Home health care is a wide range of health care services that can be given in your home for an illness or injury. Home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility (SNF).
Examples of skilled home health services include:
- Wound care for pressure sores or a surgical wound
- Patient and caregiver education
- Intravenous or nutrition therapy
- Monitoring serious illness and unstable health status
The goal of home health care is to treat an illness or injury. Home health care helps you get better, regain your independence, and become as self-sufficient as possible.
If you get your Medicare benefits through a Medicare health plan, check with your plan to find out how it gives your Medicare-covered home health benefits.
If you have a Medicare Supplement Insurance (Medigap) policy or other health insurance coverage, tell your doctor or other health care provider so your bills get paid correctly.
If your doctor or referring health care provider decides you need home health care, they should give you a list of agencies that serve your area, but must tell you whether their organization has a financial interest in any agency listed.
What should I expect from my home health care?
- Doctor's orders are needed to start care. Once you doctor refers you for home health services, the home health agency will schedule an appointment and come to your home to talk to you about your needs and ask you some questions about your health.
- The home health agency staff will also talk to your doctor about your care and keep your doctor updated about your progress.
- It's important that home health staff see you as often as the doctor ordered.
Examples of what the home health staff should do include:
- Check what you're eating and drinking.
- Check your blood pressure, temperature, heart rate, and breathing.
- Check that you're taking your prescription and other drugs and any treatments correctly.
- Ask if you're having pain.
- Check your safety in the home.
- Teach you about your care so you can take care of yourself.
- Coordinate your care. This means they must communicate regularly with you, your doctor, and anyone else who gives you care.
Non-medical care is best defined as care or assistance provided by individuals without formal medical training.
It is important to grasp the distinction between non-medical and medical care, as doing so helps families to better understand and utilize their health insurance benefits and find financial assistance to care for a loved one. Providing non-medical care generally means assisting elderly or disabled persons in performing their activities of daily living, such as eating, maintaining personal hygiene, and basic mobility. Assistance with medication is an area that toes the line between medical and non-medical care. Medication reminders for taking pills is considered non-medical, but medication administration, by nebulizer or with hypodermic needles, for example, is considered medical care.
Some of the confusion surrounding non-medical care stems from the fact that multiple phrases are used interchangeably to describe it. Readers should be aware that non-medical care is nearly synonymous with personal care, attendant care, companion care and non-medical home care. Some financial assistance programs use the phrase assistance with the activities of daily living instead.
WHO CAN PROVIDE NON-MEDICAL CARE?
This type of care is usually provided by friends, spouses and other family members. However there is a whole industry of private caregivers and even public employees who provide care typically on an hourly basis. A common misconception is that non-medical care can only be provided at home. This is not the case. Adult day care centers very often provide the elderly with non-medical care during daytime hours. Assisted living communities are live-in-residences which offer 24-hour non-medical care. Non-medical care is even provided in skilled nursing homes, although the distinction between medical and non-medical care is often blurred at that level.
HOW MUCH DOES NON-MEDICAL CARE COST?
In 2016, the cost for non-medical care varied considerably across the United States. The nationwide average was $20/hour. However, the Southern states were generally less expensive, in the $17/hour range while the Northeast and West Coast experienced hourly rates above the national average, usually between $21 - $23/hour.
IS THERE FINANCIAL ASSISTANCE FOR NON-MEDICAL CARE?
Yes, there are several sources of financial assistance to help with non-medical care. Most states have programs for lower income seniors who require assistance to manage their activities of daily living. Individuals who might otherwise be placed in a nursing home are usually qualified for these "nursing home diversion programs". Financial assistance may also be available through Medicaid HCBS Waivers, from local Area Agencies on Aging and non-profit organizations.
WHAT REGULATION EXISTS FOR NON-MEDICAL CARE?
Many states have regulations that require non-medical caregivers to have background checks and licenses, while many other states do not. Even in states that have regulation, caregivers often work privately and receive payment under the table.
Prior to a discussion of home care payment options, it is helpful to differentiate between home care and home health care. Home Care Aides provide custodial care; they help persons with their activities of daily living such as bathing, dressing, housekeeping and transportation. This is also referred to as personal care, attendant care, non-medical care and companion care.
Home Health Aides offer skilled care such as checking patient's pulses, temperature or respiration. They assist with medications, braces, ventilators and other medical equipment and can provide higher level skilled nursing as well as more basic personal care. Home health aides are also referred to as nurse aides, nursing assistants, certified nursing assistants and geriatric aides.
Both home care aides and home health aides bill on an hourly basis (with the exception of live in caregivers who sometimes bill flat rates). Home care aides can be retained through a home care agency or by hiring private caregivers. Home health aides experience greater federal regulation and are almost always hired through an agency.