Home Care FAQ

How Home Care Works and What to Expect

When it’s medical care at home from a home health agency, you will receive a call from the home care company or from the nurse or physical therapist who will be seeing you. They will tell you what day they will visit and give you a time for their visit. As they are seeing more than one patient each day, expect that they will call you if they are running late.

The first time that a nurse or physical therapist comes to your home, you should expect a visit of more than an hour. The nurse or physical therapist is trying to learn how you are today, so that as they come back they can tell if you are doing better or no change. It is important they understand how you are feeling, and they will do a complete physical. They will ask many questions, but some of the most important are:

• Do you know what to watch for that may show that you are getting worse? They know what medical conditions you have and will tell you what things to watch for that with your disease such as feeling that you cannot breathe easy or feeling faint or your ankles are very swollen if you have heart disease, or a high blood sugar number if you have diabetes, or pain anywhere in your body that you do not usually have or it is worse. They will tell you who to call, and how to reach the nurses any time, 7 days a week. 
• Which medications do you take, how many and how often? They will want to know if you take any other medications when you are feeling worse-such as aspirin, or cough syrup. They will also want to know if you or your family were given any prescriptions to bring home from the hospital or nursing home. The nurse may want to call your doctor while he or she is there to make sure that the medicines that you take are the right ones in the right amount.
• The nurse will ask you to get up and move around. She wants to be sure that you are safe in your home, especially in the bathroom where most people fall when they are ill. If she feels you need to get stronger, she may call your doctor to ask that a physical therapist or occupational therapist come to your home to help you with exercises and making your home safe. Everyone’s job is to keep you at home as long as possible, and out of the hospital.

When it’s private duty or personal care and support from a home care company:

The evaluation in your home is one of the most important parts of your choice of a home care company. You want to meet some of the people who are in charge. You should expect them to ask some important questions, not to be nosey, but to understand how they can best meet your needs and help you stay at home safely.

The evaluation will done by nurse or trained professional and probably take at least an hour. You and your family, if they are there, should expect to hear the following types of questions:

• Do you have any health conditions like heart disease, diabetes, trouble breathing, etc. that we should know about and affect how well you are able to do things each day?
• Is there someone in your house or close by who knows that you are not feeling well, and that you may need help to see a doctor.
• Do you need help getting dressed, bathing, going to the toilet, shampooing your hair or just shopping and preparing a meal?
• Can I look at your house to do a general safety check? He or she should let know things you may want to do that will make your home safer for you.
• What do you like to do? Is it watching a certain TV show, reading, sewing, playing cards or just talking?  

Once he or she is finished asking questions, the person doing the evaluation should be able to clearly  tell  you what help they think you need based on their experience, and what they understand you want. Tell them what you think, and together you should make a plan for services that will say how often the company’s employee will be in your home, for how long, and what they will do when they are there. This plan will be given to the employee who comes to your home and to you, so everyone understands what you agreed to.

Remember this is your house, and as part of the plan, you should expect to set the “rules.” These “rules” include how the person will get into the house; where the person can eat and keep their food; if they can talk on the phone-how often, and how long; what bathroom they should use, etc.

Finally, you should feel comfortable with the people coming into your home. If your personalities just don’t work, tell the home care company. They should leave the phone number and how you can call them. Being at home is a good place to be, and we want you to feel as good as you can each day you are there and one of our employees is with you.

When family or friends can’t meet all of a person’s care needs, there are basically two types of people who provide home care. There are paid healthcare professionals, who are state licensed, and work per orders of your doctor. These include nurses, physical therapists, or social workers. The second type includes aides, homemakers and companions who are there to help with daily activities so you can stay in your home, independently for as long as possible.

There are two types of home care services that you can find in most areas of the country.The first type of home care provides medical care at home and your doctor gives the home care company a plan and instructions for your care. Your treatment is provided by health care professionals such as nurses, physical therapists, speech therapists and social workers, as well as by home health aides who can help with bathing or dressing or using the bathroom while you are receiving home nursing or therapy services. This type of care is often paid for by Medicare, Medicaid or many commercial insurance companies. The services are usually provided by a Medicare or Medicaid Certified Home Health Agency, or a home care company approved by the insurance plan.

The second type of home care helps you with everyday activities that may be harder to do by yourself when you have an illness that may be getting worse such as heart disease or diabetes, and you do not always feel safe to do things like bathing or dressing or shopping by yourself and you want to stay at home as long as possible. These services are often called private duty or personal care and support services. These may be paid for by a long term insurance policy, Medicaid, or be paid for directly by you or your family.

Home care is a valuable resource for people who would rather recover or age at home. Whether the home care is provided by family members, loved ones or an aide or nursing professional from Interim HealthCare, proper financial planning is required in order to provide optimum care.

Hiring a professional caregiver to provide the appropriate rehabilitative or elderly care for your loved one is a smart decision. According to the National Association for Home Care & Hospice (NAHC), people who require home care can primarily choose between three options to finance the care.

Self-Pay

Depending on the home care services provided, insurance and the financial capabilities of the patient, you may choose to pay for home care out of pocket from your own personal savings or that of your loved one. The fee is usually set or negotiated by the home care service provider.

Public Third-Party Payers

In the case of senior citizens who require home care, there are several options available. Most Americans over the age of 65 are eligible for the federal Medicare program. If the home care agency is Medicare-certified, Medicare funds may be used to pay for certain services provided by nurses, therapists or other medical professionals.

Medicare requires that the following conditions be met before reimbursing for home health services:

• The individual to whom the services are provided is an eligible Medicare beneficiary
• A physician certifies the need for services and establishes a plan of care
• The beneficiary must meet Medicare's definition of "homebound"
• The care must be provided in the patient's place of residence
• The individual needs skilled nursing on an intermittent basis or physical therapy or speech therapy or has a continued need for occupational therapy once one of the other skilled disciplines has established a plan of care
• The services are provided by a Medicare-certified home health agency

When the above conditions are met, physicians may also order home health aide services or medical social worker services.

Private Third-Party Payers

Private health insurance plans typically cover some home care services for people who have acute needs, and those with long-term care included may also pay for senior care at home. Commercial insurers such as Blue Cross and Blue Shield generally pay for professional in-home care with a cost-sharing provision, as well as hospice services, home nursing and other needs. In addition, if the person who requires care has long-term insurance that includes in-home care coverage, the benefits can sometimes be used to pay the caregiver.

Seniors can also use resources provided by the Older Americans Act (OAA), which stated in 1965 that federal funds shall be used to enable older individuals to remain independent in their communities. This funding covers certain costs related to transportation, chores and other tasks for people over the age of 60 who have the greatest social need. In addition, seniors may be eligible for services from the Veterans Administration if they are at least 50 percent disabled because of a service-related condition. Others who need care may turn to funds provided by Medicaid, a healthcare program for low-income individuals, or social services block grant programs provided to states each year from the federal government.

If you need medical care at home after being in the hospital or a nursing home or rehabilitation facility, the discharge planner or social worker at the facility, or your doctor can help you find a home care agency in the area where you will live before you leave. Some hospitals or nursing homes have their own home care agency. You have the right to choose any agency that you or your family feel will provide the care you need. If you are in a Medicare Advantage plan, you may need to use a home care company that belongs to the plan network. Your insurance company can give you this information.

If you need help staying at home, or what is called “personal care services”, you probably have many companies to choose from. It is important for you or your family to call these companies and ask some important questions:

• What types of services do they offer?
• Listen carefully for what you think you need, like help with bathing, dressing, shopping, cleaning, laundry, cooking, etc.
• Do they offer a free evaluation in your home so that you can meet them and they can see what you may need?
• What are their hours, and are services available on the weekends and at night?
• If you have problems with your services, who can you call and can you get them at any time?

Ask these questions about the people who will come into your home:

• Have they had criminal background checks?
  You want to hear that all employees have not only had a criminal background check, but they also are bonded.
• Do they have any training in what they do?
  You want to hear that personal care employees have completed training courses in how to care for people who may not be feeling well or have trouble walking, or standing for several minutes, etc. They know how to safely help people up, sit down, bathe, dress, etc. You also want to hear that someone has checked that they do it correctly.
• Do they have a supervisor? How often should I expect the supervisor to call or see me?
  This may be different for each company, but you want to know that you will have regular contact with the supervisor so you can tell him or her about how the employee is doing, and if you feel comfortable with the employee or employees assigned to you, including their personalities.
• How do they choose who will come to my home?
  You want to hear that the person’s skills, training and experience match your needs. Importantly, you want to know that they listen to your preferences (for example, no smokers or must like cats). They also should say that they will find someone that matches your personality. How do they do that? They should offer to come to your home, meet you and get to know you!

Every person is different, especially when it comes to health and what type of home care is needed. The exact cost of care needs to be based on listening to you, your family, your doctor, and observing your individual situation.

We recommend an initial in-home care evaluation for each individual client. Often, these evaluations are done by the local Interim HealthCare office at no charge. Based on the in-home evaluation, a service plan is then developed to best meet the needs of the individual. It can include a little bit of assistance up to around-the-clock assistance. 

Charges are fairly based on quality care and individual needs. Please give our Interim HealthCare local office a call to schedule an in-home evaluation or to request more information.