The words “home health care” and “home health care agency” mean different things to different people.
With hospitals discharging patients to their homes sooner and sicker, families are not prepared and are overwhelmed. Many families do not want their loved one to go to a nursing home or skilled unit. Many families are never even given the option for home health care. Others think that when their family member is discharged form the hospital to home that there will be someone there 24 hours 7 days a week, for as long as the care is needed.
The home health care agency explained
There are two types of home health care agencies. The first addresses the health and medical care of the aging adult. Care is provided by home health care agencies, and can include the home health care aide, RN’s (registered nurse) and physical therapy. State and federal laws regulate these agencies. They are often Medicare and Medicaid certified. Many private insurances and HMO’s pay for these services as well. This means the agencies can get paid by these programs for providing home health services These services require a doctor’s order.
The services provided will be intermittent such as an RN coming in to do a dressing change or monitor vital signs. A home health care aide may come in a few times a week to assist with bathing and dressing. You must be housebound and only able to leave the house to go to the doctors or attend church to be eligible for these services.
The other type of home health care agency offers help with household duties and non-medical personal care. This could include preparing meals, bathing, dressing or moving around the house. Depending on the state, these agencies may or may not be licensed. This type of home health care allows a person with special needs to stay in their home. It is for individual’s who are getting older, are chronically ill, recovering from surgery or disabled. The best place to receive ongoing care may be in the comfort of your own home.
Studies show that our aging society not only wants to live independently as long as possible, but that they want to do it in their own home. Many have their own lives, live close to family and friends and have pets to keep them company and social activities to keep them busy. Mentally and emotionally, being at home is comfortable and often promotes wellness and healing.
Some feel that quality care at home can be expensive and is only for the wealthy
There are actually many ways for aging adults to receive qualify home health care. There are new programs such as reverse mortgages, VA benefits and long term care insurance. Many states now have state and local programs for the low income seniors that qualify for Medicaid to have waiver programs. These programs provide care at home in order to avoid an admission to a nursing home. There is a growing number of home health care agencies out there that provide for everything from companionship, to avoid loneliness to errand running and cooking and 24 hour live in services.
For medical and health care needs, there are home health care agencies that provide care when there is a change in the medical condition of the aging adult. The care required, must be deemed medically necessary by a physician.
For those individuals that want to age at home, having a good plan for the future in place is important. This may allow the aging adult to enjoy the comforts of home for as long as possible. You may no longer need to stay in a nursing home to receive good care.
If you are unsure if aging in place is an option for you or a loved one you may consider consulting with a care manager or eldercare consultant. A care manager can usually put together a plan that fits within a family budget. Care at home can be far less expensive than a move to a nursing home.
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For many caregivers and families who are searching to find out more information on how they can care for their elders and loved ones, it can seem like a daunting task. One of the most important distinctions that have to be made on your information gathering quest is to know the difference between Medicare covered Home Care vs. all other forms of home care. In this article, we will explain what Medicare Home Care is and how to find out if you or your loved one qualifies.
What is Medicare Home Health Care?
Home Health Care is skilled nursing care and certain other health care services that you get in your home for the treatment of an illness or injury.
One of the services offered to senior citizens by Medicare is Home Health Services. Medicare recipients must qualify for services, and they must be recommended by the individual’s primary care physician or specialty care physician.
Medicare beneficiaries who feel they may need Medicare home care should always look into whether they can actually qualify for Medicare home health services. It is not a general personal care or chore-worker service. Rather, Medicare home care covers limited, specifically defined at-home care related to diagnosed medical conditions, and sometimes includes personal care services.
These Medicare home care services must be prescribed by a physician, and provided through a licensed home health agency. The beneficiary must have a medical condition, or combination of conditions, that require periodic services from a skilled nurse or therapist. A plan of care will be developed that describes the specific services covered. Eligibility and coverage are evaluated strictly so the beneficiary’s conditions and care needs must be aired fully.
Medicare Home Care Qualifications
It is common for an elderly person to need assistance upon discharge from a hospital or in-patient rehabilitation stay. That individual’s physician, sometimes in concert with family members and the patient him/herself, would determine the in-home health care need and complete paperwork that refers the patient to home health care.
Other common situations include the slow physical decline elderly people experience; when that decline includes inability to care for oneself on a daily basis-but nursing home care is not yet required-the physician may recommend home health care for just those tasks the senior is unable to perform.
These four conditions must be met before homecare services can be prescribed and covered by Medicare:
1. Your doctor must decide that you need medical care in your home, and make a plan for your care at home; and
2. You must need at least one of the following: intermittent (and not full time) skilled nursing care, or physical therapy or speech-language pathology services or continue to need occupational therapy; and
3. You must be home bound or normally unable to leave home & leaving home takes a considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for non-medical reasons; and
4. The home health agency caring for you must be approved (“certified”) by the Medicare program.
You can always find more information about your benefits and rights at Medicare’s website.
Home Health is what a physician recommends on a short-term basis. This might be when a person is recovering from a severe illness or surgery, and needs assistance. Even after the hospital stay is over and they are in their house, the person might continue to need a period of nursing and medical assistance. This is what Home Health services offer. If you need the assistance of qualified Home Health personnel for yourself, or a loved one, here are a few frequently asked questions and answers.
In what situations can Home Health be recommended?
It is a specialized recommendation by the physician. The medical practitioner might determine that you need the services of nursing practitioners while you recover in your own home.
Is it covered by Mediclaim programs?
It is focused on providing medical assistance. It is usually paid by Medicare. It is meant to provide financial assistance to homebound people who are temporarily unable to leave their home without assistance. According to Medicare guidelines, if the person leaves home for “…short, infrequent trips…such as a trip to the barber…more than once a week” they are not eligible for Mediclaim coverage.
What kind of services could be covered under it?
It usually focuses on different kinds of specialized therapies to help you while you are rehabilitating. Often a person might temporarily lose the functions of certain parts of his body, or the ability to speak properly due to certain medical conditions. Health practitioners can offer physical therapy, occupational therapy, or therapy for speech or language fluency, to assist the person in their recovery. It is completely medical and does not include services to assist with basic ‘sitter’ functions such as dressing or grooming. If you require a service that assists the person with everyday functions on a long-term basis in home surroundings, in-home care could be an option.
How long does the trained nurse remain everyday with the person being cared for?
A Home Health nurse usually does not stay more than an hour. Their services focus on the medical assistance that has been recommended by the physician to help the person recover. A home care giver on the other hand offers to assist the person with everything that they find difficult to do on their own, including preparing food and going on errands. They might also escort the person for medical appointments.
Many seniors wish to live as independently as they can for as long as they can. However, when health conditions begin to decline and independent living is no longer appropriate, assisted living becomes an option. In an assisted living facility, residents are provided with an environment that allows them to have the independence they need, while having the supervision and assistance necessary to promote their safety and well-being.
Assisted living facilities have caregivers and trained staff available to monitor, supervise, and/or assist with activities of daily living. They also provide assistance with medication administration or intake. They coordinate with the appropriate health care providers for the residents to ensure their health and safety.
Many assisted living facilities do not directly employ the medical professionals necessary to provide the assistance that many of their residents may need. Therefore, the relationships between home health agencies and other medical service providers are very important. Home health agencies can provide medical services for many of the conditions that residents in an assisted living facility commonly have.
Some of the most common conditions are:
2. COPD (Chronic Obstructive Pulmonary Disease) and other respiratory illnesses
3. Abnormality of gait or dysfunction of the nervous system and/or musculoskeletal systems
4. Declining functions including those who are at high risk for falls and those who have difficulties with activities of daily living.
5. Those who need post-hospitalization treatments
6. Those who need assistance with management of medications
7. Blood draw and laboratory support
8. Catheter management
9. Diabetic teaching
10. G-tube and colostomy care
11. Infusion therapy
12. Nutrition assessment and support
13. Palliative care
14. Wound care
Home health professionals are commonly those who are certified and/or licensed with the following positions:
- Skilled Nursing
- Physical Therapy
- Medical Social Worker
- Occupational Therapy
- Speech Therapy
- Home Health Aide
Home health can promote a better rapport with their residents and future clientele by providing the service necessary to reduce the incidents of re-hospitalizations, maximizing the health and independence of patients through extensive patient education to empower health maintenance within the facility, and by providing patients with assistance and rehabilitation to ensure their safety, health, and well-being.