Home care services: What services do you need?

Home care services: Asking these questions can help you choose the best provider for your needs.

Home care services can enhance your health and quality of life by helping you maintain your independence. The type of home care service you may need depends on factors such as your mental and physical health, what kind of support you have from family or friends, and whether you live in your own home or in a facility that provides some types of assistance. Home care services can range from help with chores to professional health care and rehabilitation.

Who should consider home care service?

You may consider home care services if you need assistance caring for yourself because:

You're less able to care for yourself as you get older
You have a disability
You're recovering from an illness, surgery or a hospital stay
You're living with a chronic illness
You have a terminal illness

What home care services are available?

Home care services provide you with a range of assistance, including skilled medical care, home support services or a combination of both.

Skilled care
Conducted under the direction of your doctor, skilled care consists of services provided by health care professionals such as nurses, medical social workers and physical therapists. It can also include activities such as home dialysis and physical therapy. There are several types of professional home care providers:

Physicians diagnose and treat illnesses and work with your home care providers to determine which services you need and when you need them. They also recommend specialists when necessary.
Registered nurses (R.N.s) and licensed practical nurses (L.P.N.s) provide professional-level medical services such as injections and intravenous (IV) therapy, wound care, health education, and medical assessments. R.N.s may also provide case management services.
Social workers help you and your family find community resources and provide counseling. Social workers also serve as case managers and can help coordinate a variety of services to make sure you have the medical treatment and support you need.
Physical therapists help restore strength and mobility after surgery or an injury or if you are disabled. They use specialized equipment to relieve pain and treat injured joints and muscles. Physical therapists can also teach you or your caregivers techniques for walking and helping you move from one position to another.
Speech therapists help you regain your ability to speak and communicate, and may also help you with breathing, swallowing and muscle control. In most cases, these services are needed after surgery or stroke.
Occupational therapists (O.T.s) use rehabilitation techniques to help you learn how to manage everyday tasks such as eating, bathing, dressing and minor household chores.
Dietitians evaluate your dietary needs and advise you on how to make sure you are getting appropriate nutrition.

Home support services
These services include tasks such as light housecleaning, running errands and preparing meals. These services may be all you need to allow you to continue living independently in your own home.

Home care assistants or home health aides help with daily activities such as getting in and out of bed, getting around, bathing, using the toilet, and getting dressed.
Homemakers and chore workers help prepare meals, shop, do laundry and other housekeeping chores.
Companions stay with you if you cannot stay alone at home for medical or safety reasons. They provide companionship and some assist with household tasks.

Other services
Home care services can also include:

Medical equipment delivery, set up and maintenance
Lab tests and X-rays
Medication delivery and pharmacy services
Respiratory therapy, dental care or treatment from other health professionals
Clergy visits
Transportation
Meal delivery
Emergency monitoring systems

Combination care
Some home care offers a combination of services provided by a team that includes a mix of doctors, social workers, registered nurses, dietitians, home health agency staff, visiting nurses, therapy specialists, home care aids, chore workers, clergy and others. The team carries out a detailed care plan tailored to meet your specific needs.

Paying for home health care

Home health services can be costly. You may need to pay for home care services directly, or costs may be covered through insurance or other public or private sources.

Medicare. Medicare may pay for medical home health care services through a certified home health care agency, if a physician orders these services. Services covered by Medicare include skilled nursing assistance, or physical, speech or occupational therapy. If your home health services are covered under Medicare, your doctor, care manager or discharge planner will probably make arrangements for a home health care agency.
Medicaid. Depending on your income and assets, if you are over 65 you may be eligible for Medicaid coverage.
Older Americans Act. This federal program funds state and local programs that provide services to frail and disabled individuals who are 60 years old or older.
Veterans Affairs. If you are a veteran and at least 50 percent disabled due to a service-related injury or illness, you may be eligible for medical services through Veterans Affairs hospital-based home care services.
Community organizations. Depending on your situation and finances, certain community organizations cover home care costs.
Insurance. Many insurance programs cover some home health care services for short-term medical needs. However, long-term coverage varies. Long term care policies are available through private insurance companies and the federal government.

How can you find the home care service that's right for you?

The first step to finding a home care service is to talk to your doctor or your physical or occupational therapist about what services you'll need. You may only require an occasional visit from a nurse to administer medication, or you may need more elaborate medical care or other types of support.

Your nurse, doctor, hospital social worker or hospital discharge planner may be able to recommend several reputable home health care agencies. Your friends or family also may be able to provide some insight into which home care services provide the best care. Or you can check the Yellow Pages, under the heading "Home Health Care Services" or "Nurses." Other sources include your state and county health department and Area Agencies on Aging and the national Eldercare Locator, a public service of the Administration on Aging. Once you know what types of services you need, evaluate the costs, credentials and services offered by each provider you are considering.

Finding the right home health care services requires communication with your doctor or other health professionals, and a little research. But qualified home care is an important treatment option that can improve the quality of life of both the person receiving care — and the family members.