Essential Guide to Conducting Safe and Effective Home Visits for Community Health Workers

 
Chapter Eleven
 
Home Visiting
 
 
(2016)
Berthold, T., Editor
San Francisco, C.A.: Jossey-Bass
Reflection of Last Session
 
What did you learn?
 
 
Care management
Goal setting
 
 
What You Will Learn
 
Define home visiting and provide examples of when
and why they are conducted
Prepare for home visits
Identify key safety concerns and plan for ways to
address them
Discuss what to do (and what not to do) when you
arrive at a client’s home
Conduct a subtle assessment of the home
environment, and explain why this is important
Identify and respond to common challenges
related to home visits
 
Home Visiting
 
Meeting clients where they live:
 
An apartment
Home
Trailer
Single-room occupancy hotel
A shelter
Jail
Homeless encampment
On the streets
In the park
 
Home Visiting
 
Home visits are conducted with clients:
 
Who find it difficult to meet elsewhere
At home because it helps promote their health
Who are in the hospital, jail, or other confined
institution
To assess their home environment
To provide support
 
Prepare for Home Visits
 
Shadow another CHW’s home visit
Ask client how you can preserve privacy
Review and prepare client’s files
Organize and pack resources to bring
Plan how to get to the client’s home
Identify key objectives of the visit beforehand
Dress for the occasion
Practice cultural humility
 
Conducting Home Visits:
CHW Interview
 
Safety Guidelines for
Home Visits
 
Concerns include:
 
Witnessing violence and other illegal activity
Observing signs of neglect or abuse
The need to report harmful or abusive conduct
Damage to your car
Unintentional involvement in police actions
Witnessing domestic violence
Threats and assault
Meeting an angry/aggressive/threatening person
 
Safety Guidelines for Home Visits
 
Be prepared:
Find out information
about the location
Work with a partner
Let your supervisor
know about visit
Bring a cell phone
Dress appropriately
 
If conflict or danger arises:
De-escalate the situation if
possible
Apologize
Leave if you feel unsafe
Report violence to your
supervisor and document
in your notes
Call the police only if it is
absolutely required
 
How to Conduct a Home Visit
 
Once you introduced
yourself and are invited
into the home, confirm
that you are talking to
the client or primary
caregiver.
Explain why you are
having the visit and ask
what the client would
like to accomplish
.
 
Conduct an assessment of
client’s:
Knowledge, strengths, risks,
and needs
Health status
Adherence to treatments
Progress with risk-reduction
Health condition
Signs and symptoms
Recent test results
Upcoming appointments
 
 
How to Conduct a Home Visit
 
1.
Once you introduced yourself and are invited into the
home, confirm that you are talking to the client or primary
caregiver.
2.
Explain why you are having the visit and ask what the client
would like to accomplish
.
3.
Conduct an assessment of client’s:
 
Knowledge, strengths, risks,
and needs
Health status
Adherence to treatments
Progress with risk-reduction
 
Health condition
Signs and symptoms
Recent test results
Upcoming appointments
 
Conducting an
Environmental Assessment
 
Observe what is in sight and 
ask the client’s permission
 to
look at other parts of the home.
“Do you mind if I look in the kitchen to see what you
have to eat?”
Your
 goal 
is:
To help clients to identify any risks to their health.
To work with clients to make changes to their
environment that reduce these risks. This include:
Assisting clients to organize their medications
Reporting mold to the landlord
 
Common Challenges
 
Visits to people without homes:
Be respectful of their space whether its an overpass
or a park
Keep communication confidential, your voice low,
and follow your client’s lead
 
When clients are angry:
Be patient, stay respectful, professional, and polite
If the client is acting in a threatening manner, leave
 
Common Challenges
 
Clients who are incarcerated:
 
Gain security clearance and maintain professional
relationships with staff
Assist clients in making plans for when they are
released
Help them figure out how to reduce their risks
 
Practice
 
 Visit:
http://homvee.acf.hhs.gov/mo
dels.aspx
Discover a tip or suggestion in
one of the model programs.
Come prepared to share.
Complete Chapter 11 HW & DB
on Blackboard
Read Chapter 12
 
Resources:
 
Image on slide 2
digital-drugs-binaural-beats
 by 
digitalbob8
 is licensed under 
CC BY 2.0
 
Image on slide 3
Bring Light Bulb 
is available in the public domain under 
CC0 Public Domain
 
Image on slide 4
Sioux Falls Jail
 by 
Incase
 is licensed under 
CC BY 2.0
 
Image on slide 5
Home
 is available in the public domain under 
CC0 Public Domain
 
Video on slide 7
Conducting Home Visits: CHW Interview, Foundations
 by 
Foundations for Community Health
Workers 
is licensed under a 
Standard YouTube License
 
Image on slide 14
WHS Front Door
 is available in the public domain
 
 
Unless otherwise noted this material by 
St. Louis Community College
 
is licensed under a
Creative Commons Attribution 4.0 International License
.
This product is partially funded by the MoSTEMWINs $19.7 million grant from the U.S. Department of Labor Employment and Training
Administration. The product was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The
Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including
any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy,
continued availability, or ownership
MoSTEMWINs
 
Acknowledgements:
Adapted from the 
Foundations for Community Health Workers, 2
nd
 Edition
(Berthold)
 with permission from Wiley Publishing by the 
Institute of Workforce
Innovation of the Metropolitan Community College Kansas City
 and the 
Workforce
Solutions Group of St. Louis Community College
.
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Learn the key aspects of conducting home visits as a community health worker, including defining home visiting, preparing for visits, assessing safety concerns, addressing challenges, and handling different client environments. Safety guidelines and protocols for encountering various situations during home visits are also discussed.

  • Community Health
  • Home Visits
  • Safety Guidelines
  • Health Worker
  • Client Assessment

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  1. Foundations For Community Health Workers (2016) Berthold, T., Editor San Francisco, C.A.: Jossey-Bass Chapter Eleven Home Visiting

  2. Reflection of Last Session What did you learn? Care management Goal setting

  3. What You Will Learn Define home visiting and provide examples of when and why they are conducted Prepare for home visits Identify key safety concerns and plan for ways to address them Discuss what to do (and what not to do) when you arrive at a client s home Conduct a subtle assessment of the home environment, and explain why this is important Identify and respond to common challenges related to home visits

  4. Home Visiting Meeting clients where they live: An apartment Home Trailer Single-room occupancy hotel A shelter Jail Homeless encampment On the streets In the park

  5. Home Visiting Home visits are conducted with clients: Who find it difficult to meet elsewhere At home because it helps promote their health Who are in the hospital, jail, or other confined institution To assess their home environment To provide support

  6. Prepare for Home Visits Shadow another CHW s home visit Ask client how you can preserve privacy Review and prepare client s files Organize and pack resources to bring Plan how to get to the client s home Identify key objectives of the visit beforehand Dress for the occasion Practice cultural humility

  7. Conducting Home Visits: CHW Interview

  8. Safety Guidelines for Home Visits Concerns include: Witnessing violence and other illegal activity Observing signs of neglect or abuse The need to report harmful or abusive conduct Damage to your car Unintentional involvement in police actions Witnessing domestic violence Threats and assault Meeting an angry/aggressive/threatening person

  9. Safety Guidelines for Home Visits Be prepared: Find out information about the location Work with a partner Let your supervisor know about visit Bring a cell phone Dress appropriately If conflict or danger arises: De-escalate the situation if possible Apologize Leave if you feel unsafe Report violence to your supervisor and document in your notes Call the police only if it is absolutely required

  10. How to Conduct a Home Visit Once you introduced yourself and are invited into the home, confirm that you are talking to the client or primary caregiver. Conduct an assessment of client s: Knowledge, strengths, risks, and needs Health status Adherence to treatments Progress with risk-reduction Health condition Signs and symptoms Recent test results Upcoming appointments Explain why you are having the visit and ask what the client would like to accomplish.

  11. How to Conduct a Home Visit 1. Once you introduced yourself and are invited into the home, confirm that you are talking to the client or primary caregiver. 2. Explain why you are having the visit and ask what the client would like to accomplish. 3. Conduct an assessment of client s: Knowledge, strengths, risks, and needs Health status Adherence to treatments Progress with risk-reduction Health condition Signs and symptoms Recent test results Upcoming appointments

  12. Conducting an Environmental Assessment Observe what is in sight and ask the client s permission to look at other parts of the home. Do you mind if I look in the kitchen to see what you have to eat? Your goal is: To help clients to identify any risks to their health. To work with clients to make changes to their environment that reduce these risks. This include: Assisting clients to organize their medications Reporting mold to the landlord

  13. Common Challenges Visits to people without homes: Be respectful of their space whether its an overpass or a park Keep communication confidential, your voice low, and follow your client s lead When clients are angry: Be patient, stay respectful, professional, and polite If the client is acting in a threatening manner, leave

  14. Common Challenges Clients who are incarcerated: Gain security clearance and maintain professional relationships with staff Assist clients in making plans for when they are released Help them figure out how to reduce their risks

  15. Practice Visit: http://homvee.acf.hhs.gov/mo dels.aspx Discover a tip or suggestion in one of the model programs. Come prepared to share. Complete Chapter 11 HW & DB on Blackboard Read Chapter 12

  16. Resources: Image on slide 2 digital-drugs-binaural-beats by digitalbob8 is licensed under CC BY 2.0 Image on slide 3 Bring Light Bulb is available in the public domain under CC0 Public Domain Image on slide 4 Sioux Falls Jail by Incase is licensed under CC BY 2.0 Image on slide 5 Home is available in the public domain under CC0 Public Domain Video on slide 7 Conducting Home Visits: CHW Interview, Foundations by Foundations for Community Health Workers is licensed under a Standard YouTube License Image on slide 14 WHS Front Door is available in the public domain

  17. Acknowledgements: Adapted from the Foundations for Community Health Workers, 2nd Edition (Berthold) with permission from Wiley Publishing by the Institute of Workforce Innovation of the Metropolitan Community College Kansas City and the Workforce Solutions Group of St. Louis Community College. MoSTEMWINs This product is partially funded by the MoSTEMWINs $19.7 million grant from the U.S. Department of Labor Employment and Training Administration. The product was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership Unless otherwise noted this material by St. Louis Community College is licensed under a Creative Commons Attribution 4.0 International License.

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