 257 million in 1997. Those figures are just for Medicare. Home care is frequently used for new mothers, infants, children, and adults with injuries and illnesses. Insurance companies also realize the enormous potential of home health care.  A few factor contributing to the grow of home health care are:

	The aging of the U.S. population
	The increased acceptance by physicians, Clients and third-party payers of home health care services as a viable alternative for administering care outside of an institutional setting
	The cost effectiveness of home health care versus hospitalization (home health care is estimated to cost approximately 50% of equivalent care delivered in the hospital)
	The deterioration of the family unit which forces the dependence of individuals on outside caregivers.
	Patients have altogether avoided institutional care
	Patients tend to recovery more quickly at home
	Patient and family tend to be more involved in the patients care.
	Patients enjoy the support and family and friends

 These are a few of the reasons why homecare is so popular.

Who  Pays for home care?

You do. Either through private pay, or through Medicare, Medicaid or private insurance. Medicare and Medicaid are tax payor based programs, and private insurance is premium supported, so in the end you pay for the care directly or indirectly.

What about advance directives?

An advance directive tells your doctor what kind of care you would like to have if you become unable to make medical decisions. The law now says that at the time you are admitted to the hospital, the hospital staff must tell you about advance directives.

Advance directives can take many forms. Laws about advance directives vary from state to state. You should be aware of the guidelines of your state laws regarding the scope and technical requirements that apply to advance directives.

A good advance directive describes the kind of treatment you would want to receive for different levels of illness. For example, the directives would describe what kind of care you would want if you have a critical illness, a terminal illness or permanent unconsciousness. Advance directives usually tell your doctor that you don't want certain kinds of treatment when you are this ill. However, they can also say that you want a certain treatment, no matter how ill you are.

Living Wills
Living wills are one type of advance directive. They only come into effect when you are terminally ill. Being terminally ill generally means that you have less than six months to live. In a living will, you can describe the kind of treatment you want in a certain situations. A living will doesn't let you select someone to make decisions for you.

Durable Power of Attorney for Health Care
A durable power of attorney (DPA) for health care is like a living will, but it becomes active any time you are unconscious or unable to make medical decisions. In a DPA, you select a family member or friend who will be your medical decision-maker if you become unconscious or unable to make medical decisions. A DPA is generally more useful than a living will. If you don't have another person you trust to make these decisions for you, the DPA may not be right for you.

Living wills and DPAs are legal in most states. Even if they aren't officially recognized by the law in your state, they can still guide your loved ones and doctor if you are unable to make decisions about your medical care. Ask your doctor, lawyer or state representative about the law in your state.

Do-Not-Resuscitate Orders
Unless given other instructions, hospital staff will try to help all patients whose hearts have stopped or who have stopped breathing. You can indicate with an advance directive form or by talking with your doctor that you don't want to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. In this case, a do-not-resuscitate (DNR) order is put in your medical chart by your doctor. DNR orders are accepted by doctors and hospitals in all states.

Most patients who die in a hospital have had a DNR order written for them before they die. Patients who are not likely to benefit from CPR include people who have cancer that has spread, people whose kidneys don't work well, people who need a lot of help with daily activities, or people who have severe infections such as pneumonia that require hospitalization. If you already have one or more of these conditions, you should discuss your wishes about CPR with you doctor, either in the office or when you go to the hospital. It's best to do this early, before you are very sick and are considered unable to make your own decisions.

Should I have an advance directive?
Most advance directives are written by older or seriously ill patients. For example, a patient with terminal cancer might write that she does not want to be put on an artificial respirator if she stops breathing. This action can reduce her suffering, increase her peace of mind and increase her control of her death. You might want to consider writing an advance directive even if you are still in good health. An accident or serious illness can happen suddenly, and if you already have a signed advance directive, your wishes are more likely to be followed.

How can I write an advance directive?
You can write an advance directive in several ways:

NOTE: Advance directives and living wills are not complicated legal documents. They can be short, simple statements about what you want done or not done if you can't speak for yourself. Remember, anything you write by yourself or with a computer software package should follow your state laws. The orders should be notarized if possible, and a copy should be given to your family and your doctor.

This information provides a general overview on advance directives and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on the subject.

State-Licensed/Medicare Certified