Home-care services are generally divided into one of the following types of care: Skilled care and Non-skilled care (often referred to as companion or home-maker services).
Skilled care must be performed by licensed professionals, such as nurses, therapists or social workers. Registered nurses provide services such as the initial consultation, monitoring of medications, wound care, infusion therapy and catheter care, in addition to wellness education for diabetes and other diseases. Licensed therapists and social workers perform physical, speech, respiratory, occupational and social therapies.
Non-skilled care is for those who need help with custodial tasks such as bathing, toileting and dressing. In this scenario, a home health aide, personal care aide or "companion" would be assigned, usually under the guidance of the nurse or physical therapist.
NOTE: There are some agencies that specialize in Alzheimer's care or can provide nurses and aides who are specially trained to deal with the challenges of caring for someone with the disease. When contacting these organizations, ask if they provide this expertise.
How do I pay for it?
- Medicare will cover home care for beneficiaries with Alzheimer's as long as: a) there is a skilled need as defined by Medicare guidelines, and b) the individual's doctor writes a prescription requesting it. Unfortunately, if an individual needs help with custodial tasks only and there are no associated skills needed, then home care must be paid for privately.
- Medicaid, the joint federal and state program for people who have limited income or assets, may cover home-care services for eligible persons. If eligible, you will be assigned a Medicaid-licensed home-care agency. Services vary by state; contact your local agency on aging or Medicaid office to learn what is covered in your area.
- Managed care or "Medicare managed care" may cover home care if the home-care agency is contracted with your particular managed care organization (MCO). A telephone call to your MCO provider to find out its terms beforehand is recommended.
- Private insurance plans may also cover some of the costs of home-care services. With the exception of people eligible for Medicaid, a large proportion of the home-care costs are paid for privately by the individual or family.
For more information on paying for long term care go to Legal and Financial Planning.