home visits by nurses

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Best Visiting Nurse Services

AccentCare is the best visiting nurse service, with performance ratings above industry standards

One day you or a loved one might need a visiting nurse for medical care in your home. In the United States, it’s a relatively common experience. According to the Centers for Disease Control and Prevention (CDC), about 4.5 million Americans are treated in their homes every year by more than 12,000 home healthcare agencies. Many people prefer the ease of having medical care in their own home, rather than having to travel to a hospital or doctor's office.

When the time comes, you’ll need to do some research to find a visiting nurse service that fits your personal needs. With that in mind, we reviewed over 40 home healthcare companies to find the best visiting nurse services available.

Best Visiting Nurse Services of 2024

Best Overall: AccentCare
Best for Post-Operative Assistance: Elara Caring
Best Technology: Enhabit Home Health & Hospice
Best for Specialized Care: Interim HealthCare
Best for Hospice (End-of-Life Care): ProMedica Hospice
Our Top Picks

Elara Caring

Enhabit Home Health & Hospice
Interim HealthCare
ProMedica Hospice
See More (2)

Final Verdict

How to Choose

Methodology

Best overall : accentcare.

Services offered : Personal care, behavioral health, rehabilitation, medical assistance, hospice and palliative care, care management, health alert systems
Number of locations : 260 locations across 31 states

We selected AccentCare as the best overall provider of skilled home health care based on its accessibility (there are over 260 locations) and performance ratings that are above industry standards.

Programs for chronic conditions

Specialized programs, including behavioral health and stroke

Tele-monitoring program for early intervention

Some locations have different names, which can be confusing

Website’s location search page is hard to find

All of AccentCare's agencies are accredited by Community Health Accreditation Partners (CHAP) and have earned an overall 4.6-star quality rating and recognition from the We Honor Veterans program. AccentCare treats over 140,000 patients a year. Along with skilled home health care and private duty nursing, it offers hospice care, personal care services, and care management.

AccentCare also uses technology to supplement visiting nurse home care visits with tele-monitoring that can deliver biometric data (blood pressure, pulse, blood glucose, etc.) in close to real-time to keep the medical support team informed and ready to take action if necessary. AccentCare is the fifth largest provider of skilled home health in the U.S.

Best for Post-Operative Assistance : Elara Caring

Services offered : Home health care, hospice care, rehabilitation, recovery care, personal care, behavioral care
Number of locations : 200+ locations across 16 states

Elara Caring focuses on recovery and rehabilitation, excelling in nursing, physical therapy (PT) , occupational therapy (OT), and speech therapy .

Also offers hospice care and behavioral health services

Delivers proactive customized care (CAREtinuum)

Only available in 16 states

Elara Caring's CAREtinuum program, a system that uses predictive analytics to identify patients at risk, sets it apart from other companies for post-operative assistance. For example, Elara’s CAREtinuum Fall Risk Program patients are 72% less likely to return to the hospital due to falling.

Elara Caring offers a wide range of in-home clinical services, treating more than 65,000 patients a day. Along with skilled home health, Elara Caring offers hospice care, personal care, and behavioral care. Its behavioral care supports a wide range of conditions, including depressive/anxiety disorders, schizophrenia, bipolar, and other disorders.

Even though Elara only has locations in about one-third of the states in the U.S., it is the ninth largest provider of skilled home health in the country.

Best Technology : Enhabit Home Health & Hospice

Services offered : Home health care, hospice care, post-operative care, transition program from hospital to home, long-term care
Number of locations : 355 locations across 34 states

We chose Enhabit Home Health & Hospice for its easy-to-use technology that makes a customer’s online experience simple, with comprehensive information quickly available.

Locations in 34 states

Variety of programs to enhance skilled nursing, including skilled therapy, balance and fall prevention, and orthopedics

Not all locations offer hospice

Website offers Spanish translation, but only portions of the site are available in Spanish

The online software at Enhabit streamlines each step, from referral processing to scheduling to management of physician orders, in order to optimize patient care and attention. This connection between patients, doctors, and in-home care providers makes processes easier and more transparent.

In addition, Enhabit’s web portal provides one-stop access to manage diagnoses, patient history, medications, and plan of care. Enhabit is also able to deliver better care for patients through predictive analysis, to identify potential risks.

Best for Specialized Care : Interim HealthCare

Interim Healthcare

Services offered : Home health care, senior care, in-home nursing services, respite care, transitional care; at-home physical therapy, occupational therapy, and speech therapy.
Number of locations : 300+ locations across 41 states

We chose Interim HealthCare for its focus on home care for adults or children with special needs due to an injury or illness.

Promotes a more engaged existence at home for patients and their families

Offers caregivers more than 300 continuing education units

Available in nearly 50 states

Independently owned franchises mean inconsistencies in customer satisfaction

Interim HealthCare's services include care for adults and children who are developmentally delayed or need to use a feeding tube. Specialized offerings include home care for arthritis, multiple sclerosis , joint replacement, hypertension , paraplegia and quadriplegia, and traumatic brain injury (TBI).

Interim also offers many specialized interactive online training courses and live webinars for specific needs, such as dementia care. Interim HealthCare University provides extensive training resources available for free to employees, including over 300 lessons for both clinical and non-clinical staff and management in areas such as fall prevention, home care technology, and transitioning from a facility.

Interim’s HomeLife Enrichment program looks beyond basic needs to address the mind, spirit, and family as well as the body. The focus is to add purpose, dignity, and self-worth to basic safety and independence.

Interim HealthCare has a network of more than 300 independently owned franchises (employing nurses, aides, therapists, and other healthcare personnel) serving about 173,000 people every year.

Best for Hospice (End-of-Life Care) : ProMedica Hospice

Services offered : Home hospice care, pain management, spiritual support, comforting treatments, bereavement services
Number of locations : In 26 states

ProMedica Hospice provides the comfort and quality of life that hospice is known for, with fast and effective responses to patient discomforts such as pain, shortness of breath, and anxiety.

Advance directive not required for hospice care

Fully accredited

Provides employees with training, continuing education, and tuition assistance

Only available in 26 states across the U.S.

ProMedica Hospice has locations in 26 states, offering services such as pain and symptom management therapies. Heartland can provide hospice care in any “home”—including a private home, an assisted living facility, or a skilled nursing center.

While some hospices require a do not resuscitate (DNR) order before providing care, ProMedica (formerly Heartland Hospice Care) doesn’t. In situations where Medicare will be paying for the care, a DNR is not required because the care is considered palliative (providing comfort, instead of a cure or treatment).

ProMedica Hospice develops talent by offering its employees training and education opportunities at many of its locations. For example, its nursing assistant training programs include assistance with the cost of taking a state certification exam.

ProMedica Hospice also offers bereavement services, advanced planning services, and the possibility to grant funds to help offset financial burdens created by terminal illness.

While each visiting nurse service on this list has its strengths, AccentCare is our top pick due to its wide variety of specialized programs and high quality rating. The caretakers at AccentCare are skilled and experienced. Plus, home care visits are supplemented with an advanced tele-monitoring system.

Guide to Choosing a Visiting Nurse Service

When it comes to selecting the best visiting nurse services for you or a loved one, there are several factors you should look for to help inform your decision.

Accreditation : Home healthcare agencies and companies must be licensed in order to operate in a state. As you research the best visiting nurse services, ensure that the agency you select is licensed in the state you live. Consult with the Centers for Medicare & Medicaid Services (CMS) or the Joint Commission, which offers accreditation to home health providers.
Insurance : Check your available coverage and what potential out-of-pocket costs may be by asking any potential visiting nurse service if it accepts your insurance. Often, services take Medicare, Medicaid, private insurance, or Veterans Administration benefits.
Services needed : Depending on your needs, you may require more specialized nursing care. For example, visiting nurse services can be tailored to the patient if they need after-surgery care, rehabilitation therapy, medication administration, or personal care and companionship.
Visiting hours : Many visiting home nurses operate between the hours of 8 a.m. and 5 p.m. However, depending on the needs of the patient, in-home hours can often be adjusted. Ask a home healthcare provider if they also arrange for evening or overnight visits, should you need them.

Frequently Asked Questions

What are the duties of a visiting nurse.

A visiting nurse is a skilled medical professional, usually a registered nurse, who oversees all aspects of the medical care you receive at home, as ordered by a physician. This might include evaluating your medical condition and health needs, monitoring your vital signs and assessing risk factors, and administering medication. A visiting nurse is also trained to care for specific conditions such as COPD, diabetes, dementia, and Alzheimer’s. They can change dressings for surgical incisions or wounds and provide hospice care .

When your visiting nurse leaves, they make sure that you and your caregivers have the necessary information and supplies to support the plan of care.

Is a Visiting Nurse the Same as a Home Health Aide?

A visiting nurse is a skilled medical professional, while a home aide typically has limited formal medical training and provides services such as help with personal hygiene, meals, and transportation. A home health aide may stay in your home for several hours providing care, while a visiting nurse will stay for a shorter time to perform specific tasks.

Does Medicare Cover Visiting Nurse Services?

If you have Medicare, home health care, such as that provided by a visiting nurse, is covered 100% by Medicare when your doctor certifies that you meet the required guidelines. If you do not have Medicare, consult with your healthcare insurance to determine your policy parameters for coverage, including necessary copayments, if any.

Hospice (including a visiting nurse, if one is on your team) is covered by Medicare, Medicaid, the Veteran’s Health Administration, and private insurance. Although most hospice care is provided at home, it is also available at hospitals, assisted living facilities, nursing homes, and dedicated hospice facilities.

Always double-check coverage with your insurance provider and ask the visiting nurse service if it accepts your insurance plan.

For this ranking, we looked at more than 40 home health providers. The primary criteria were the number of locations and national footprint, so the ranking would be useful to a large number of people. In addition to reviewing companies' areas of expertise, we also looked at their website interface, navigation, and usability and how they are ranked in areas such as quality care and patient satisfaction by services such as the U.S. government’s Centers for Medicare and Medicaid Services (CMS) Home Health Star and Home Health Compare .

AE Pictures / Getty Images

Centers for Disease Control and Prevention, National Center for Health Statistics. Home health care .

LexisNexis Risk Solutions. LexisNexis Risk Solutions ranks top home health and hospice providers .

Nursing Home Visit

Description

A nursing home visit is a family- nurse contact which allows the health worker to assess the home and family situations in order to provide the necessary nursing care and health related activities. In performing home visits, it is essential to prepare a plan of visit to meet the needs of the client and achieve the best results of desired outcomes .

To give care to the sick, to a postpartum mother and her newborn with the view teach a responsible family member to give the subsequent care.
To assess the living condition of the patient and his family and their health practices in order to provide the appropriate health teaching.
To give health teachings regarding the prevention and control of diseases.
To establish close relationship between the health agencies and the public for the promotion of health.
To make use of the inter-referral system and to promote the utilization of community services

The following principles are involved when performing a home visit :

A home visit must have a purpose or objective.
Planning for a home visit should make use of all available information about the patient and his family through family records.
In planning for a home visit, we should consider and give priority to the essential needs if the individual and his family.
Planning and delivery of care should involve the individual and family.
The plan should be flexible.

The following guidelines are to be considered regarding the frequency of home visits:

The physical needs psychological needs and educational needs of the individual and family.
The acceptance of the family for the services to be rendered, their interest and the willingness to cooperate.
The policy of a specific agency and the emphasis given towards their health programs.
Take into account other health agencies and the number of health personnel already involved in the care of a specific family.
Careful evaluation of past services given to the family and how the family avails of the nursing services.
The ability of the patient and his family to recognize their own needs, their knowledge of available resources and their ability to make use of their resources for their benefits.
Greet the patient and introduce yourself.
State the purpose of the visit
Observe the patient and determine the health needs.
Put the bag in a convenient place and then proceed to perform the bag technique .
Perform the nursing care needed and give health teachings.
Record all important date, observation and care rendered.
Make appointment for a return visit.
Bag Technique
Primary Health Care in the Philippines

2 thoughts on “Nursing Home Visit”

Thanks alots for the impressive lessons learnt from the principal of community health care and nursing home

Home visit nursing

Nursing Home Visit – Tips & What To Expect

If you are preparing for your first nursing home visit, read this guide. This is packed with helpful tips so you can be prepared.

Reasons Nurses Do Home Visits

There are lots of reasons that a nurse might visit someone’s home. Before I share some of my tips, it’s important to understand the purpose of the visit. Each type of home visit will have different goals and outcomes, so you’ll do different things when you arrive.

These are the main reasons that nurses might do home visits:

Care for a sick patient as a home-care nurse
Teach care techniques to a postpartum family
Assess the living condition of a patient and/or their family members for upcoming care
Teach people about prevention and control of diseases from within their homes
To promote the utilization of community services

Nursing Home Visit - Tips & What To Expect

7. Make Another Appointment

Your chances of doing a home visit as a nurse will depend on where you work. Typically, community outreach organizations and home health care agencies will do the most frequent home visits.

How To Decide Whether To Do A Home Visit

If you are a new nurse, you probably won’t be the one making the decision about whether to visit a patient’s home, but it is still good to know how the decision is made.

Typically, these are the main guidelines that health care providers use to decide whether nurses should visit a patient in their home:

The needs of the patient and their family – including physical, psychological, and educational
Patient and family’s acceptance and willingness to cooperate
Patient and family’s ability to recognize their needs and their ability to use the resources for their benefits
How many health personnel are already involved in the care of this specific family
The policy of the agency in regards to the home visits

How To Do A Home Visit

When it comes time to do your first home visit, just follow these steps in order. This will help you have a pleasant experience and make sure you don’t forget something important.

1. Greet The Patient

Arrive with a smile and introduce yourself. Remember to state where you are coming from and your role in the agency. Make sure you ask them their name and what they prefer to be called (if they have a nickname).

2. Tell Them The Purpose Of The Visit

Go into detail about why you are there and what you are hoping to accomplish. This part should be detailed so that they know what to expect.

3. Assess The Patient

Next you will do a quick observation and assessment. This is a silent and mental one so that you know what you will have to do while on your visit.

4. Set Your Bag In A Clean Place

Make sure your bag is sitting on a table that is lined with clean paper. Then, wash your hands with soap and water. Take out all the tools you will need for your visit so they are easy to access. Put on an apron, close the bag, and you are ready for your nursing care treatment.

5. Perform Your Nursing Care

After you are all prepared, you can do the care which you came to do. One of the most important things you will do on these visits is educate the patient and/or their family. Listen to their questions attentively and answer them the best you can. Direct them to any community services if you cannot help them right away.

6. Keep Excellent Records

Write everything down. Record the date, what you observed, and all the care you gave the patient. Also write down everything you told the family for caring for the patient at home.

If necessary, make an appointment to return and give more care. This is always needed, but don’t leave until you verified whether they need a follow up.

Nursing Home Visit: Final Thoughts

It might be nerve-wracking to think about visiting a patient or their family at their home. If you are really nervous, you can ask a friend or family member to help you prepare. Do a few practice runs as you introduce yourself and go through the motions of the assessment and care.

Set realistic expectations for yourself. If you need notes to remember what to ask, then take them along. Always ask for help when you need it. These can be very valuable and give the education and support that the patient and/or their family

More Nursing Tips

If you enjoyed these nursing home visit tips, then here are some more tips and advice about life as a nurse.

How To Get ACLS Certified
How To Write A Cover Letter
The Best Accelerated Nursing Programs

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Visiting Nurses

Nursing, Behavioral Health, Home Support, Palliative Care, and Therapy

Continuing the tradition of your visiting nurse.

When a VNA nurse, social worker, therapist, or caregiver arrives at your door, you can expect expert compassionate care. We believe everyone, no matter their station, deserves to live their life at their optimal level of health, well-being, and independence, according to their personal beliefs and choices. People turn to the VNA during times of illness or injury so you can remain where you most want to be — at home.

Whether it takes a few days or a number of weeks, your home care team will be there to provide caring support and assistance. Our staff strives to help you recover comfortably and safely at home, as well as help your caregivers manage your care.

Highly Skilled Care from the Comfort of Home

The kind of care you receive at home is crucial to recovery. Through a combination of evidence-based best practices, a patient-centered team approach, and education for your caregivers, our home health staff members are committed to providing highly skilled care right in your home.

The VNA leverages over 100 years of expert care to offer a wide variety of services to meet the needs of our community.

Signs that might indicate a need for home health care:

Change in ability to complete daily living activities
Change in appetite, weight loss or difficulty in swallowing
Recent hospitalization or surgery
Dependence on a caregiver
Difficulty managing medications

New medical diagnosis and a need for teaching

Falls or increasing risk of falls

Wound care needs

Difficulty with pain

Difficulty in breath

Specific care offered by our skilled nurses and expert caregivers includes:

Skilled Nursing (assessments, teaching, intervention, etc.)

Physical Therapy

Occupational Therapy

Medical Social Work

Home Health Aides

Home Support Providers

Speech Therapy

Palliative Care

Behavioral Health Care

Fall Prevention

Ostomy Care

Medication Management

Telehealth Visits

Physician-ordered mother and child visits

Frequently Asked Questions

What is the hcs service area.

Some or all of HCS programs are offered in 52 towns in southwestern New Hampshire. Visit our Service Area page for more information.

What is Home Health Care?

Home Health Care encompasses a wide range of health care services provided in the patient’s home with the purpose of maintaining a patient’s optimal level of health, well-being, and independence, according to their personal beliefs and choices. Home care is a collaborative effort involving caregivers, physicians, and an interdisciplinary home care team. It is a cost-effective alternative to extended hospitalization, rehabilitation, or a nursing home stay. Patients are usually more comfortable in their own home and studies have shown patients recover quicker at home.

What are the Medicare criteria for Home Healthcare?

In order to receive home health care services under Medicare, the patient must require:

Skilled, intermittent nursing care, physical therapy, or speech therapy
Have a physician’s order for home health care
AND be homebound. Medicare considers a person to be homebound if leaving the home would require a considerable effort and if they have a condition due to an illness or injury which restricts the ability to leave home except with the aid of devices or assistance of another person. Homebound patients may leave their home if absences from the home are infrequent or for periods of relatively short duration.

What can I expect at an admission visit?

During your first visit, the nurse or therapist will share a lot of information with you. They will also make sure the information we have about you is correct. The first visit may take up to two hours. The nurse or therapist will talk about:

Your discharge paperwork and/or doctor’s orders
Your role as a patient/caregiver, including payment responsibilities
Your “Plan of Care,” including the services you will receive and how often team members will visit
Your goals for home care
Your medicines, including side effects and how and when to take them
Your risk for falling
How to contact the office with question or concerns

What is a typical visit like?

Because everyone’s situation is different, there is no typical visit. We work with you and your doctor to design a treatment plan based on your specific situation. The VNA team members spend as much time as they need with every patient to make sure they are getting the care needed to get healthy again.

How often will a clinician visit me?

Your specific needs and your insurance coverage will help to determine how often VNA team members visit you. The total number of visits scheduled depends on your specific needs. VNA team members visit patients an average of two to three times a week. Visits will happen less often as you improve.

How are visits scheduled?

A VNA team member will try to call you on the evening before to schedule a visit for the next day. However, sometimes they may not be able to call until the morning of the visit. We are sorry when we cannot offer more notice. We get new patients added to the schedule every day. Sometimes, they are very sick and require urgent visits. This causes our homecare team members’ schedules to change. They will always try to give you an estimated time when they will arrive. Please answer your phone or return our calls promptly.

Will I have the same nurse and/or therapist all the time?

We understand the importance of building trust with your caregiving team. That is why we try our best to schedule the same team of clinicians to visit your home every time. Changes in time of day, day of week, and after-hours may impact our ability to schedule the same nurse or therapist, so we cannot guarantee the same provider every time.

How can I pay for this?

Home Healthcare, Hospice & Community Services accepts Medicare, Medicaid, and many private insurances. Home Healthcare, Hospice & Community Services does not deny anyone the care necessary for their health and safety solely on the basis of ability to pay. If you do not have insurance coverage, you may be eligible for service at a reduced fee or free care.

How do I make a referral?

If you or someone you know could use the expert skilled care provided by the VNA, please contact us by calling 603-352-2253 or 800-541-4145 or by emailing us at [email protected] . Please do not email protected health information. You can also view our “ Make a Referral ” page to learn exactly what is needed for a complete referral to any of our programs.

Who do I contact if I have questions?

For details about specific programs that HCS can offer, give us a call at 603-352-2253 or join us for Walk-in Wednesdays !

Our VNA Services

Our Visiting Nurses program leverages over 100 years of expert care to offer a wide variety of home health care services to meet the needs of our community.

Behavioral Health

The Behavioral Health Home Care program assists patients and families who are broken and wounded by mental illness to move toward wholeness.

Home Support

Home Support Providers deliver light housekeeping services as established on an individualized plan of care so individuals can remain independent.

Palliative Care

The Palliative Care Conversation brings compassionate listening, support and clarification of needs and wishes, right in the comfort of your home.

The Rehabilitation Team at HCS works with your physician and orthopedic specialist to help you recover, improve, and maintain your safety and independence!

ABOUT HCS SERVICES

Home Healthcare, Hospice & Community Services offers comprehensive services to the residents of southwestern New Hampshire. Services include:

Hospice at HCS

Palliative Care Support

Rehabilitation Therapies

Healthy Starts Program

Nutrition for Seniors

Transportation

Castle Center Life Enrichment Day Program

Medical Social Work/Outreach

Wellness Programs

Financial Information

Home Healthcare, Hospice & Community Services accepts Medicare, Medicaid and many private insurances. Home Healthcare, Hospice & Community Services does not deny anyone the care necessary for their health and safety solely on the basis of ability to pay. If you do not have insurance coverage, you may be eligible for service at a reduced fee or free care.

For information or to make an appointment, please call 603-352-2253 .

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Matrix For Me

Read our COVID-19 Advisory for updates on how our providers follow CDC guidelines to ensure your health and safety.

Good Health Begins with a Conversation

About matrix medical network.

View the “What to Expect” video to learn more about the In-home health and wellness visit. from Matrix Medical Network .

Watch the “What to expect” video, to learn more about an In-Home Health Assessment

Matrix is a leading provider of comprehensive health and wellness visits, advanced diagnostics, and care management services. In partnership with your health plan, we help you stay healthy by providing care in the convenience of your home, on a video call, or on one of our mobile health clinics located in your community. And, we share results with you and your primary doctor, so you stay connected to care.

Matrix healthcare professionals take the time to listen to your health concerns and provide you with personalized support and focused attention that may not be available during regular doctor visits. Our licensed health providers include physicians (MD/DO), nurse practitioners, physician assistants, and medical technicians.

To ensure Health Plan Member and Matrix Provider health and safety, we follow the Centers for Disease Control and Prevention (CDC) recommended guidelines and protocols.

Health and Wellness Visit Benefits

Why should i schedule my visit today.

Now, more than ever, it’s important you stay healthy and connected to care. Your personalized visit with a Matrix Nurse Practitioner supports your regular doctor’s care. Even if you are healthy and see your doctor regularly, Matrix health and wellness visits (in your home or on a video call) can identify health risks early – before they become serious

How will my doctor learn about my assessment results?

Matrix will send a Personal Health Summary with results to you and your primary doctor after the visit. Together, you can make informed decisions about your health.

In-home Health and Wellness Visits

What happens during my in-home visit.

A Matrix Nurse Practitioner will meet with you for about 50 minutes in the comfort and convenience of your home. Our providers follow COVID-19 (Coronavirus) safety precautions recommended by the CDC including screening, good handwashing and equipment cleaning and use of personal protective equipment like masks and gloves.

During your visit, you will receive: • A comprehensive health and wellness assessment • A full review of your medical history and medications • Personalized recommendations for additional care, screenings, and resources if needed • Answers to your health questions, including questions about COVID-19 and guidance about testing and safety practices

Or, call 1-855-286-9062 (TTY:711)

Monday-friday 8 am-8 pm, local time saturday 8 am-5 pm et, telehealth video wellness visits, what is a video wellness call.

A video wellness call takes place over a phone, tablet, or computer with a nurse practitioner. It offers a safe and convenient health and wellness visit alternative to an in-person visit.

How do I know if I am eligible for a video wellness call?

If you would like to know your eligibility status, please call us. Not all Members are eligible. Your health plan notifies Matrix if, and when, you are eligible for a no cost video wellness call. If eligible, Matrix will contact you to schedule your call. Before your appointment, we’ll confirm you have the required device and are prepared to connect to your video wellness call.

What happens during the video wellness call?

A Matrix Nurse Practitioner will perform your visit over a live video call. You will receive:

A health and wellness assessment
A full review of your medical history and medications
Personalized recommendations for additional care, screenings, and resources if needed
Answers your health questions including any questions about COVID-19 (Coronavirus) and guidance about testing and safety practices

What are the technical requirements?

To participate, you just need a cell phone, tablet or laptop computer that allows for FaceTime or Google Duo video calls. We recommend that you also have a Wi-Fi internet connection. To learn more, visit: Matrix Telehealth: Video Wellness Calls.

Call 1-855-214-4807 (TTY:711)

In-Home Visits

1-855-286-9062 (tty:711).

Video Calls

1-855-214-4807 (tty:711).

Comprehensive Health and Wellness Assessment

Early Identification of Health Risks

Answers to Your Health Questions

Full Medication Review

Necessary Health Screenings

Connections to Community Resources

Of members were happy with their visit and would have us back.

"I appreciate the chance to talk to someone about my health. It has been hard adjusting to this stage of my life. Matrix has been very helpful as I become used to the changes."

Louise - health plan member, do you have questions we're here to help.

For assistance please call us toll-free 1-855-256-9062 or submit the online form.

Nursing Visits

Home nurse visits.

Seniors At Home registered nurses can make home visits to coordinate health care and medical management needs.

Our expert nurses work with physicians, family members, and caregivers to coordinate care and detect medical issues early—and avoid any unnecessary hospitalizations. The goal of our visiting nurse service is to help you live a safer, healthier, more independent life at home.

“Thank you so much for your help. The RN that visits my mother weekly has made us feel so comfortable—we are forever grateful.” Beverly, San Francisco

Our Visiting Nurse Service Includes

Nursing assessment and consultation
Medical care planning with physicians
Individualized nursing care plans
Medication management
Medication organization and planning (Mediset pre-filling)
Wellness checks

Seniors At Home is licensed by the state of California as a Home Health Agency; a California legal requirement to provide home nurse visits.

To learn more about our skilled nursing visits, call us at 415-449-3700 or contact us online .

Award-Winning Care

“Seniors At Home is always my top recommendation when a patient needs home care because of their reliability, consistency, and wide scope of care. Families thank me for referring them to Seniors At Home.” Mary, Medical Social Worker, San Rafael
“Seniors At Home is a very generous and sensitive organization that provides excellent service.” Margaret, 85, San Carlos
“Knowing that there was a team behind the scenes helping us to orchestrate and manage mom’s care was invaluable.” Amy, Jennifer, and Jessica, San Francisco
“After a very serious surgery, I was given excellent service and, most of all, support. Thank you for being there when I needed it the most.” Anna, 81, Rohnert Park
“Thank you so much for the caring and support you’ve given my family and my dad. Everyone that came to our home became family. We appreciate everyone at Seniors At Home so very much!” Joe, Belmont
“I greatly appreciate the excellent care and professional caliber of all personnel, from your office staff to my caregiver. I am always ready to recommend you!” Douglas, 79, Tiburon

Schedule a Consultation with One of Our Experts

Call us today to get started or contact us online. We are happy to answer any questions you have about aging or senior care.

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Home care safety

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Home care is unique, placing nurses and other healthcare professionals in patients’ homes and personal space, and doesn’t include typical healthcare organization requirements.
Home care safety can be divided into three responsibilities: workers’ responsibility to protect their own safety, agency and organization responsibility to train workers and provide workplace safety practices, and patient and family responsibility to promote home care team member safety.

CNE 1.25 contact hours

Learning Objectives

Discuss strategies home care nurses can use to protect themselves from workplace violence.
Describe strategies employers can use to protect home care nurses from workplace violence.

The authors and planners of this CNE activity have disclosed no relevant financial relationships with any commercial companies pertaining to this activity. See the last page of the article to learn how to earn CNE credit.

Expiration: 5/1/23

Healthcare organizations with the mission of caring for people in their homes provide a valuable service. Keeping these workers—nurses, therapists, hospice team members, aides, and others—who provide this care requires policies and procedures that focus on safety assessment, risk identification, and situation management.

What makes home care unique?

For purposes of clarity in this article, “home care” will be inclusive of any care models that comprise home visits, regardless of the program or type/kind of home visit. And “home” will mean wherever the patient calls home. For many, home is a sacred and personal space, and most people wouldn’t enter someone’s home without knowing him or her first. However, home care, including hospice at home and other community-based home visiting models, requires providers to enter the homes of people they don’t know personally. Essentially, they’re guests in this personal space.

When care is delivered in the home, no healthcare organization dictates visiting hours, sets visitor age requirements, establishes a dress code, or creates other standards. And because home care personnel may be the only providers seeing the patient, they must be comfortable working independently but also recognize that they’re part of a larger team of care providers, which includes the patient, other clinicians, and informal caregivers, such as family and friends.

This combination of factors can create safety issues for those who provide care. (See Safety risks .)

Clinicians who provide home care face many safety risks because they:

work alone, even in high risk areas
may be exposed to a variety of potentially serious or even life-threatening hazards including overexertion, stress, guns and other weapons, illegal drugs, and verbal abuse and other forms of violence
may be exposed to blood-borne pathogens, communicable disease, needlesticks, latex sensitivity, temperature extremes, and unhygienic conditions (including lack of water, unclean or hostile animals, and animal waste)
must often commute long distances from worksite to worksite
are in the personal setting of a person’s home, travel in and out of unfamiliar neighborhoods, and interact with older people who may become aggressive because of dementia
care for many people age 65 years and older, a population with the highest rate of gun ownership in the United States
may lack safety training or security escorts when making evening/night visits
may not have immediate help if a violent incident occurs and must manage it initally on their own
may make incorrect assumptions based on their desire to be culturally humble and respectful of the person/family they are visiting. For example, a home care provider who sees marks on an elderly patient’s arms may assume that he or she is being physically abused by family members. However, if the provider had asked questions first, he or she might have learned that the patient had been visited by an integrative health practitioner and the marks are part of the healing modality.

Resources: Brouillette et al. 2017, Hanson et al. 2015, Mendes 2018, National Institute for Occupational Safety and Health 2010, PHI, Pinholt 2014

Workplace violence

Wherever providers practice, they must recognize the possibility of violence, so those who work in the home also should be aware of the patient’s community, know how to avoid violent situations, and be familiar with their organization’s policies and procedures related to violence avoidance and de-escalation.

Recent U.S. Bureau of Labor statistics show that home care workers experience more than double the national rate of workplace injuries for all industries. In addition, studies have shown that 5% to 61% of home care workers have experienced some form of workplace violence. In the United States, home care workers are most susceptible to verbal abuse and aggression, threats, and sexual harassment. Over a 3-year period in the United Kingdom, 1,544 assaults (including sexual assault, hostage situations, headbutting, biting, strangulation, and weapons use) against lone healthcare workers occurred. In Australia, a survey of 300 physicians who make home visits was conducted using an electronic form that evaluated their experiences over a year. Findings showed that nearly one in two physicians encountered aggression; verbal aggression was most common.

Nurses, providers, and others can take measures to prevent or mitigate violent situations. Some strategies may be learned in new employee orientation, while others may be shared by colleagues or in violence-prevention training. However, safety and violence-avoidance training should not be a one-time event; it requires practice, ongoing education, and awareness.

Home care safety can be divided into three responsibilities: workers’ responsibility to protect their own safety, agency and organization responsibility to train workers and provide safety practices in the workplace, and patient and family responsibility to promote home care team member safety.

Worker responsibilities

Because most home care workers practice alone, they have a responsibility for their own safety and to avoid violence, when possible. You should receive orientation about your specific agency’s policies and procedures (including personal safety, blood-borne pathogens, and conducting home visits), and also must participate in ongoing safety training. If training isn’t provided by your organization, request it.

Previsit strategies . Know and follow your organization’s policies and procedures for home visits, including what to do if you have concerns about your safety or experience violence. Create a professional presence, which should be reflected in your clothing, and demonstrate a caring and concerned attitude toward your work.

Be respectful and watch for clues about household norms; this begins when you call to make plans for the initial visit. Ask for directions, where to park, where to enter the home, who will greet you, and if any pets are in the home. In addition, establish care priorities for each home visit, try to schedule the visits during daylight hours, and let your agency know when you plan to return from each visit. Keep all healthcare equipment, supplies, and personal belongings locked in the trunk of your vehicle and remove only what’s needed at each visit.

Visit strategies . During the home visit, explain everything you’re doing and ask before touching anyone. In a tense situation or one that’s getting more tense, know that asking too many questions can be overwhelming and patients and families can get irritated. In this instance, ask questions that are specific only to the reason the person was admitted to the service and save other questions that concern the patient’s general condition for another visit. If a patient or family member’s behavior begins to escalate, remain calm and caring to diffuse anger; don’t match threats or give orders. Throughout the visit, use basic safety precautions, including being alert to your surroundings and watching for signals of potential violence. These include shouting, verbal abuse, threatening gestures, weapons, or signs of drug or alcohol misuse. Kindly but firmly establish and maintain professional boundaries and recognize your own limits and abilities. The National Council of State Boards of Nursing has additional information on establishing professional boundaries. (See Be prepared .)

Just as you would in other healthcare settings, stay up-to-date with patient care standards, policies, and processes related to infectious diseases, blood-borne pathogens, and sharps injuries. Refer to your organization, professional association, and the Occupational Health and Safety Administration (OSHA) for the most recent recommendations and guidelines.

The National Institute for Occupational Safety and Health has created a checklist for home care workers’ safety. Examples of questions from the checklist include:

Does your initial and annual training include information on:
preventing musculoskeletal disorders
reviewing the blood-borne pathogens plan
knowing what to do if you believe you’re in danger or encounter unsanitary conditions
obtaining ergonomic equipment
reducing stress
recognizing violent or aggressive behavior
calming an angry patient?
Do you know how to report your safety concerns?
Do you have appropriate personal protective equipment, including gloves?
Do you have a cell phone?
Are weapons removed from the area of service (for example, bedroom or living room)?
Is your car serviced regularly?

To access the full checklist, download NIOSH Hazard Review: Occupational Hazards in Home Healthcare .

Be aware of your surroundings

When you arrive in the patient’s neighborhood, ask yourself:

Do I see any safety hazards?
What are the road and sidewalk conditions?
Can I park in a well-lit place with no spaces where someone could hide?
Are homes well kept?
Are people loitering on the streets or in yards?
Do I smell anything unusual (such as odors from the manufacture of illegal drugs) or hear potentially dangerous sounds (such as gunshots or shouting)?

The Centers for Disease Control and Prevention (CDC) developed a free mobile app (CDC Homecare Safety) that includes tips for safely handling threatening behavior when providing home care. It can be downloaded at no charge from the Apple App Store or Google Play.

Employer responsibilities

OSHA recommends that employers regularly (at least once a year) assess and control risks of workplace violence to ensure worker protection. Policy revisions may be needed when a change occurs in the nature of the workplace (for example, if an employee’s vehicle is stolen from the agency parking lot or an employee was verbally abused during a home visit), type of work provided, or work conditions (such as increased or decreased staffing levels, increased patient acuity, or increased number of patients on service). Management should allocate sufficient resources—including mandatory compensated training for managers, supervisors, and direct care employees and providing an escort for staff working in high crime areas. Employers also should uphold program expectations (for example, maintain compensated safety training and staff assistance in high crime areas even when budgets are tight and resources hard to find).

Policies and procedures . Employee safety policies and procedures should encompass personal safety measures when making home visits, zero-tolerance for all incidents of violence, and specific steps staff should take if they’re concerned about their safety or experience violence during a home visit. (See Ensuring employee safety .)

Mendes recommends that healthcare organizations implement measures that support staff preparation for violent situations. In addition to training, organizations should provide access to appropriate tools (such as a household safety checklist) to manage difficult situations and offer appropriate debriefing support (for example, with a trauma counselor) after a violent event. And organizations should have procedures for investigating reports of dangerous environments or encounters.

Organizations might consider inviting an officer from the local police department to train staff annually, provide updated crime statistics for the geographic area served by the organization, and offer examples of precautions staff can take. Some municipalities have a dedicated community officer who can do this. Agencies also could make local police aware of the presence of home care employees so they can increase patrols in the area.

Pets can pose safety and health risks, including allergies, infections, and bite injuries. Organizations should assess whether pets have created a risk in the past, clarify how the risk was addressed, and consider a policy for asking that pets be secured before home visits. More research is needed on this topic.

Organizations can use a checklist from the National Institute for Occupational Safety and Health report NIOSH Hazard Review: Occupational Hazards in Home Healthcare to ensure their employees are safe when providing home care. Here are sample questions from the checklist.

Are workers taught how to identify verbal abuse and what to do about it?
Does an active safety program exist with a safety manager and a safety committee that includes employees from across the company?
Does annual training review new safety issues identified from the previous year?
Are workers part of the selection process for needle devices with safety features?
Has an infection control and prevention plan been developed?
Does an animal-control policy exist requiring animals to be restrained during home visits?

Emergency preparedness . Does your organization have a plan for home care workers in the event of a natural disaster, large-scale violence, riot, pandemic, or other emergency? In 2017, the Centers for Medicare and Medicaid Services (CMS) established national emergency requirements for all participating organizations, including hospitals, home health agencies, and hospices. Organizations must have a functional emergency preparedness program that describes their comprehensive approach to meeting the health, safety, and security needs of the facility, its staff, and its patient population and community before, during, and after an emergency or disaster. The book Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital by Dr. Sheri Fink details lessons learned about disaster and emergency preparedness as well as implications for leadership.

Please be aware that the CDC has released interim guidance for home care related to the coronavirus (COVID-19). This guidance can be found here .

Patient and family responsibilities

Patients and their families also have a role in creating safe environments for home care personnel. Patients and families should be provided with a document from the organization that explains their rights and responsibilities, which may include:

adhering to the worker safety information and organization’s policies
informing home care workers of potential hazards (for example, a guard dog) during the call to schedule the initial visit
restraining pets during visits
removing tripping hazards in the home or be willing to remove the hazard during the visit
providing an escort (patient, family member, or friend) to walk home care personnel to their car in high crime neighborhoods
limiting a potentially violent family member’s access during the visit
refraining from shouting or swearing at home care personnel
refraining from inappropriately touching home care personnel.

Safety is a team effort

Adhering to best practices can help minimize risks and keep home care personnel safe. Organizations with a thoughtful and organized safety orientation and onboarding process can provide a structure that supports employees in their journey to becoming effective home visiting team members. Safety as a quality improvement project could benefit all team members who make home visits and the managers and organizations seeking to provide the framework and processes to promote safety. More research is needed to better determine the scope of home care worker risk and safety and to identify improvement recommendations. We challenge you to help in this important effort.

Tina M. Marrelli is president at Marrelli and Associates, Inc., and chief clinical officer at e-Caregiving.com in Venice, Florida. Nathalie Rennell is an instructor at Arizona State University Edson College of Nursing and Health Innovation in Phoenix.

Brouillette NM, Quinn MM, Kriebel D. Risk of sharps injuries to home care nurses and aides: A systematic review and meta-analysis. J Occup Environ Med. 2017;59(11):1072-7.

Curtin L. Workplace violence: Don’t risk it, de-escalate it. Am Nurse J. 2019;14(5):72.

Extent of nurse assaults revealed. Nurs Manage. 2018;25(1):7.

Fink S. Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital. New York: Crown; 2013.

Hanson GC, Perrin NA, Moss H, Laharnar N, Glass N. Workplace violence against homecare workers and its relationship with workers health outcomes: A cross-sectional study. BMC Public Health. 2015;15:11. bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-014-1340-7

Ifediora CO. Evaluation of aggression in Australian after-hours doctor home-visit services. J Eval Clin Pract. 2018;24(2):388-95.

International Association for Healthcare Security and Safety Foundation. 2016 best practices for preventing violence in home health. iahssf.org/best-practices/2016-best-practices-for-preventing-violence-in-home-health

Marrelli T. Handbook of Home Health Standards: Quality, Documentation, and Reimbursement. 6th ed. 2018; Venice, FL: Marrelli and Associates, Inc.

Mendes A. Dealing with violence as a community nurse. Br J Community Nurs. 2018;23(3):150-1.

National Council of State Boards of Nursing. A Nurse’s Guide to Professional Boundaries. 2018. ncsbn.org/ProfessionalBoundaries_Complete.pdf

National Institute for Occupational Safety and Health. NIOSH hazard review: Occupational hazards in home healthcare. January 2010. cdc.gov/niosh/docs/2010-125/pdfs/2010-125.pdf?id=10.26616/NIOSHPUB2010125

Occupational Safety and Health Administration. Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. 2016. osha.gov/Publications/osha3148.pdf

Occupational Safety and Health Administration. Quick reference guide to the bloodborne pathogens standard. osha.gov/SLTC/bloodbornepathogens/bloodborne_quickref.html

PHI. Understanding the direct care workforce. phinational.org/policy-research/key-facts-faq/

Pinholt EM, Mitchell JD, Butler JH, Kumar H. “Is there a gun in the home?” Assessing the risks of gun ownership in older adults. J Am Geriatr Soc. 2014;62(6):1142-6.

3 Comments .

The CDC link for guidelines during the covid-19 pandemic gives an “oops” error. Link not working. Can you provide that again please??

Thank you for pointing out this technical issue! We have updated the link within the article, but here is the corrected link as well: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-home-care.html

Best, Lydia Kim, Digital Content Editor

Comments are closed.

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HouseCalls is check-in care that comes to you

Did you know you can set up a yearly preventive care visit at home.

UnitedHealthcare® HouseCalls — our yearly in-home health and wellness service — is a health plan feature for Medicare and Medicaid members, offered at no additional cost to you. It’s a way to help our members stay on top of their health between regular doctor visits.

Why is a HouseCalls visit a good idea?

Benjamin Franklin said it best, “An ounce of prevention is worth a pound of cure.” We agree. The goal of our preventive care visits is to help you maintain your independence and continue doing what you love long into the future. We know there’s no way to prevent all health emergencies and accidents, but we believe that by taking care of yourself, you may be able to improve your odds of avoiding them. That’s where HouseCalls comes in.

UnitedHealthcare® HouseCalls

Video transcript.

These days, you can have just about anything delivered to your door.

How about a home delivery of good health and wellness? It comes from UnitedHealthcare and is called HouseCalls.

HouseCalls is a yearly health and wellness visit that happens in the privacy of your very own home. No driving to an appointment. No sitting in a waiting room.

Here’s how it works.

Our HouseCalls team finds a time that’s convenient for you and schedules the visit. A health care practitioner, a physician’s assistant, medical doctor or nurse practitioner, comes to you at the scheduled time. The clinician completes a health evaluation, including a physical exam and other important screenings, then YOU decide what happens next.

You can discuss questions to ask your doctor at your next appointment, review instructions from your last doctor’s appointment or chat about other health concerns you haven’t had a chance to talk to your doctor about. Whatever you need.

The visit takes about 45-minutes to an hour – plenty of time to answer your important health questions.

Your practitioner will even send a summary of your HouseCalls visit to your doctor.

And unlike those other home deliveries – there’s no additional cost for a HouseCalls visit, it’s a feature of your medical plan. If you’re in good health or you already see your doctor regularly – you might not think HouseCalls is for you, but it is. Think of it as an extra layer of care – valuable one-on-one time you don’t always get in the doctor’s office.

So, when you get a phone call from our HouseCalls team – take advantage of this great program and schedule your HouseCalls visit. Or just call us and make an appointment!

It’s Easy. It’s Convenient. It’s UnitedHealthcare HouseCalls.

What to expect during a HouseCalls visit

During a HouseCalls visit, you’ll meet with the same types of professionals you’d see in a doctor’s office — a licensed physician or nurse practitioner. They’ll answer your health-related questions, perform a physical exam and offer a health screening in the comfort of your own home. If you choose, your family members, loved ones or caregivers are welcome to sit in on this visit and ask additional questions. A typical visit will range from 45 minutes to a full hour.

The results of your exam and screening will be forwarded to your primary care provider (PCP) and you’ll receive a summary of your visit in the mail.

During your visit, here are some typical topics you'll cover

An overview of your medical history and prescription medications
Conversations about overall well-being, like how to help you stay active, sleep well and manage stress
Tips on to help you avoid trip hazards in your home
Community resources and support

Open the door to the convenience of a medical visit in your home

Meet with licensed medical staff on your schedule, in the convenience of your home. Once they arrive, talk about health concerns at your pace (the visits are focused on you and you alone). Use the results to help coordinate care with your doctor.

Be prepared to provide a urine sample during your visit—drink fluids in advance
Wear shoes or slippers that are easy to remove (your feet will be checked)
Know where to find medication bottles so they are ready to review
If applicable, have blood pressure readings available for review
If you have diabetes, please provide blood sugar test results, as well as your blood glucose meter

Remember, at the end of your visit, you’ll receive a personalized checklist of topics to discuss with your doctor at your next appointment. Plus, you and your doctor will receive a mailed summary of your visit.

Want more good news?

HouseCalls is included at no extra cost in most Medicare and Medicaid members as part of your health plan. 1 Schedule at a convenient time and we’ll come to you.

Call to request a visit 1-866-799-5895 , TTY 711 , Monday – Friday 8 a.m. – 8:30 p.m. ET

For medical emergencies, call 911.

Look out for your health

A UnitedHealthcare® HouseCalls visit is a no-cost, yearly health check-in that can make a big difference.

Call 1-866-799-5895 ,

TTY 711, to schedule your visit.

HouseCalls brings yearly check-in care

To you at home.

Connect for up to a full hour of 1-on-1 time with a licensed health care practitioner. Every visit includes a physical, tailored recommendations on health care screenings and plenty of time to ask questions that matter to you.

After your visit, HouseCalls connects with your primary care provider (PCP) to help keep them informed about your health. It's a great way to feel confident knowing an extra set of eyes is looking out for you between regular PCP visits.

What is a HouseCalls visit?

[Text On Screen – SAY HELLO TO HOUSE CALLS]

Say hello to HouseCalls.

[Text On Screen- PAID ACTOR PORTRAYAL.]

HouseCalls is our way of looking out for your health, so you can focus on your future. Here’s what it’s all about.

[Text On Screen – HERE’S WHAT IT’S ALL ABOUT]

Once a year, a licensed health care practitioner can come to your home to spend up to an hour with you on your health and wellness.

[Text On Screen- EASY, CONVENIENT, INFORMATIVE]

It's designed to be easy, convenient and informative.

[Text On Screen- HEAD-TO-TOE EXAM]

[Text On Screen- IMPORTANT HEALTH SCREENINGS]

[Text On Screen- HEALTH GOALS DISCUSSION]

You'll get a head-to-toe exam, important health screenings and plenty of time to talk about your health goals.

We'll also provide guidance on managing your health and if you need it, give you referrals for other health plan resources and services.

HouseCalls is a great way to stay on top of your health between regular doctor's visits.

At the end of your visit, you'll get a personalized checklist so you can feel more confident in what to discuss with your regular doctor.

[Text On Screen- COST? NO EXTRA COST TO YOU]

[Text On Screen- INCLUDED IN YOUR HEALTH PLAN]

If you're wondering how much all of this is going to cost, the best part is, there is no extra cost to you. It's included in your health plan.

[Text On Screen- HOUSECALLS VIDEO VISITS ARE NOT AVAILABLE WITH ALL PLANS.]

A HouseCalls visit takes place in the comfort of your own home or by video if you prefer.

So, say hello to HouseCalls and invite us in for a visit today.

[Text On Screen – SAY HELLO TO HOUSE CALLS TODAY]

Access one of the most popular UnitedHealthcare offerings, at no cost to you

Schedule your visit

Call 1-866-799-5895 , TTY 711

Monday–Friday, 8 a.m.–8:30 p.m. ET

Your in-home health check-in

Up to a full hour with a licensed health care practitioner
Ask the questions that matter to you and get valuable health tips
No cost — it's included in your health plan

Get rewarded

Meet your friendly housecalls medical staff.

Just like the professionals you see in your regular doctor’s office, our licensed health care practitioners may be nurse practitioners, physician assistants or medical doctors. They’re state licensed and maintain national certification.

We perform background checks on these professionals to provide additional peace of mind for our members. Your loved ones, caregivers or friends are welcome to be present during the visit — it’s up to you.

Ready to open the door to better health?

Getting ready for your housecalls appointment, tips to help you prepare: .

Wear shoes that are easily removed to have your feet checked
Make a list of upcoming appointments with your PCP and specialists
Make sure all of your medications, both prescription and over-the-counter vitamins and supplements, are in their original bottles for our review
If you record blood pressure readings, please have your results available for review
If you have diabetes, please have your blood glucose meter handy
Make a list of questions and concerns you’d like to discuss

During your appointment

You'll have up to a full hour of 1-on-1 time with your health care practitioner for a physical, select lab tests, health screenings and more
A HouseCalls visit can be completed while sitting at your kitchen table or in the living room, and you can use the time to ask any health-related questions
The visit is tailored to your individual needs, so screenings and conversation topics can vary

After your appointment

Less travel time. more face time..

Think of HouseCalls as an extra layer of care — valuable 1-on-1 time you don't always get in the doctor's office. And it's tailored to your individual needs.

Schedule today

To secure your spot, call us at 1-866-799-5895 , TTY 711

Have a question?

Find answers to frequently asked questions.

If you have a specific question about your upcoming appointment or need to reschedule, call us at 1-866-799-5895, TTY 711 , Monday–Friday, 8 a.m.–8:30 p.m. ET

We're here to help.

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30 Safety Tips for the Home Care Nurse

Home Care Nurses have a unique and rewarding job. But, sometimes you can be in unsafe situations. Here are 30 tips to keep you safe during your Homecare visits. Specialties Home Health Article

Home Health Nursing
Helpful Tips
Patient Safety

Updated: Oct 5, 2020

Home care nurses have a unique and rewarding job. You provide skilled care where the patient lives. You get to experience their everyday life and impact their overall health and well-being.

But, there are dangers when traveling all day in and out of homes and in new neighborhoods. This isn't just anecdotal, consider stories like the New Orleans home health nurse who was abducted at gunpoint in 2012.

Safety concerns for home health nurses are real.

As a former field nurse in home care and hospice, I have had my fair share of stories of family members that gave me the creeps, "tomato plants" that looked very much like marijuana plants, and patients with guns hidden under mattresses. Even though there were times I felt unsafe, I loved my patients and the unique perspective I was given into their lives. But, you do need to implement simple ways to stay safe.

Safety Tips and Tricks for the Home Care Nurse

Keeping yourself safe doesn't take a lot of work, but it does require intention. Here are a few easy ways to increase your safety knowledge.

1. Know your workplace policies for safety and violence prevention. Don't wait until you are in the middle of a crisis to understand how to activate your company's safety program.

2. Report any unsafe situations as soon as possible. Even if it is just a feeling, be sure to report it to your supervisor. You may not be the next staff member in that home. It is your responsibility to keep others safe too.

3. Be active in your agencies safety committee.

4. Map out your visits so that you know where you are going. Wandering around new neighborhoods looking lost is not safe.

5. Be sure your car is full of fuel and in good working condition.

6. Create a car emergency kit that includes:

Candle to keep you warm
Band-aids, hand sanitizer, antibiotic ointment
Road flares
Rain poncho
Whistle to signal for help
Non-perishable foods or snacks
Ice scraper
Kitty litter for slick roads
Blanket and warm clothing
Flashlight and extra batteries

7. Park on the street if possible. You don't want to be blocked in if you need to leave quickly.

8. Trust your gut. If a situation feels unsafe, it probably is, and you need to get out quickly. Make sure the patient is safe, leave the home, and call your supervisor.

9. Set boundaries. If a patient or family member starts saying things or acting in a way you do not like, tell them. Be polite and direct. Avoid being argumentative.

10. Keep your cell phone on you at all times. Make sure it's fully charged before you leave in the morning and charge it throughout the day.

11. Know your company's policy on joint visits and behavioral contracts. Contact your supervisor if you need to implement either of these interventions.

12. Start your visits early. Avoid nighttime visits if possible.

13. Take a self-defense course.

14. Don't carry large amounts of cash on you.

15. Always wear your agency badge and carry your driver's license or other ID.

16. Watch your step. Be sure to pay attention to the ground and floors in homes so that you don't fall, trip, or become injured in other ways.

17. Be alert, but not nosey. You're there for the patient. If you are unsure what others in the home are doing, don't go snooping around. Do your job and leave the home. Remember, if the patient is in their right mind, they have the right to live however they desire.

18. Ask your patient to contain any aggressive pets before you enter the home.

19. Keep your sharps container in your nursing bag for easy access when you are in the patient's home.

20. Carry spray or 91% alcohol to fight against bed bugs and other critters you may come in contact with in patient homes. Wipe down the bottom of your nursing bag, soles of your shoes, and any equipment that may have come into contact with surfaces in the patient's home.

21. Always have hand sanitizer in case the patients home doesn't have running water.

22. Document in the patient's home when possible. Don't sit in their driveway or on the street for long periods of time finishing up your charting.

23. Know your service area. Learn the unsafe neighborhoods and find out where the closest police stations are in the areas that you serve the most.

24. Be prepared. Set up your visits and supplies the night before. If you must take supplies into a home, put them in bags and label them with the patient's name the night before. This allows you to gather your supplies and get into the home quickly. Don't make multiple trips back and forth to your car and don't rummage through your car getting ready for the visit. You must be alert at all times.

25. If you are confronted by someone who asks for your money, nursing bag, or other belongings, hand it over!

26. Make sure someone in your company has your schedule, just on the off chance that someone can't find you.

27. Keep trash bags in your trunk. If you go into a home that you suspect may have an insect infestation, don't take your nursing bag into the house. Place the necessary equipment into a trash bag and only carry in what you need.

28. Buy a plastic stool that you can keep in your car. During your visit, set your bag on the stool use it to take a seat. This prevents you from sitting on plush furniture that may be soiled or infested.

29. If there are safety concerns in a patient's home or building, call ahead and let them know you are coming. Most patients will be more than happy to open the door or keep an eye out for you if possible.

30. Don't talk or text while you are driving.

If you are a home care nurse, do you need other resources for safety? Check out this great list of OSHA resources specifically for home healthcare workers .

Do you have other safety tips that you use when making home visits? Put your suggestions in the comments below. You could save someone else just by sharing the things you do every day to keep yourself safe.

About Melissa Mills, BSN

Home Care Nurses have a unique and rewarding job. But, sometimes you can be in unsafe situations. Here are 30 tips to keep you safe during your Homecare visits.

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FBI shows up at home of Texas nurse who opposes ‘transgender medicine’

Opposition to “transgender medicine” saw a whistleblowing Texas nurse get a house call from the FBI.

“They threatened me.”

Orwellian screws have been increasingly put to Americans who have dissenting opinions toward President Joe Biden’s leftist administration which has employed crackdowns, indictments, and arrests that appear, at the very least, to be meant as deterrents to speaking out. While the Justice Department has vehemently denied allegations of a weaponized federal government, a new video published by Christopher Rufo along with a whistleblower’s testimony belied even Attorney General Merrick Garland’s claims.

Tuesday, writing for the City Journal, the senior fellow of the Manhattan Institute shared details of nurse Vanessa Sivadge who’d accepted a position at Texas Children’s Hospital in 2021 only to find herself aiding in exposing an alleged illegal effort to continue practicing chemical castration of minors.

As a result of her role in blowing the whistle on doctors at TCH, she received a visit from two FBI agents at her home, seen in a video shared by Rufo on social media with the caption, “This is where we are now: The Biden Administration sent two FBI agents to intimidate a nurse who told the truth about the child sex-change program at Texas Children’s Hospital. The regime is mobilizing to threaten and imprison anyone who opposes ‘transgender medicine.'”

In the video, special agents Paul Nixon and David McBride could be heard telling the nurse they want to talk about “some of the things that have been going on at [her] work lately.”

She recounted how they referred to her as a “person of interest” in their investigation of the whistleblower who had exposed TCH’s child sex-change program, contending the individual had broken federal privacy laws. She claimed, “They threatened me.”

“They promised they would make my life difficult for me if I was trying to protect the leaker. They said I was ‘not safe’ at work and claimed that someone at my workplace had given my name to the FBI.”

Details of Sivadge’s experience with the FBI came only days after the Justice Department unsealed a four-count indictment on Dr. Eithan Haim, who is alleged to have obtained and disclosed “personal information” from patients at TCH.

“In April 2023, Haim allegedly requested to re-activate his login access at TCH to access pediatric patients not under his care. The indictment alleges he obtained unauthorized access to personal information of pediatric patients under false pretenses and later disclosed it to a media contact,” said the DOJ in their release on the indictment.

As with Haim, Sivadge claimed that TCH had continued its child gender program despite an investigation from Texas Attorney General Ken Paxton and the passage of a law in the Lone Star State banning transgender procedures and treatments on minors.

She alleged that doctors had “cut corners” and committed Medicaid fraud to secure funds for the hospital’s child sex-change program.

“The largest children’s hospital in the country is illegally billing Medicaid for transgender procedures. It is evident that the hospital continues to believe it is above the law not just by concealing the existence of their transgender medicine program from the public, but by stealing from the federal government,” the nurse told Rufo.

Sivadge described how doctors also seemed to be steering patients in the direction of transgender procedures rather than dealing with underlying conditions of addiction, anxiety, depression, or discomfort with puberty, “In the cardiac clinic, we were taking sick kids and making them better. In the transgender clinic, it was the opposite. We were harming these kids.”

Speaking with Rufo, she explained, “I work very closely with this provider, Dr. Richard Roberts. I’ve been in the room with him when he speaks with these patients. Dr. Roberts is extremely encouraging of their transition and will essentially do whatever he can to make sure that they are happy, at least externally happy. Because I am absolutely certain that they are not internally happy. He is very accommodating. He does whatever they want. Essentially, there is no critical analysis of the process.”

Meanwhile, as Haim and Sivadge both became targets of the DOJ, Garland recently released an op-ed where he claimed, “The Justice Department makes decisions about criminal investigations based only on the facts and the law. We do not investigate people because of their last name, their political affiliation, the size of their bank account, where they come from, or what they look like. We investigate and prosecute violations of federal law — nothing more, nothing less.”

For her part, the nurse argued she remained undeterred in exposing what was happening, “My faith and my gut, just knowing right from wrong, compels me. I was born for this. I have no doubt this is what I am supposed to do.”

Sivadge also recounted deep regret for her role in impacting the lives of the minors under TCH’s care, “I was told to do something I knew was wrong. It made me sick that the lie called ‘gender-affirming care’ was being sold to parents and children and creating hugely lucrative profits in secret–and I was part of it.”

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Whistleblower nurse claims FBI threatened her after she accused children’s hospital of illegally billing taxpayers for ‘transgender medicine’

A whistleblower who accused the nation’s largest children’s hospital of illegally billing taxpayers for “transgender medicine” for kids claims that FBI agents showed up to her house to intimidate her for speaking out.

Vanessa Sivadge, who is a nurse at Texas Children’s Hospital, said the alleged feds “promised they would make life difficult” for her and that she was “not safe at work” after she started speaking out about the facility’s gender-affirming care practices.

Texas Attorney General Ken Paxton is investigating her allegations, a spokesperson for his office told The Post.

Sivadge told conservative journalist Chris Rufo that the hospital was billing gender-affirming care to Medicaid.

Texas law prohibits the use of taxpayer funds for such gender-affirming care for children.

This is where we are now: The Biden Administration sent two FBI agents to intimidate a nurse who told the truth about the child sex-change program at Texas Children's Hospital. The regime is mobilizing to threaten and imprison anyone who opposes "transgender medicine." pic.twitter.com/XbtZVnp5Kw

“It is evident that the hospital continues to believe it is above the law — not just by concealing the existence of their transgender medicine program from the public, but by stealing from the federal government,” she said.

Two weeks later, Rufo reported, the men who identified themselves as FBI agents showed up at her door and accused her of breaking federal privacy laws.

“They threatened me,” Sivadge told Rufo.

“They promised they would make life difficult for me if I was trying to protect the leaker. They said I was ‘not safe’ at work and claimed that someone at my workplace had given my name to the FBI.”

In her conversation with Rufo, she also alleged that one doctor she worked with took an uncritical approach to providing medical intervention for h children who said they wanted transition to another gender.

“He is extremely encouraging of their transition and will essentially do whatever he can to make sure that they are happy, at least externally happy,” she said.

“Because I am absolutely certain that they are not internally happy. He is very accommodating. He does whatever they want.”

Sivadge declined to comment when reached by The Post.

Previously, in 2023, Dr. Eithan Haim , a surgeon who completed his residency at the Texas Children’s Hospital, leaked documents to Rufo that reportedly revealed the hospital was conducting gender-affirming surgeries on kids in secret to skirt state law.

Paxton issued an opinion declaring gender-affirming care on minors is a form of child abuse in 2022 , and the hospital announced weeks later that it would stop the procedures.

However, just three days after the hospital’s announcement, they implanted a hormone device into an 11-year-old girl for gender dysphoria, Haim alleged .

Haim also claimed that the hospital only increased the frequency of such procedures from that point, while “potentially hundreds more children received hormone interventions for gender dysphoria” over the next year.

In response to the allegations, the Texas legislature banned drug and surgical sex changes for minors.

But the next month, when Haim was supposed to graduate from his residency at the hospital, he received a knock at his door from authorities who handed him a letter identifying him as a “potential target” in a federal probe, he claims.

He has since been indicted on four counts of violating HIPPA medical privacy laws.

While Paxton is pressing the issue, Texas state Rep. Brian Harrison is calling for the state legislature to hold hearings to investigate the whistleblowers’ claims and the Biden administration’s “unconstitutional tyranny.”

“We need Republicans to be courageous in fighting back against the unconstitutional tyranny of the Biden administration,” Harrison told The Post.

“And so what I’m asking is that the Texas House of Representatives act in the way that it should act, and the way that I’m demanding it to act, which is to hold immediate hearings, but also to launch formal investigation and subpoena any federal official, the DOJ and HHS, who may have been involved in this, any hospital executives who knew that they were engaged in practices that were, in fact, child abuse,” he added.

“The Biden administration, their goal here is to stifle dissent. They want to silence opposition,”

A spokesperson for Texas Children’s Hospital didn’t respond to The Post’s request for comment. The DOJ also didn’t respond when reached for comment.

Whistleblower nurse claims FBI threatened her after she accused children’s hospital of illegally billing taxpayers for ‘transgender medicine’

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Iran J Public Health
v.51(4); 2022 Apr

Effect of Home Visits by Nurses on the Physical and Psychosocial Health of Older Adults: A Systematic Review and Meta-Analysis

Emine ergin.

1. Department of Public Health Nursing, Faculty of Health Sciences, İstanbul Aydın University, İstanbul, Turkey

Belgin Akin

2. Department of Public Health Nursing, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey

Deniz Kocoglu-Tanyer

3. Department of Public Health Nursing, Faculty of Nursing, Selcuk University, Konya, Turkey

Background:

One of the best ways to maintain and develop physical and psychosocial health is to make regular home visits. This meta-analysis aimed to determine (by subgroups) the effects of interventions based on nurses’ home visits on physical and psychological health outcomes of older people.

This search was carried out using the The CINAHL, Cochrane, MEDLINE, PubMed, Science Direct, Web of Science, and Turkish databases. Experimental and observational studies were included.

The meta-analysis included 26 (with subgroups 50) out of 13110 studies. The minimum and maximum values of the effect size (Hedges g) were g = −0.708 and g = 0.525, respectively. The average effect size was g = 0.084 (SD = 0.21).

Conclusion:

Home visit interventions are effective in reducing the frequency of hospitalization in the older adults, and improving physical and psychosocial health. They are negatively effective on falls and have no significant effect on the quality of life.

Introduction

Rapid aging of the world’s population is one of the major global demographic trends ( 1 ). Population aging is soon a candidate to emerge as a global public health problem. By 2050, one in six people in the world will be > 65 years old ( 2 , 3 ). As fertility decreases and life expectancy increases, the population rate of certain age groups rises. This phenomenon, known as population aging, is progressing rapidly worldwide ( 4 ). Although old age is not a problem in developed countries, it can be an issue in developing countries that have not yet completed demographic transition ( 5 ).

Recent health policies encourage older people to receive home care, and methods such as home visits are needed in addressing older people health problems ( 6 , 7 ). Home visits done by nurses reduce hospitalization and mortality, as nurses can provide precautions for risky situations. Home visits have a positive effect in the older adults by improving the quality of life ( 8 , 9 ).

In a meta-analysis, investigated the influence of physical activity on physical health through home visits in community-dwelling elderly people and found that studies focusing on the elderly population yielded better results (d = 1.09) ( 10 ). A different systematic review ( 11 ) and meta-analysis ( 9 ) revealed that home visits in the elderly have a weak effect on physical functionality and daily life activities [(SMD = −0.10 (−0.17–0.03)].

This meta-analysis was carried out for the following reasons: a) The recent studies have contradictory results regarding the effectiveness of home visits in the elderly; b) Previous meta-analysis evaluated outcomes such as hospitalization, mortality, quality of life and fall, but the effect sizes were not studied according to subgroup variables (age, intervention, income or duration, and frequency of home visits); c) in this context, there are studies conducted not only with nurses, but also with other health professionals. Therefore, this study was conducted to fill the information deficiency found in other meta-analysis in the relevant literature.

We aimed to determine (by subgroups) the effects of interventions based on nurses’ home visits on physical and psychological health outcomes of older adults.

This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered in PROSPERO (CRD42017054228) ( 12 ). The protocol of this systematic review was published already ( 13 ).

Search strategy

This search was carried out using the The CINAHL, Cochrane, MEDLINE, PubMed, Science Direct, Web of Science, and Turkish databases by using Medical Subject Heading (MeSH) terms [“home visits” or “home based” and [“elderly health”] and [“community health nursing” or “visiting nurses”] and [“physical health”] and [“psychosocial health”] and [“old people” or “elders” or “seniors”] and [“intervention”] and [“effect”]. The timeframe chosen for searching the articles was from 2004 to 2017 ( 13 ).

Eligibility Criteria

Population: Older adults at age ≥ 60, with or without any form of chronic illness.

Intervention: Studies exploring the effects of home visits practices by nurses in older adults were included. To improve the physical (self-efficacy, activities of daily living, nutrition, physical activity, etc.) or psychosocial (mental health, self-confidence, cognitive function, etc.) health of the older adults.

Comparison: Pre–post test single group or comparison group only observational study or control group (an inactive control intervention) (e.g., placebo); (no treatment); (standard care) or (a waiting list control) or (an active control intervention).

Outcomes: Outcome measures included :(a) physical health outcomes; (b) hospitalization outcomes; (c) fall outcomes; (d) quality of life outcomes; and (e) psychosocial health outcomes.

Study design: Randomized controlled trial (RCT) or non-randomized trials or observational design original peer-review study or research reports; English or Turkish language.

Selection of studies and data extraction One reviewer identified duplicate literatures Endnote X8. Sorted them according to inclusion and exclusion criteria. Two reviewers (BA, DKT) independently assessed the full text of studies and entered the data abstraction table.

Quality assessment of included studies

The Quality Assessment Tool for Quantitative Studies (QATQS) was used for quality assessment of the articles ( 14 – 16 ). The methodological quality of the studies can be categorized as “weak,” “medium,” and “strong” using this tool. The quality assessments of the studies were conducted independently by two researchers (BA & DKT).

Data analysis

The Comprehensive Meta-Analysis Software v3 (Code is CMA3264) was used in the data analysis, and the Hedge’s g was used to calculate the effect size ( 17 ). The effect size classification was used ( 18 ). The Cochran’s Q test, I 2 statics, a non-parametric statistical test was used to verify the presence of heterogeneity between the studies and meta-regression analysis examined ( 19 ).

Publication Bias

Publication bias of the study was tested using Funnel Plot diagram, Orwin’s failsafe number test, Egger’s regression analysis, and Begg and Mazumdar Rank Correlation analysis ( 20 , 21 ).

PRISMA guidelines were used in the reporting of this meta-analysis ( 12 ). The quality assessment of this meta-analysis was conducted in line with the A Measurement Tool to Assess Systematic Reviews (AMSTAR) ( 22 ).

Study identification and selection

Overall, 13110 articles were recorded to End-Note X8 (2016; Researchsoftware, X8, DISC, NL) and 130 duplicates article were removed. Abstracts were checked and evaluated independently by the researchers. Then, two reviewers read the full text of potentially eligible studies (n = 69). A total of 26 articles were assigned as suitable ( Fig. 1 ).

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Object name is IJPH-51-733-g001.jpg

Flow chart of the screening and study selection process

Study characteristics

According to the PICOS elements, we finally reached 26 studies ( 23 – 48 ) with subgroups 50. Ten of studies contributed to the effect size. Involving those of physical health (n = 2), psychosocial health (n = 4), hospital admission (n = 2), and falling (n = 2). Characteristics of the included studies were presented in Table 1 . The characteristics of the 26 studies from the Turkey (n=1), Germany (n=4), Canada (n=4), Netherlands (n=4), New Zealand (n=2), Mexico (n=1), Sweden (n=3), America (n=3), Switzerland (n=1), Japan (n=2), and England (n = 1). Sample size ranged from 59 to 766 and all studies were 7709. Fig. 2 presents the meta-analysis diagram (forest plot) showing these studies and their effect sizes. Effect of home visit in older adults the minimum and maximum values of the effect size (Hedges’s g ) were g = −0.708 and g = 0.525, respectively.

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Object name is IJPH-51-733-g002.jpg

Forest plot

Summary of the characteristics of studies

RCT: Randomized controlled trial, CCT: Controlled clinical trial

Quality Assessment

Among 26 included studies, some studies ( 29 , 31 , 34 , 40 , 41 , 46 , 48 ) were considered as a strong methodologically quality, other studies assessed as a medium methodological quality. In reliability analysis, Kappa coefficient ( ᴋ ) is in the range of 0.86 and 95% confidence interval [(CI :0.742–0.977)]. In this study, the value of kappa 0.86 was very good agreement between assessors ( 49 ).

Outcome Analysis

The remaining 26 studies ( 23 – 48 ) included 50 outcomes. The mean effect size Hedge’s g in this study is 0.090, and this level indicates a weak and positive effect. In this study, there was a heterogeneous distribution ( I 2 = 41.972%, Q = 84,443, df = 49, P < 0.001) and heterogeneity was low.

Physical health outcomes

The effect sizes for physical health were g = 0.31 (95% CI: 0.07 to 0.56) ( 30 ) and g = 0.31 (95% CI: 0.11–0.52) ( 32 ). The effect size for physical health outcomes is medium and positive.

Hospitalization outcomes

The effect sizes of referral to the hospital were g = 0.53 (95% CI: 0.09–0.96) ( 24 ) and g = −0.28 (95% CI: 0.50 to −0.05) ( 31 ). The effect size for hospitalization outcomes is medium and positive in one study, while medium and negative in another study.

Fall outcomes

The effect sizes of falls were g = −0.32 (95% CI: 0.53–0.12) ( 31 ) and g = −0.71 (95% CI : −1.19 to −0.23) ( 37 ). The effect size for fall outcomes is medium and negative.

Quality of life outcomes

In the studies quality of life outcomes (the total score) was not given by the researcher. For these reason this study found no significant effects of home visit interventions on the quality of life of older adults.

Mortality outcomes

The effect size of this output could not be calculated because there was no study with sufficient data regarding mortality.

Psychosocial health outcomes

The effect sizes for psychosocial health outcomes were g = 0.32 (95% CI: 0.06 to 0.57) ( 38 ); g = 0.30 (95% CI: 0.09−0.50) ( 32 ); g = 0.29 (95% CI: 0.01–0.57) ( 47 ); g = 0.42 (95% CI: 0.13–0.71) ( 24 ). The effect size for psychosocial health outcomes is medium and positive.

Subgroup analysis

Age group (Q B = 23.660, P < 0.001), health status (Q B = 12.450, P = 0.006), using a model (Q B = 4.968, P = 0.026), and type of visits (only by a nurse or by a nurse within a team) (Q B = 11.200, P = 0.001) were significant moderators. The type of applied intervention (Q B = 6.346, P = 0.096), geographical region where the study was conducted (Q B =6.269, P =0.180), human development indexes (Q B =1.332, P =0.248), income levels (Q B =0.000, P =0.992) of countries, and study design (Q B = 0.005, P = 0.943) were not moderators.

Moderating effect of home visits in older adults health

A meta-regression analysis was performed to determine the effect of continuous moderator variables on studies’ effect sizes ( 50 ). Sample size did not affect effect size, in contrast, there was a significant positive linear correlation between the frequency of visits and effect size (B = 0.0012, t = 1.94, P =0.05).

Publication bias assessment

No publication bias was observed in the funnel plot diagram ( Fig. 3 ).

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Object name is IJPH-51-733-g003.jpg

Funnel plot diagram

In the last 20 years, many studies have investigated the effects of home visits on older people ( 11 , 51 – 54 ). The aim of conducting this meta-analysis is to produce outcomes with high level of evidence based on contradictory situations. Home visits performed by nurses have a weak and medium effect on physical health, referral to the hospital, fall and psychosocial health, which are some of the older adults’ health outcomes. The positive and highest effect was determined on the referral to the hospital outcome (g=0.525, P =0.018). Then again, the highest positive and medium effects were on psychosocial and physical health outcomes (g = 0.417 and g = 0.314). An interesting result is the presence of studies with a negative medium effect on the fall outcome (g = −0.321 and g = −0.708).

In this meta-analysis, two studies reported that home visit interventions have a medium and positive effect on the physical health outcome of the older adults (g = 0.314, P = 0.014; and g = 0.314, P = 0.003) ( 30 , 32 ). According to a meta-analysis conducted in recent years, it was found that home visits have a weak impact on daily life activities and instrumental life activities ( 9 ). In a different meta-analysis, physical health outcomes in intervention groups were found to be better compared to other groups ( 55 ). This is believed to be caused by differences in the study population and design, as well as different tools and measurements used to diagnose physical health

In this study, a medium and positive effect (g = 0.522, P = 0.018) was observed in one of two studies where the effect of home visit interventions on the hospital outcome were evaluated ( 24 ), while there was a moderate and negative effect on the other study (g = −0.275, P = 0.017) ( 31 ) and the reason for the different results might be lack of using a model or the characteristics of the populations of the visitors and those who were visited. The study, where a positive effect was observed on the referral to the hospital outcome, is a randomized controlled study which was conducted in Japan using the Omaha model. This study was conducted in the older people > 65 years old with a chronic disease, in which only nurses performed home visit interventions and the total duration covered 3 months ( 24 ).

Two studies reported that home visit interventions for the older people had a negative and medium size effect on the fall outcome (g = −0.321, P = 0.002, and g = −0.708, and P = 0.004) ( 31 , 37 ). The ineffectiveness of home visits in preventing falls can be associated with insignificant moderators. Both studies were conducted in Switzerland and Germany, enrolled older people aged >80 years, and did not use models, and the nurse made the visits by participating in team. Thus, home visits alone are insufficient to prevent the older people from falling, and multifaceted interventions involving environmental arrangements are needed. Through home visits, falls in older people can be addressed more systematically and specifically, the risk of falls can be reduced, and age-specific interventions can be planned.

It was observed that the studies included in the metadata analysis for the “fall” outcome involved the older people (over 80 years) and old people with high risk of falling; the interventions made were in the context of counseling, education, and health enhancing activities; and involved applications aimed at developing the elderly without making structural arrangements in the environment of the elderly.

Home visit initiatives did not have a significant effect on the quality of life of the elderly ( P ≥ 0.05) in this study. It is believed that one reason might be measurement tools used in the studies, and the other reason might be the fact that when calculating the effect sizes in the studies related to quality of life. In this study, the effect size of the mortality outcome could not be calculated. The studies included did not contain sufficient mortality data to calculate the mortality outcome. In this study, the effect of home visit initiative on psychosocial health outcome of the elderly was positive and at medium level (g=0.417, g=0.318, g=0.297, g=0.292) ( 24 , 32 , 38 , 47 ). In a meta-analysis, similar to the results of this study, it was reported that effect sizes on the psychosocial health outcome were at small and medium levels ( 53 ). It is seen that home visits have a consistent and positive effect on psychosocial health due to the effects such as social support, communication, and strengthening self-sufficiency.

Summary of Subgroups

The group with the highest positive effect is the of 60–75-year age group (g = 0.48). In the planning of home visits to the elderly, preferring the young elderly group especially may increase the effectiveness of the initiative. The necessity of applying home visit interventions to risky groups such as the elderly with chronic diseases, especially the elderly with disabilities. In this way, the level of independence is increased by providing qualified and continuous care to the elderly in their environment.

The reason why the type of initiative implemented is not a moderator is that the activities are intertwined. For example, “health-improving” activities also include “counseling” and “education.” A study found that education carried out through home visits increases healthy lifestyle behaviors and compliance with treatment ( 27 ). Using a model ensures the systematic execution and implementation of home visits, while promoting evidence-based practices. There is a need for cross-country comparisons. If a number of studies from each country were included in the meta-analysis, it could be concluded how effective it is in any country.

This meta-analysis found that home visit interventions are effective in reducing the frequency of hospitalization in the older adults, and improving physical and psychosocial health; they are negatively effective on falls and have no significant effect on the quality of life. The effect size on mortality could not be calculated due to insufficient data. Considering nurse home visits or a nurse-centered case management as a primary service delivery model may be a cost-reducing health policy. Moreover, research results should be evaluated by meta-analyses.

Journalism Ethics considerations

Ethical issues (including plagiarism, data generation, etc.) were observed by the authors.

Acknowledgment

I like to thank Doğan, H. a statistical expert who has supported and assisted us in the data analysis. This study is supported by Selcuk University Scientific Research Projects Coordinator (Project No: 15102040).

Conflict of interest

The authors declare that they have no conflict of interest.

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COMMENTS

Home care visits: how they work, and what to expect
A home care visit is when a professional carer comes to your home, often for between 30minutes to a few hours a day, to provide support with day to day tasks. This can range from personal care such as washing and dressing, to more practical task such as cooking meals or getting you moving. Its often referred to as hourly care, or domiciliary ...
Best Visiting Nurse Services of 2024
Final Verdict. While each visiting nurse service on this list has its strengths, AccentCare is our top pick due to its wide variety of specialized programs and high quality rating. The caretakers at AccentCare are skilled and experienced. Plus, home care visits are supplemented with an advanced tele-monitoring system.
Nursing Home Visit
Description. A nursing home visit is a family-nurse contact which allows the health worker to assess the home and family situations in order to provide the necessary nursing care and health related activities. In performing home visits, it is essential to prepare a plan of visit to meet the needs of the client and achieve the best results of desired outcomes.
Home Visit: Opening the Doors for Family Health
All levels of prevention can be addressed during home visits. Research has demonstrated that home visits by nurses during the prenatal and infancy periods prevent developmental and health problems (Kitzman et al., 2000; Norr et al., 2003; Olds et al., 1986). Olds and colleagues demonstrated that families who received visits had fewer instances ...
Nurses' activities and time management during home healthcare visits
Patient education was observed during only 3.5% of home visits. Still, the nurses may have also given emotional support, engaged in caring conversations, encouraged patients' physical activity or conducted rehabilitative acts while performing other nursing activities. As noted previously, the simultaneous performance of nursing activities ...
Home-based primary care visits by nurse practitioners: A systematic
Home-based nurse practitioners demonstrate reductions in rehospitalizations and emergency department visits in a clinically complex patient population through an academic-clinical partnership. Journal of the American Association of Nurse Practitioners , 30 ( 6 ), 335-343. 10.1097/JXX.0000000000000060 [ PubMed ] [ CrossRef ] [ Google Scholar ]
Home Care: More Than Just A Visiting Nurse
When patients leave the hospital and return home with home nursing care, they go from highly supportive medical environments with potentially many physicians, nurses, aides, and other professionals, to non-medical environments with formal and informal caregiver support frequently supplemented by visits from home care nurses.
Nursing Home Visit
4. Set Your Bag In A Clean Place. Make sure your bag is sitting on a table that is lined with clean paper. Then, wash your hands with soap and water. Take out all the tools you will need for your visit so they are easy to access. Put on an apron, close the bag, and you are ready for your nursing care treatment. 5.
CMS Updates Nursing Home Guidance with Revised Visitation
Mar 10, 2021. Home health agencies. The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), issued updated guidance today for nursing homes to safely expand visitation options during the COVID-19 pandemic public health emergency (PHE). This latest guidance comes as more ...
CMS Announces New Guidance for Safe Visitation in Nursing Homes During
The vulnerable nature of the nursing home population, combined with the inherent risks of congregate living in a healthcare setting, have required aggressive efforts to limit COVID-19 exposure, including limiting visitation. ... Outdoor visits pose a lower risk of transmission due to increased space and airflow. The guidance released today also ...
Visiting Nurses
Therapies. The Rehabilitation Team at HCS works with your physician and orthopedic specialist to help you recover, improve, and maintain your safety and independence! Home Healthcare, Hospice & Community Services continues the tradition of your visiting nurse. Home Healthcare at HCS provides nursing, palliative care, and rehabilitative therapies.
Matrix For Me
A Matrix Nurse Practitioner will perform your visit over a live video call. You will receive: A health and wellness assessment. A full review of your medical history and medications. Personalized recommendations for additional care, screenings, and resources if needed. Answers your health questions including any questions about COVID-19 ...
Nursing Visits
Medication management. Medication organization and planning (Mediset pre-filling) Wellness checks. Seniors At Home is licensed by the state of California as a Home Health Agency; a California legal requirement to provide home nurse visits. To learn more about our skilled nursing visits, call us at 415-449-3700 or contact us online.
Home care safety
For purposes of clarity in this article, "home care" will be inclusive of any care models that comprise home visits, regardless of the program or type/kind of home visit. American Nurse Journal, the official, clinically and career-focused journal of the American Nurses Association (ANA), is a fresh voice of nursing across America
HouseCalls
HouseCalls is included at no extra cost in most Medicare and Medicaid members as part of your health plan. 1 Schedule at a convenient time and we'll come to you. Call to request a visit 1-866-799-5895, TTY 711, Monday - Friday 8 a.m. - 8:30 p.m. ET. For medical emergencies, call 911.
UnitedHealthcare® HouseCalls
Look out for your health. A UnitedHealthcare® HouseCalls visit is a no-cost, yearly health check-in that can make a big difference. Call 1-866-799-5895, TTY 711, to schedule your visit.
PDF Nursing Home Visitation Frequently Asked Questions (FAQs)
Nursing Homes. 4. Can visits occur in a resident's room if they have a roommate? A: Yes. Ideally an in-room visit would be conducted when the roommate is not present, howeverif that is not an option and as long as physical distancing can be maintained, then a visit may be conducted in the resident's room with their roommate present.
Nursing Home Visits: Tips and Regulations
Generally, nursing home visits are allowed, though some nursing homes may have specific visiting hours. Because seniors in nursing homes were disproportionately affected by COVID-19 at the height of the pandemic [1], nursing homes were often closed to visitors to protect staff and high-risk residents, according to Centers for Disease Control ...
30 Safety Tips for the Home Care Nurse
Flashlight and extra batteries. 7. Park on the street if possible. You don't want to be blocked in if you need to leave quickly. 8. Trust your gut. If a situation feels unsafe, it probably is, and you need to get out quickly. Make sure the patient is safe, leave the home, and call your supervisor. 9.
HouseCall Primary Care
Caring for the seniors in our community is the mission of HouseCall Primary Care. We appreciate their special care needs, and our practice is directed toward meeting those needs wherever they are. Our care model is team-based, patient focused, and holistic, designed to deliver excellence in patient care. We strongly believe a team-based ...
The Practice of Home Visiting by Community Health Nurses as a Primary
Home visit is an integral component of Ghana's PHC delivery system. It is preventive and promotes health practice where health professionals render care to clients in their own environment and provide appropriate healthcare needs and social support services. ... Hollenbeak C. S. Cost-effectiveness of postnatal home nursing visits for prevention ...
Home Visit
Schedule home visits at convenient times for the client and obtain consent for the visit. Respect the client's privacy and autonomy. 4. Communication: Establish effective communication with the client and their family. Listen actively, address concerns, and encourage open dialogue to better understand their needs. 5.
FBI shows up at home of Texas nurse who opposes 'transgender medicine'
Tuesday, writing for the City Journal, the senior fellow of the Manhattan Institute shared details of nurse Vanessa Sivadge who'd accepted a position at Texas Children's Hospital in 2021 only ...
Whistleblower nurse claims FBI threatened her after she accused
A whistleblower who accused the nation's largest children's hospital of illegally billing taxpayers for "transgender medicine" for kids claims that FBI agents showed up to her house to ...
Home
I moved from acute care to academe for new challenges and new ways to contribute to patient care. More time for research, scholarly pursuits, and teaching and mentoring my fellow nurses is enriching my practice as a nurse.
KOOL NAILS
31 reviews and 66 photos of KOOL NAILS "I know Thao from her previous nail salon, and was so excited when she took over Kool Nails bc it's closer to home. Let me tell you, Thao is the sweetest person ever and knows what she's doing when it comes to your nails. Her team is an amazing group of women. I got my gel mani done by Jessica and it was my first time trying cat eye gel.
Find Healthcare Providers: Compare Care Near You
Find Medicare-approved providers near you & compare care quality for nursing homes, doctors, hospitals, hospice centers, more. Official Medicare site. ... Visit the data catalog on Data.cms.gov. ... Home Health Agency Quality Of Patient Care Star Rating See how home health agency quality of patient care star ratings are calculated, based on 8 ...
Effect of Home Visits by Nurses on the Physical and Psychosocial Health
Considering nurse home visits or a nurse-centered case management as a primary service delivery model may be a cost-reducing health policy. Moreover, research results should be evaluated by meta-analyses. Journalism Ethics considerations. Ethical issues (including plagiarism, data generation, etc.) were observed by the authors. ...
Sheri Biggs beats Trump-backed candidate in South Carolina runoff
Republican nurse practitioner Sheri Biggs has won the GOP primary runoff for South Carolina's 3rd Congressional District, Decision Desk HQ projects, in an unusual race that pitted Donald Trump ...
Why children develop complications after blood clots
The study involves three visits over about one year: Visit 1: Participants provide clinical and demographic information and blood samples for lab testing at their enrollment site. Visit 2: Our team arranges travel to Children's Medical Center Dallas where participants will undergo three days of exercise tests, MRI and blood tests. Visit 2 ...

Best Visiting Nurse Services

Best Visiting Nurse Services of 2024

Final Verdict

Methodology

Best for Post-Operative Assistance : Elara Caring

Best Technology : Enhabit Home Health & Hospice

Best for Specialized Care : Interim HealthCare

Best for Hospice (End-of-Life Care) : ProMedica Hospice

Guide to Choosing a Visiting Nurse Service

Frequently Asked Questions

Is a Visiting Nurse the Same as a Home Health Aide?

Does Medicare Cover Visiting Nurse Services?

Nursing Home Visit

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Nursing Home Visit – Tips & What To Expect

Reasons Nurses Do Home Visits

7. Make Another Appointment

How To Decide Whether To Do A Home Visit

How To Do A Home Visit

1. Greet The Patient

2. Tell Them The Purpose Of The Visit

3. Assess The Patient

4. Set Your Bag In A Clean Place

5. Perform Your Nursing Care

6. Keep Excellent Records

Nursing Home Visit: Final Thoughts

More Nursing Tips

About The Author

Debunking 5 Myths About Millennial Nurses

Male Nurse Jokes and Memes For All the Murses Out There

Best Medical Dictionaries for Nurses

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Nursing, Behavioral Health, Home Support, Palliative Care, and Therapy

Highly Skilled Care from the Comfort of Home

Signs that might indicate a need for home health care:

Specific care offered by our skilled nurses and expert caregivers includes:

Frequently Asked Questions

What is Home Health Care?

What are the Medicare criteria for Home Healthcare?

What can I expect at an admission visit?

What is a typical visit like?

How often will a clinician visit me?

How are visits scheduled?

Will I have the same nurse and/or therapist all the time?

How can I pay for this?

How do I make a referral?

Who do I contact if I have questions?

Our VNA Services

Behavioral Health

Home Support

Palliative Care

ABOUT HCS SERVICES

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For information or to make an appointment, please call 603-352-2253 .

Matrix For Me

Good Health Begins with a Conversation

Watch the “What to expect” video, to learn more about an In-Home Health Assessment

Health and Wellness Visit Benefits

How will my doctor learn about my assessment results?

In-home Health and Wellness Visits

Or, call 1-855-286-9062 (TTY:711)

How do I know if I am eligible for a video wellness call?

What happens during the video wellness call?

What are the technical requirements?

Call 1-855-214-4807 (TTY:711)

In-Home Visits

Video Calls

Comprehensive Health and Wellness Assessment

Early Identification of Health Risks

Answers to Your Health Questions

Full Medication Review

Necessary Health Screenings

Connections to Community Resources

"I appreciate the chance to talk to someone about my health. It has been hard adjusting to this stage of my life. Matrix has been very helpful as I become used to the changes."

Nursing Visits

Our Visiting Nurse Service Includes

Award-Winning Care

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