Acute medical care is no longer only available to those in a nursing care facility. Patients recently discharged from the hospital, as well as the chronically ill, the aged and the disabled can regain and retain their independence thanks to home health care providers. And home care isn’t merely meant for the elderly; people of every age, including children and families, can benefit from it. Consider that one of every four patients getting home care is under the age of 65.
Home care services range from help with fundamental daily activities like cleaning or getting dressed to the kind of high tech care found in hospitals. Home care programs are tailored to the requirements of the patient; therefore, the services provided in a given program may involve a number of different home care workers with different skill sets.
Types of Care
There are two primary types of home care: Rehabilitative and Basic.
Rehabilitative Home Care
Provided to patients in recovery from illnesses or in rehabilitation programs, this type of home care may involve a team featuring a doctor, a nurse, a nutritionist, homemaker (or companion), a home health aide and one or more therapists.
The most common rehabilitative home care service is known as skilled nursing. A nurse’s responsibilities include the changing of dressings, administration of medications, and monitoring their patients for complications or serious changes in their health. Nurses educate both the recently discharged hospital patient as well as their families on how to perform some of the nursing procedures so that in time they can perform them without needing a nurse to be present.
There are two types of nurses: The registered nurse (RN) and the licensed practical nurse (LPN). RNs have either a four-year college nursing degree, or a Bachelor of Science in Nursing (BSN); they are trained to make educated judgments regarding a patient’s condition and care; they can also perform a number of basic patient exams. An LPN has less formal nursing education than an RN, and an LPN is typically only trained in routine nursing tasks.
Another common home health care provider is a therapist. In short, therapists restore, maintain and/or enhance their patients’ abilities, depending on their needs. For instance:
• A physical therapist focuses on enhancing movement.
• A speech therapist focuses on restoring communication problems.
• An occupational therapist focuses on the basic daily living problems encountered at home or on the job site.
Basic Home Care
The second type of home care is called basic home care. Patients requiring basic home care often have a disabling health condition, a disability, of suffer from a chronic illness that would normally prevent them from being at home. To that end, basic home care services include ongoing supervision that steers patients towards enabling them to achieve some independence. Among the services provided, the most inexpensive ones are provided by homemakers and home health aides.
Sometimes called companions, homemakers perform a number of tasks geared towards maintaining the cleanliness and safety of the home; in short, they contribute to the patient’s well-being. Responsibilities include basic housekeeping (vacuuming, cleaning, making/changing the bed), grocery shopping and meal preparation, and finally basic personal care (aide with bathing and getting dressed).
Home Health Aides meanwhile perform three basic services: personal care, basic nursing and incidental homemaking. While they perform some very basic nursing functions, such as taking a patient’s temperature and encouraging patients to follow some treatment recommendations, they can not provide skilled nursing care.
Home Health Care: Determining If It Is The Right Choice Begin by talking to your doctor, and be certain to let the doctor become aware of your willingness to work them in order to come to a decision. You might also discuss the issue with a hospital discharge planner; after all, their job is to discuss these services with you.
If it is indeed the right choice, an assessment by the home care agency is next, which is carried out by an RN most often, and done either at your home or at the hospital. They will evaluate your situation and confirm that such services are indeed necessary. They will also ascertain if you might benefit from additional services.
The agency will establish a plan tailored to your needs and offer it to you for review. The plan will detail goals in treatment, specified services to be provided, the level of care administered, and any required equipment or supplies. They should advise you to discuss the proposed plan with your doctor prior to finalizing it.
Costs and Affordability
Typically, home health care agencies accept private payments as well as reimbursement payments from private insurers.
Patients with Medicare need to first determine if they qualify for home health care services, which can be determined by speaking to your doctor, the hospital discharge planner, or the agency itself. Patients must also determine whether the agency is certified by Medicare to provide services to Medicare patients.
Now, in order to qualify for Medicare paid visits, patients need to first qualify for skilled care. Medicare unfortunately will not cover basic home health care services when limited to basic assistance, such as bathing, dressing or feeding. In the event a Medicare patient does qualify for services according to the agency’s guidelines, the agency will bill Medicare directly. However, there are some situations—when the patient is not homebound, for instance—in which Medicare will only cover 80% of costs and the patient will be responsible for the rest.