When Mary, a longtime home health aide (HHA) with Visiting Nurse Service of New York’s private pay affiliate Partners in Care, filled in for a colleague recently, she found that her new client wasn’t even attempting to follow the vegetable-rich diet prescribed by her physician. “I began digging deeper to find out why she wasn’t eating in a healthier way,” Mary recalls. “When she told me she didn’t know how to prepare vegetables in a way she liked, I offered to cook some dishes for her. She ended up loving them, and today her entire diet has changed for the better!”
Home health aides’ duties have traditionally included preparing meals, helping clients bathe and dress themselves, and perhaps doing some light housekeeping. As Mary’s story shows, however, HHAs are becoming increasingly involved in the health care of their clients as well. In Mary’s case, she’s benefited from a VNSNY program that trains Partners in Care HHAs to act as “health coaches.” The program, supported by a grant from New York State, teaches HHAs to use techniques like motivational interviewing to help patients manage chronic medical conditions and make important lifestyle changes.
“Our aides don’t tell clients what to do. Instead, we teach them to offer suggestions and ask questions, digging down into what might be stopping clients from taking their medications or eating healthy foods,” says Sheniqua Johnson, RN, who runs the health coach training program for Partners in Care. “Once we understand what the issue is, we can begin to address it.”
Several hundred of Partners in Care’s HHAs have now gone through Sheniqua’s one-week course. To assess the program’s impact, Partners in Care recently teamed with NYU Langone Medical Center on a project evaluating whether HHA health coaching helps congestive heart failure (CHF) patients manage their condition at home. Following their discharge from the hospital, the participating CHF patients had five sessions with their HHA health coach, in which they were encouraged to take their medications as prescribed, weigh themselves daily and follow a low-sodium diet. The study then compared these patients’ outcomes to those of another group of heart failure patients who went home with standard physician and nursing care, but no additional health coaching. While both groups had similar hospital readmission rates, those receiving health coaching went longer before readmission on average, and also showed significant improvements in overall symptom management.
“HHA health coaching is an effective and cost-efficient way to reinforce the information clients receive from their doctors and nurses,” notes Jennifer Leeflang, Senior Vice President of Partners in Care. “It’s helping our patients feel more confident about managing their health and keeping their symptoms under control. At the same time, our aides feel empowered by their new role—so there’s a real value there.”