Home Visits: Enhancing Individual and Family Care
Concept of Home Visits
Home visits are activities that facilitate individualized care and family development within their natural environment. This approach allows for the assessment, definition, treatment, support, and monitoring of health issues for both the individual and the family.
Objectives
- To assess the health needs of the family.
- To directly and actively assess the physical environment and family dynamics.
- To directly evaluate the performance of self-care.
- To create a care plan tailored to the family’s specific situation and resources.
- To foster a climate of trust.
Target Situations
- Assessing pre-crisis situations.
- Addressing crisis situations and/or existing problems.
- Monitoring the family throughout their life cycle.
Types of Home Visits
- On-demand: The visit is requested by the user.
- Scheduled: This type of visit is a routine part of a home care program.
- Situation-dependent: Directed to provide care in specific circumstances, such as:
- An acute phase.
- A chronic situation.
- Geriatric and postpartum care.
- Palliative care.
- Supporting the caregiver.
Phases of a Home Visit
1. Preparation
This involves reviewing the patient’s history before the home visit, gathering information related to:
- Cultural values and work.
- Family composition.
- Clinical history.
- The family’s lifestyle.
- Housing conditions.
Planning the visit based on collected information includes defining the nurse’s objectives and scheduling the appointment (day and time) with the family. Preparing necessary materials, such as medical supplies, a sphygmomanometer, or dietary plans, is also crucial.
2. Introduction to the Family
Nursing professionals should introduce themselves to the family and engage in a brief, informal conversation. They should explain the objectives of the visit and express their interest in the health of the entire family unit. This phase is crucial for fostering a climate of trust and empathy.
3. Development
This phase involves the delivery of nursing care. It requires:
- Assessing the family’s needs through interviews and observation.
- Determining nursing diagnoses, autonomy issues, and collaborative problems.
- Planning care, which must specify:
- Objectives for the family and/or patient (i.e., desired outcomes).
- Care strategies to improve the patient’s independence or provide support.
4. Registration and Evaluation
Registration: Recording essential information is necessary. The information collected at home must be documented in the patient’s record or the home visit history at the primary care health center. This is important because it:
- Provides a record of the care provided.
- Ensures continuity of care.
- Allows for the assessment of the quality and efficiency of the service.
- Highlights the specific contributions of the nursing service.
Evaluation: Continuous assessment is performed during all visits to evaluate the effectiveness of the planned objectives and the care provided for identified problems.
Healthy Housing
Healthy housing encompasses basic sanitation, clean and structurally adequate spaces, and support networks to ensure safe and healthy environments.
Assessment of Housing
- Accessibility of housing, including the presence of an elevator.
- Type of air conditioning equipment (stoves, braziers, heating).
- Availability of piped water or a well, and whether hot water is available.
- Presence of a toilet and shower or bath.
- Identification of risks, such as furniture obstructing movement, rugs, steps, etc.
- Evaluation of hygiene, including cleanliness and assistance with household chores.
- Assessment of environmental conditions, such as moisture (e.g., stained walls), lighting (availability of natural light), and ventilation.
- Evaluation of overcrowding, defined as more than three people sharing a bedroom.