About Senior Home Care
Seniors who would like to continue living independently, but who are also in need of additional help with their healthcare needs may benefit from home healthcare services. A range of home healthcare services is available depending on the needs of individuals, and home healthcare providers can be hired as necessary, whether on a full-time or part-time basis. Home healthcare providers can help with tasks such as bathing, grooming, dressing, and mobility needs, or they may help with the administration of medications or the performing of basic medical tasks.
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What is In-Home Care?
In-home care primarily includes assistance with daily living activities. Typically, in-home visits happen several times per week for less than 8 hours at a time. In-home care does not include services offered by skilled nurses such as medication management, injections, IVs, wound dressings, or other medical procedures. Therapy is also not included. Usually, in-home care services are provided in the individual's home and are non-medical in nature. The services may include things such as meal prep, medication reminders, light housekeeping and chores, dressing and grooming, help with mobility, and general companionship.
In-Home Care vs. Home Health Care
Although they sound similar, there are major differences between in-home care and home health care. Home health care offers more medically-based help such as injections, IVs, wound care, medication and pain management, therapy and other medical procedures. Home health care requires a written order from a doctor, while in-home care does not. Home health care is similar to the care that one would receive in a nursing home or skilled nursing facility, and it is typically less expensive. Medicare covers home health care but it does not typically cover in-home care.
Often times, home health care and in-home care is used in conjunction with one another to provide a solid regimen of care for the elder in need. For instance, a home health care nurse can change medications for the elder, while an in-home caregiver can help seniors to remember to take their medications. While an in-home caregiver can observe independent therapy exercises done by the resident and report to the physical therapist, the therapy program has to be administered by the home health therapist first.
What Is the Cost and How to Pay
In-home care expenses are most frequently paid for out-of-pocket or by a combination of other methods such as Social Security, pensions, Veterans benefits, insurance, home equity, and various savings. According to a survey conducted by CareScout in June 2017, the national average cost per month for in-home care was about $4,000. This figure is expected to rise to over $5,360 in the next ten years. Home health care, also referred to as a home health aide, costs about $4,100 per month according to the CareScout survey, and it is projected to rise to over $5,500 over the next decade. Home health care and in-home care are not inexpensive but they cost significantly less than care in a nursing home or skilled nursing facility (SNF).
Long-Term Care Insurance
Long-term care insurance is a policy that is purchased through a private insurance company. Similar to health insurance policies, the price varies greatly depending on age, general health and amount of coverage. Coverage could be denied for people with pre-existing conditions such as Alzheimer's disease or Parkinson's disease. Not all insurance will deny based on these conditions so it is important to explore different insurance companies.
Medicare is a federal government program for those 65 or older with low income and limited assets. It generally does not pay for in-home care, but it will cover home health aide services such as therapy services (occupational, speech, physical) and skilled nursing care. Home health services may also include medical social services, medical supplies for use at home, durable medical equipment, or injectable osteoporosis drugs. That said, Medicare does not pay for around the clock health aide care, meals or personal assistance.
Medicaid is a Federal and State health insurance program for those with low income and limited assets. Administration of the program varies by state, according to the Centers for Medicare and Medicaid Services (CMS). The Medicaid home and community-based service (HCBS) waiver program provides general health coverage and coverage for certain services to help seniors stay at home or in a community-based setting. Since Medicare only covers home health care if certain criteria are met, such as being homebound and needing skilled care, additional services may still be needed.
Medicaid can be used to supplement the amount and kind of services received. If Medicare's requirements for home care aren't met, eligibility for a Medicaid HCBS waiver program is still possible. According to MedicareInteractive.org, services covered through an HCBS waiver program vary by state and may include:
- Personal care, homemaker tasks and chores
- Skilled nursing and therapy care
- Home modifications
- Adult daycare
- Respite care
- Case management
Aid and Attendance Benefit for Veterans
According to the VA website, the Aid and Attendance benefit (A&A) benefit is a special benefit for war era veterans and their surviving spouses. It is a tax-free benefit designed to provide financial assistance to help cover the cost of long-term care in the home, board and care, assisted living communities, and private-pay nursing homes. This benefit is for those who are mentally or physically incapacitated, or require the regular attendance of another person or caregiver in at least two of the daily activities of living. To learn more about the eligibility requirements and to apply for these veteran benefits visit VeteransAid.org online.
In situations when costs aren't covered through other means, paying via private funds is an option. Sources of private funds for a home health aide or in-home care include retirement accounts and 401Ks, savings accounts, annuities and insurance plans (including life settlements), trusts and stock market investments. Home equity and bridge loans can also be used when increasing care services. Social Security can also be used as a payment source for those who need care services inside their home.
Additional Home Care and Home Healthcare Resources
- How to Pay for Home Healthcare
- How to Hire the Best Caregiver for a Senior in Need
- Senior Home Care - Registered Nurses vs. Home Caregivers
- How to Screen a Home Health Care Provider
- Dispelling Common Myths About Home Care
- What is Home Health Care?
- Examining Homecare Options: Continued Independence