Home Care 101 for Aging in Place

This article was written in partnership with BAYADA, based on content shared in a Hively discussion co-hosted by Kirsten Kilburn, Director at BAYADA Home Health Care.

Aging in place—a place of familiarity and with community—is no new concept. A recent AARP study shows that 77 percent of adults 50 and older want to remain in their homes for the long term—a number that has been consistent for more than a decade; however, what options are available when it comes to more hands-on care that may be needed within the home?

Enter home care onto the scene: home care can help achieve the highest quality of life possible for you or your loved ones, and here, you can find information and resources on what those options are. And while the time to utilize home health services may still be far down along the horizon, it is never too early to plan ahead or find resources for a loved one.

But firstly, what is home care?

Home care includes supportive care provided by professional caregivers such as nurses, aides, and therapists (whether short-term or long-term), all from within the home, that allows a person to live safely in their home. In-home care services can help someone who is aging and needs assistance to live independently, including care for: managing chronic health issues, recovering from a medical setback, and special needs or disabilities.

It can enable safety, security, and increased independence, but more practically speaking, it can ease management of an ongoing medical condition; help avoid unnecessary hospitalization; or aid with recovery after an illness, injury, or hospital stay—all through care given in the comfort and familiarity of home. Home care can include:

• Help with daily activities such as dressing and bathing

• Assistance with safely managing tasks around the house

• Companionship

• Therapy and rehabilitative services

• Short- or long-term nursing care for an illness, disease, or disability—including tracheostomy and ventilator care

The following charts will define three different types of home care and outline types of assistance provided, how they are paid for, and whether a physician prescription is needed to enable care.

WHAT ARE THE TYPES OF HOME CARE?

​PERSONAL CARE AND COMPANIONSHIP	PRIVATE DUTY NURSING CARE	HOME HEALTH
➞ Help with everyday activities like bathing and dressing, meal preparation, and household tasks to enable independence and safety Also known as... Non-medical care, home health aide services, senior care, homemaker care, assistive care, or companion care Services may include: Assistance with self-care, such as grooming, bathing, using the toilet Enabling safety at home by assisting with ambulation, transfer (e.g., from bed to wheelchair), fall prevention Assistance with meals, housekeeping, errands, medication reminders, appointments escort Companionship and engaging in hobbies Supervision for someone with dementia	​➞ Long-term, hourly nursing care at home for adults with a chronic illness, injury, or disability Also known as... Home-based skilled nursing, long-term nursing care, catastrophic care, tracheostomy care, ventilator care, nursing care, shift nursing, hourly nursing, or adult nursing Services may include: Care for diseases and conditions such as Traumatic brain injury (TBI), Spinal cord injury (SCI), ALS, MS Ventilator care Tracheostomy care Monitoring vital signs Administering medications Ostomy/gastrostomy care Feeding tube care Catheter care	➞ Short-term, physician-directed care designed to help a patient prevent or recover from an illness, injury, or hospital stay Also known as... Medicare-certified home health care, intermittent skilled care, or visiting nurse services Services may include: Short-term nursing services Physical therapy Occupational therapy Speech language pathology Medical social work Home health aide services

HOW IS IT PAID?

​Personal care and companionship services are usually paid directly by the person receiving care (private pay), or through long-term care insurance. Other funding sources may be: Private pay Long-term care insurance Veterans benefits Workers’ compensation

​Private duty nursing care can be paid through a variety of sources, including: Private pay Health insurance Veterans benefits Workers’ compensation Medicaid (with qualifications) Direct payment by person receiving care (private pay)

​When specific qualifications are met (generally, when services are ordered by a physician and a clinical assessment deems them necessary), Home Health services are typically paid for by: Medicare Private insurance

IS A PHYSICIAN PRESCRIPTION REQUIRED?

​Personal care and companionship does not need to be prescribed by a doctor. Ongoing care provided based on client's needs, up to 24 hours a day, 7 days a week, including possible live-in care.

Private duty nursing care needs to be prescribed by a doctor. Care is provided primarily in shifts, up to 24 hours a day, 7 days a week.

Home health care needs to be prescribed by a doctor. Care is provided through visits from specialized clinicians that last up to an hour, on a short-term basis until individual goals are met.

While the multiple types of home care may serve different needs, they share a common goal: to enable happier, more independent living for the people receiving care, and to provide support and peace of mind for their families.

Ultimately, home care is extremely personal, so consulting a specialist could help you feel confident that you are achieving your desired outcomes with your home care plan. Each of the professionals listed below are just suggestions for situations that may require more specific guidance.

• Aging in Place Specialist – Someone such as a trusted professional at BAYADA Home Health care, can be a great start to your process and can answer any questions you may have about aging in place!

• Medicare Specialist – A licensed Medicare agent can help educate and guide clients through the complex process of understanding Medicare and the selection process of specific plans.

• Geriatric Care Manager & Life Care Planners – These specialists coordinate care and services to meet the full social, emotional, physical, and healthcare needs of your loved one.

• Elder Law Attorney – Elder Law Attorneys provide legal advice and support for those specifically navigating the unique requirements and processes of older clients and loved ones.

• Senior Financial Planner – These professionals specialize in planning for living on a fixed income, budgeting for long- and short-term healthcare costs, investing in retirement accounts, and acting as an estate planning guide.

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Want to learn more about Home Care Services and ask specific questions related to you or a loved one? Kirsten has offered free 1-on-1 consultations to our members to discuss your specific health needs as you age in place. She can be reached at (617) 337-2000 or Kkilburn@bayada.com.

To learn more about BAYADA, visit here