What Services Do Non-Medical Agencies Provide?

Caregiver services provided through in-home care agencies generally include personal care, companionship and supervision, as well as help in the home with the activities of daily living (ADL) and the instrumental activities of daily living (IADL) such as meal preparation, medication reminders, laundry, light housekeeping, errands, shopping, transportation, and companionship.

ADLs refer to six specific activities (bathing, dressing, transferring, using the toilet, eating, and walking) that reflect an individual's capacity for self-care. The number and severity of a person's ADL assistance needs often is used to determine eligibility for Long Term Care insurance benefits or may be used as part of an assessment tool by an in-home care agency to determine the agency's charges for in home care services and also to appropriately staff assignments with qualified caregivers.

Instrumental activities of daily living (IADL) refers to six daily tasks (light housework, preparing meals, taking medications, shopping for groceries or clothes, using the telephone, and managing money) that enables the individual to live independently in their home. Any agency you contact will be able to describe the specific services their caregivers can and can't provide, in greater detail.

Below is an easy yet effective way to identify the tasks non-medical, personal care agencies may generally provide compared to those tasks a skilled agency must provide. This checklist saves time and reduces confusion in understanding the various duties and qualifications of in-home care agencies versus skilled home healthcare agencies. Although these tasks vary by state licensure regulations, the tasks with the green check can usually be provided by non-medical, in-home care agencies in most states:

Household Tasks

  • Light Housekeeping: clean and keep tidy all living areas
  • Laundry: wash and change bed linens and launder personal
  • Meals: cook, grocery shop, prepare food ahead for later meals
  • Organization: scheduling daily tasks, mail sorting, other home maintenance

Transportation, Companionship, Safety

  • Transportation: drive and escort shopping, errands, bank, doctor appointments
  • Companionship: encourage social participation, escort on outings and to recreational events, everyday stimulating conversation, phone call assistance
  • Safety: supervise in home to avoid falls, household accidents and ensure easy access to emergency contacts

Personal Care

  • Eating: assist feeding, provide nutritious meals and adequate fluids
  • Bathing: assist bathing, transferring in/out tub/shower, bed-baths as needed
  • Dressing / Grooming: assist dressing, glasses, hearing aides, special orthotics (i.e. braces), hair care, shaving, oral hygiene
  • Ambulation: assist walking, safe use of assistive devices, range of motion and strengthening exercises
  • Toileting: assist to bathroom, bedside commode, urinal, bedpan usage
  • Incontinence: assist changing diapers, undergarments, pads, related skin care

Communication

  • Therapy: assess, plan, implement and evaluate therapy to regain speech, breathing and swallowing function
  • Teaching: instruct speech therapy regime, evaluate technique and compliance
  • Assistance: help performing prescribed exercises, report progress to supervisor

Support

  • Referrals: identify and arrange local resources for home care services, adult daycare, respite, financial assistance and support groups
  • Intervention: identify and arrange local resources for family and individual counseling and crisis intervention

Wound and Bedsores

  • Wound / Bedsore: assess wound, incision or bedsore healing, signs and symptoms of infection and evaluate response to treatment
  • Teach Care: instruct wound or bedsore regime, evaluate technique, compliance
  • Treatment: perform wound / bedsore care per prescribed regime, report signs and symptoms infection and progress to supervisor

Alzheimer's & Dementia

  • Home Safety: closely supervise for safe environment, secure area with use of monitoring alarm devices to avoid wandering
  • Emotional Support: provide structured activity at appropriate cognitive level to minimize confusion

Diabetes

  • New Diabetic: teach special skin care, insulin injection technique, blood glucose monitoring, hypo/hyperglycemia and related emergency protocol
  • Diet: prepare special prescribed diets, encourage compliance with restrictions
  • Glucose Monitoring: check blood glucose per orders, report results to supervisor
  • Insulin: remind insulin injections per prescribed regime, follow-up and report compliance to supervisor

Ostomies: Colostomy, Urostomy

  • New Ostomy: teach ostomy care, preventive skin care, troubleshooting
  • Care: assist with ostomy changes, monitoring peri-stomal skin blood work and report results to physician

Feeding Tubes: G-Tube, NG Tube

  • New Tube: teach pro-active skin care, dressing changes and troubleshooting problems with blockage, tube placement, skin infections
  • Tube Changes: insert new tube per dr. authorized plan of care and as needed
  • Feeding: teach tube feeding regime, evaluate competency and compliance
  • Care: perform daily and as needed dressing changes and skin care to tube site

Catheters: Foley Indwelling and External

  • New Catheter: teach drainage bag changes and cleaning, securing tubing, trouble shooting dislodged catheters, placement, blockages, drainage amounts
  • Catheter Changes: insert catheter per authorized plan of care and as needed
  • Care: perform daily and as needed catheter care including emptying drainage bag, monitoring intake and output, cleaning and securing tubing and bags

Basic Health Monitoring

  • Skin: monitor for signs of breakdown, apply pressure reduction measures
  • Nutrition: monitor weight, nutritional intake, adhere to dietary restrictions
  • Vital Signs: take blood pressure, temperatures, pulses and report changes
  • Intake / Output: encourage adequate fluids, monitor fluid intake and urine output
  • Lab Monitoring: perform prescribed blood work and report results to physician

Medication Management

  • When capable: remind to take medications and follow-up
  • When Forgetful: give oral medications prepared by responsible party and follow-up
  • Teaching: instruct new medications or monitor changes in regime per plan of care, assess response, side effects, and adverse reactions
  • Injections: administer prescribed injections per authorized plan of care, report side effects, adverse reactions
  • Supplies: manage supply of prescriptions to have all meds on-hand

Mobility

  • Home Assessment: evaluate home safety needs, arrange for adaptive equipment
  • Therapy: assess, plan, perform and evaluate physical therapy to regain strength and maximal activities of daily living plan
  • Teaching: instruct prescribe exercise regime and safe ambulation with/without assistive devices
  • Assistance: help perform prescribed exercises, report progress to supervisor

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