Most older Americans want to live in their homes as long as possible, but finding and providing the help they need is often not easy. There is a severe shortage of home health aides in many parts of the country. Hiring them is expensive. And most middle-class people will have to pay for long-term home health care themselves. Here's a guide to finding home care for seniors.
What kind of home care is required?
After a fall or surgery, some older adults may need short-term care from a nurse or therapist at home to help them recover. Medicare, the federal insurance program for people age 65 and older, typically pays for this type of home health care. For example, nurses make sure wounds are healing properly, and physical therapists help patients stand up after knee replacement surgery.
But millions of older Americans need months or even years of assistance to stay safely at home, rather than moving to an assisted living facility or nursing home. You may need assistance getting out of bed, showering, or going to the bathroom. to go to the doctor. Shopping for groceries and cooking meals. They need a home health aide or personal care assistant, but they may not have much, if any, medical training.
How can I find help?
We offer a wide range of services, including simple housekeeping and hiring a personal nurse. From making a simple list of the type of help you or your loved one needs and the number of hours needed each day or week, Monica Moreno, senior director of care and support at the Alzheimer's Association, says I suggest you start.
To identify agencies and services available in your area, Moreno recommends researching the following information: database Community resources provided jointly by the Association and AARP, the nonprofit organization representing older Americans. You can search by location. A list of agencies and a brief description of what they offer can be found in the Home Care category. AARP has guide To find a home health aide.
Should I use an agency?
Medicare certifies and gives star ratings for: home medical agency, companies that provide home care services are not supervised by the federal government and do not have to be licensed in each state. However, good agencies will conduct background checks on their employees and provide training and support. If an aide becomes ill or quits, the agency can find a replacement. Some companies may even insure and insure caregivers.
When choosing an agency, Jennifer Bautista, chief operating officer of the American Home Care Association, suggests inviting a few agents into your home to conduct evaluations. Ask how they vet their employees, whether they conduct criminal background checks, and whether they require employees to perform CPR and first aid. Be sure to ask for referrals for individual aides and talk to families who have hired aides before.
After choosing an agency, we recommend trying out several caregivers before finding the right one. The more information you share about your loved one's needs, the easier it will be for the agency to find the right aide. “It's a lot like matchmaking,” Batista says.
How about finding a partner through word of mouth?
Nicole Jolwich, an attorney and director of advocacy and campaigns for the advocacy group Caring Across Generations, said many families have had success finding caregivers by asking people they trust for recommendations. She “cast a wide net, posted on private social media, asked her family and friends,” she said, adding that she found caregivers for her grandparents by asking people in the community. said.
Churches and other religious institutions, local charities, and community organizations may also have suggestions. Your primary care physician or local health care provider may have experience with a particular home care agency or may know individual caregivers. If you decide to hire someone privately, be sure to do a thorough background check and talk to family members who have previously hired the person. Family Caregiver Alliance, a California nonprofit organization, guide.
Will Medicare pay for the assistant?
Many home health agencies will incorrectly state that they cannot provide home aides and will tell clinics and patients that Medicare will not pay for them. “This is a long-standing problem,” says Judith A. Stein, executive director of the Medicare Advocacy Center, a nonprofit legal group.
While it is true that Medicare does not pay for long-term care, it may pay for an aide as part of the patient's care plan if the person is temporarily licensed as a home nurse or therapist. there is. Because Medicare pays a lump sum per patient, agencies often refuse to provide staffing. In other words, agencies receive no additional compensation for providing aides in addition to nurses and therapists. Talk to your doctor about whether you need an aide and specify one in the care plan you submit to the agency.
Medicare patients now receive fewer visits from aides than they did about 25 years ago, and the center is currently appealing a judge's dismissal of aides. lawsuit They argued that Medicare, which is run by the U.S. Department of Health and Human Services, is preventing thousands of people from using supplements.The judge did it admit That many people were unable to receive care.
Will my assistant's expenses be covered by other insurance?
Medicaid, a state federal program for the poor that provides long-term care, often covers the cost of aides as an alternative to nursing homes. However, due to labor shortages, it may be difficult to find qualified personnel. Families are frustrated by frequent no-shows, and agencies often experience high employee turnover due to the low wages paid under the program.
Some private Medicare Advantage plans offer home care as a supplemental benefit, and some assistance may be covered by long-term care insurance. If you or your loved one is a veteran, it may be worth checking with the Veterans Administration to see if they will pay for home care.
How much does an assistant cost?
If you decide to pay privately, the hourly rates charged by agencies vary widely, and some agencies may only have positions available for a few hours a week.In San Jose, California, half of the agents charged more than $37 According to long-term care insurance company Genworth, the number of home health aides hired will be one hour in 2021. Agencies nationwide charge about $27 an hour, a little more than half of which goes toward paying employees.
There is no good estimate of how much someone working for themselves can claim. You may save some money because the middleman doesn't take a cut, but some independent caregivers charge about the same fees as agencies.
How do I report an issue?
If your agency is licensed by your state, you can contact the government agency that oversees your agency if you have a problem. You can also file complaints with various state agencies, such as the state health department.
Where else can I get help?
State or local agencies that focus on senior citizen organizations or nonprofit organizations can provide information.You can also try elderly care locator. The Alzheimer's Association also has some initiatives. advice To find a caregiver, we offer a 24-hour helpline at 1-800-272-3900.
What about respite care?
Family caregivers should also consider taking time off from time to time with respite care. Depending on the situation, the cost may be covered by insurance, and some local authorities and community organizations may be willing to cover the cost of an assistant for a short period of time. Churches and other organizations may also provide respite care.
