Home-Care Services
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.
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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.
To learn more about the different types of coverage click below:
Medicare
Medicaid
Medigap
Long-term-care insurance
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Where can I find a home-care nurse?
Nurses are employed by home health agencies and can be found by
contacting the agency. Click
here to find a home health agency near you. You can also contact
the Visiting
Nurse Association for information and referrals.
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What questions should I ask when I call a home-care agency?
- Is the agency insured? Is the agency bonded? Are the individual workers
insured and bonded?
- What level of supervision is provided? A registered nurse?
- How often are home visits made? Will you be notified before visits?
- What kind of reference/background check is done on agency employees?
- Do I get a chance to meet and talk in advance with the person who will
be providing the care for my loved one?
- Will the agency attempt to consistently assign the same aides to the case?
- Does the agency check to be sure the aide is coming as agreed? How quickly
can back-up be provided?
- If I am not satisfied with the caregiver provided, what are my options?
Can I request another caregiver?
- What are the fees? Is there a charge for initial assessment?
- Is there a sliding fee scale?
- Are there any extra fees for supervisory visits, or for services such as
running errands or providing transportation?
- Are there different fees for holidays, weekends and overnight stays?
- Before contracting with you, may I have the fees in writing?
- Are there a minimum number of hours I must contract for?
(Note: Not all agencies require a minimum.)
Specific Alzheimer's-related questions to ask the home healthcare provider:
- Does your staff have Alzheimer's-specific training? If so, give examples.
- Does the agency serve a large number of people with Alzheimer's? How many?
- Is it possible for the aide to spend time with the person with Alzheimer's,
prior to actual contracted time, in order to see if they are comfortable with
one another?
- May I call references that have used your agency to care for a person with
Alzheimer's?
For a comprehensive list of professionals and services in your area, click below.
Resource Locator
The Resource Locator lets you search for providers by name, state, city, or ZIP code from a list of more than 30 types of health care professionals and services.
Source: Some questions reprinted from "Caring: A Guide to Caring
for Persons with Alzheimer's Disease," from the New York City Department
for the Aging, Alzheimer's and Long-Term Care Unit.
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