Home care services: how to get them for free in Lithuania?

 

“The rapid aging of society and long-term illnesses pose new challenges in people’s everyday lives. When it becomes difficult to properly take care of themselves, home care services become vitally important. Last year, more than 70 thousand residents in Lithuania needed these services. In a press release, specialists from the State Health Insurance Fund remind us of the most important things about home care services reimbursed by the Compulsory Health Insurance Fund.

 

Who and when are they provided?

 

“Home care provides a person with the opportunity to receive continuous and high-quality care in their own environment when, due to their health condition, they can no longer take care of themselves or go to a medical institution. These services are especially important for elderly or seriously ill patients who need health-related care and professional assistance. This is an effective alternative to inpatient care, allowing them to receive the necessary services without leaving home,” says Oksana Burokienė, advisor to the Service Compensation Department of the State Health Insurance Fund (VLK). Home care services reimbursed by the Fund are available to all residents insured by compulsory health insurance who have difficulty fully functioning in their daily lives due to a changed health condition or functional impairment.

 

The need for care is determined according to the Care Needs Assessment Questionnaire. It is assessed whether a person can independently serve themselves, eat, take care of personal hygiene, see, hear, move, orient themselves in the environment, express their thoughts, and also assess the adaptability of the living environment, the help of relatives, and the need for specialized care. Based on the scores collected, the need for care is classified as low, medium, or high, which determines how many times a year nursing specialists will visit the patient's home. The questionnaire is completed by a family doctor, a nurse working in the family doctor's team, a geriatrician (an elderly person's doctor), a nurse working with a geriatrician, a doctor treating the patient in a hospital, or a nurse. A referral for home care is issued by the patient's family doctor.

 

Home care services can also be provided to patients after operations, when their ability to take care of themselves is temporarily impaired. In this case, the need for care is determined by the surgeon, who issues a referral and provides nursing recommendations. With a referral, the patient should contact their polyclinic, which will arrange for the provision of home care services.

 

A whole team of specialists helps

 

Home care services must be available to everyone who has been identified as needing them, therefore all primary outpatient health care institutions must provide them to residents who have registered with them themselves or conclude a contract for them with another medical institution. A specialist working in the team of home care service providers provides services according to the individual needs of the patient and his or her competence: The nurse performs injections, connects drips, takes blood or urine samples, performs an electrocardiogram, takes care of pressure ulcer prevention, care, care of wounds and artificial body openings, feeding through a tube, etc. A nursing assistant measures blood pressure and temperature, helps with personal hygiene, provides assistance with feeding, bathing the patient, changing their position, etc. A physiotherapist helps restore or improve movement function, strengthens physical capacity, etc. An occupational therapist teaches daily skills - from personal hygiene to leisure or work activities, helps adapt the home environment, select assistive devices: braces, crutches, a wheelchair, eating utensils, etc. According to O. Burokienė, outpatient home care services are a help not only for the patient, but also for their relatives: "Knowing that there is a team of nursing specialists nearby gives more peace of mind and confidence that their loved one will be able to feel dignified and will be properly cared for." Nursing specialists come to the patient's home every day from 8 a.m. to 8 p.m., as well as on weekends and holidays. The duration of the visit depends on the prescribed procedures - permanent, 24-hour home care is not provided.

Home care services may also be provided in social care institutions that have a health care activity license to provide general practice care services and that house 25 or more people. When visiting them, specialists from the home care team may only perform the following procedures prescribed by a family doctor or a nurse working with a family doctor: taking samples for diagnostic tests, performing an electrocardiogram, measuring intraocular pressure, performing interventional procedures, caring for artificial body openings, ulcers or bedsores, and suctioning mucus. People living in social care institutions that do not have a personal health care activity license to provide general practice care services and that house fewer than 25 people may be provided with all the services of specialists from the home care team. Nursing needs are growing every year According to the VLK data, more and more Lithuanian residents receive home care services paid for by the fund every year: in 2023, 60 thousand received them, in 2024 - 65 thousand, and last year - over 70 thousand patients. As the need grows, the volume and financing of the services provided are also increasing: in 2024, 2.5 million services were provided and over 45 million euros were used, and last year - 2.7 million services, which required more than 56 million euros of fund funds to pay for. "Home care services help patients receive professional help during a sensitive period of life, therefore transparency and clarity are extremely important. We want these services to be provided consistently, qualitatively and in accordance with the established procedure, and patients feel safe and properly informed," emphasizes O. Burokienė, urging patients receiving home care and their relatives to take an active interest in the services provided and their quality. Information about the services provided is published on the E. health portal.”