THE CONCEPT OF FAMILY CENTER CARE

Home care is not a new concept in pediatrics.Over time the term is referred to parent caring
for mildly ill children at home,to nursing home visits after the children are discharged from the
hospital,to palliative and hospice care,and ,recently to care at home for chiLdren with more
serious chronic illness and dependence on medical technology.As discussed in this chapter home
care refers to care provided in the familys resisdence for children with complex or simple health
care need ;that care also includes the particular needs of the family within the context of the
childs health care need .

The purpose of home care services is to promote,maintain ,or restore health or to maximize
the level of independence while minimizing the effect of disability and illness,including terminal
illness.Homecare differs from hospice care ,which is a program of palliative and supportive care
that provides physical,physchologic,social and spiritual care for dying persons ,their families
,and others love ones.Hospice services are available both in the home and in inpatient
settings.End of life care and planning should be considered for any child with a terminal
diagnosis. Some patients may be admitted for end of life home care services before being ready
for admission to hospice services.Many hospice programs have admissions criteria that do not
permit theraphies such as intraveneous antibiotics,total parenteral nutrition ,or enteral feedings
that the family may wish continue .It is therefore important to discuss the type of care the family
wishes for the child early in discharge planning to clarify expections for home care.