How To Remain at Home: Home Care Agencies

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Home care includes a wide variety of services-from skilled intravenous therapy to snow shoveling-all provided to individuals in their homes or in an assisted, nursing, or hospital facility. Home care often supplements the care individuals receive in a hospital or facility; 25% of the care we classify as home care is actually performed in hospitals or facilities.

Whether performed in the comfort of their own homes or in a facility, home care helps seniors to maintain their independence. Additionally, home care prevents the full responsibility of caregiving from falling on friends and family. These services are intended to promote, maintain, or restore health and help individuals to manage the responsibilities of daily life. Aides and nursing professionals can be engaged privately or through an agency.

*What types of Home Care are available?*

An incredibly diverse field, home care can serve a variety of senior need levels. Home Care can include home support care, skilled nursing care, or hospice care. For information about hospice care, please see our hospice section.

Home Support Care- is for seniors who are no longer able to perform all of the functions of daily living by themselves but who do not yet require skilled medical services. A home health aide can help with activities of daily living (ADLs), which include bathing, dressing, transferring, eating, and hygiene. Additional services generally include meal preparation, mobility exercises, light housekeeping, laundry services, medication reminders, and accompaniment to appointments. Training and certifications will vary from provider to provider.

Skilled Nursing Care – is care that 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, speech therapy, physical therapy, feeding tube administration, and more.

*How much will Home Care services cost, and who will pay for them?*

Home Support Care – is traditionally a “private-pay” service, which means that it is an out-of-pocket expense for the customer. Prices range from $10-$20 per hour. However, most long-term care insurance policies will cover home support care. You should carefully review your long term care insurance policy with your insurance agent to be sure that the type and amount of coverage you will need will be covered. If you qualify for Medicaid, a government program for low-income individuals, it may pay for some of your home support care needs. Since laws vary from state to state, you will need to contact your local Area Agency on Aging for more information concerning government benefits.

Skilled Nursing Care – will be paid for by Medicare, a government program that covers some of the medical needs of seniors over the age of 65, as long as it is determined to be “intermittent skilled care,” which includes occupational, respiratory, speech, and physical therapy. Major medical health insurance will also cover a limited number of skilled home visits. The number of visits covered will depend on your medical diagnosis and your health insurance plan. Be sure to fully understand what Medicare and your health insurance policy will cover before making arrangements for skilled nursing care. Costs for these services vary greatly depending upon coverage by Medicare, Medicaid, and private insurance and the degree of services required.

*How do I choose a home care provider? *

The questions below will help you choose the home care provider that is appropriate for your medical needs and family situation. Regardless of whether the care you seek is skilled or home support care, it is important that you know the answers to the following questions.

*What should I consider when hiring privately or through an agency?*

*Is the agency performing criminal background checks?
*How long and what geographical areas are covered in the background check they perform?
*What are the experience levels and specialties of aides available?
*Will the agency be responsible for finding a replacement caregiver if my regular aide is sick or on vacation?
*What hours can I speak to someone from the agency?
*Is the agency licensed and bonded?

*Should the family perform a background check?
*What is the aid’s previous experience?
*Who will replace my caregiver if they are sick or on vacation?
*Does the caregiver have any type of licenses or certifications?
*Do I have to do reference checking?
*Who will be my advocate if I have a problem with my caregiver?

Points to consider when choosing a home care provider:

– How can I cancel the service I requested?

– How much is the cancellation charge?

– Who do I call if my caregiver is unable to work?

– What is their phone number?

– What are the fees?

– What exactly is covered by those fees?

– Will the agency respond to requests for “short notice” services?

– Is there an extra charge for these services?

– Is there a minimum or a maximum number of hours of home care service per day?

– Is there a minimum or a maximum number of days of home care service per week?

– Is there someone available to assist me 24 hours a day, 7 days a week?

– How long will it take someone to return my call after business hours?

– How do I make changes to the initial caregiver schedule?

– Do the aides provide transportation if needed?

– What type of screening does the agency perform?

– How long will I wait for service after placing my request?

– Will the same caregiver assist me every day or will it be somebody different?

– Will someone from the agency call to see if I am satisfied with the services provided to me?

– How often will they call and check-in with me?

– Will I be responsible for providing meals for the caregiver?

– Will my live-in caregiver require a private bedroom?

– Will my caregiver clean my house and do my laundry?

– Do I need to sign a contract with the agency?

– How long is the contract good for?

– What does it entail?

– Do I need to have a qualified, elder law attorney review this contract before signing it?

Special thanks to Family & Nursing Care, for their materials and guidance while compiling this article.

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