Posted by Positive Aging SourceBook on 01/10/2020

Home Care - Receive assistance at home

Home Care - Receive assistance at home

Home care can include a wide variety of healthcare and supportive services from professional nursing and home health aide services to physical, occupational, respiratory and speech therapies. An advancing industry, home healthcare is essentially skilled nursing care and certain other forms of healthcare that you get in your home for the treatment of an illness or injury. It is an important option to consider regardless of one’s age or health conditions.

Options in Home Care

An incredibly diverse field, home care includes companion care, home healthcare or skilled nursing care.

COMPANION CARE is provided by caregivers or companions, who serve as surrogate family members, performing many of the tasks that family members would typically complete. Assistance from companion caregivers can include meal preparation, medication reminders, laundry, light housekeeping, shopping, transportation and assistance with exercising. The overall goals of companion care providers are to ensure that the home environment remains safe and that the individual has a companion to spend time with when family is not available.

HOME HEALTHCARE is for those who are no longer able to perform all of the functions of daily living by themselves but who do not require skilled medical services. A home health aide can help with activities of daily living (ADLs), which include bathing, dressing, transferring, eating and toileting. Additional services generally include meal preparation, mobility exercises, housekeeping, laundry, medication reminders and transportation.

SKILLED NURSING CARE is prescribed by a physician and is administered by a registered nurse. The services provided by skilled nurses include: administering injections, administering medications, wound care, IV monitoring, blood tests, catheter care, respiratory therapy, physical therapy, feeding tube administration and more.


Planning for Care at Home

by Phyllis Mensh Brostoff 

If you took a poll of older adults and asked each person if they wanted to remain in their own home until the end of their life, most people would say, “of course.” That is a wonderful goal, which often takes a lot of sound planning to be successful. Anything can get in the way—accidents, illness, lack of energy, declining physical abilities—of achieving your desired independence. It is hard to give up even a little autonomy, but asking for assistance can help keep you where you want to be—in your own home.

What if You Become Homebound?

If you are recovering from an acute illness, you may be eligible for home health services that are paid for by the Medicare program. An Aging Life Care Manager™ can help you access licensed home health services by facilitating a conversation with your physician about your need for skilled nursing services, physical therapy, occupational therapy, and/or speech therapy in your home. This is an important conversation to have with your doctor and discharge planner if you are in the hospital or a nursing facility and need to decide on and plan for services in your home once you are discharged.

However, Medicare will only pay for these services if you are “homebound.” Homebound is defined as only leaving your home for “medical treatment or short, infrequent absences for non-medical reasons, like attending religious services.”

You may also receive help from a home health aide under the supervision of a professional nurse or therapist. A physical or occupational therapist can evaluate your home and recommend equipment (such as grab bars in the bathroom) that will improve your safety.

Accessing services

These services must be obtained from a state licensed home health agency certified to provide Medicare-reimbursed services. They may be freestanding agencies, or they may be part of a large, hospital-based organization. Licensed home health services are usually time-limited, ending when you have met the goals of treatment and the need for the skilled care has ended.

If you have enrolled in a Medicare Advantage program, you may also have access to additional services such as home visits after a hospitalization.

Other Home Care Services

Many other care services are provided in the home but are not licensed or paid for by Medicare. An Aging Life Care Manager can help you understand what they can offer, access reputable services, and monitor them on an on-going basis.

Non-Medical Aides, Companions and Homemakers

There are many types of paid care giving services available—often called non-medical aides, companions and homemakers—who many people hire privately. If you do, you or your family should check at least two work-related references, develop a specific set of tasks and expectations for the caregiver, arrange to pay all appropriate taxes, and have the required insurance coverage.

Caregiver services can also be arranged through an agency. While this may cost more per hour than hiring an aide yourself, hiring an agency assures you of coverage when the aide is sick, on vacation or quits. The agency also carries liability insurance and is responsible for all employment taxes and employee bonding. An Aging Life Care Manager can help you find a reputable agency and get important questions answered, such as: do they check police and driver license records; do they provide supervision; how do they handle cancellations; and how long have they been in business?

Thank you to the Aging Life Care Association™ for permission to share this information. You may learn more about Aging Life Care™ at aginglifecare.org


Medicare and Home Care

When it comes to understanding Medicare coverage, many individuals can find themselves confused by a complex web of information. This especially applies to those who want to know if they are eligible for Medicare coverage when entering a nursing home or receiving home health care. Below is some helpful information on whether you can use your home health care benefits if you have Medicare and what services and products it will cover.

First, you can use your home health care benefits if all of the following applies to your situation. Your doctor must prescribe that you need medical care at home and create a care plan. The care you need has to be intermittent and in the form of skilled nursing care, physical therapy, occupational therapy or speech therapy. The home health agency must be Medicare-certified and you must be homebound, or unable to leave the home unassisted.

Once you have established those requirements, it is important to understand what Medicare will actually cover, which includes the following:

•    Home health aide services on a part-time or intermittent basis, as long as there is a skilled need

•    Medical social services

•    Certain medical supplies

•    Durable medical equipment (wheelchair, walker, bedside commode, etc.)

Given the services and products that Medicare does cover, it is also valuable to take note of what is not covered. Care that is required 24 hours a day will not be covered. Other services not covered include personal care provided by home health aides such as bathing and dressing, along with homemaker services like cleaning and laundry. Also not included are home-delivered meals.

If you require care that goes beyond intermittent visits for a limited amount of time, or if your needs are not covered by Medicare, an important option to consider is private duty home care. For more information on Medicare coverage, visit medicare.gov.

Information Provided by Family & Nursing Care and adapted from medicare.gov.


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