What is In-Home Care?

In-home care services can provide companionship, supervision and assistance with personal care in the comfort and convenience of a person’s own home–making it possible for older adults to live at home rather than move into a senior living community. As baby boomers advance in years, come to retirement age and start collecting social security, before they know it their adult children find themselves caring for elderly parents. When routine phone calls or even alert systems are not enough, but the elderly don’t want to spend their retirement living outside the home they are familiar and comfortable with, their loved ones can still assure their health and well-being.

Care in the home may include some combination of skilled health care services, such as nursing interventions, and non-medical or assisted living services, but there is a distinction to be made: the term “home health care” is understood to mean licensed nursing care, while in-home care or home care refers to non-medical care, personal care, custodial care or domiciliary care. These differences are important because they help determine the appropriate level of care provided, which in turn will determine the actual cost of care and also the funding sources available to pay for care.

In-home care from a professional agency is appropriate whenever an individual prefers to stay at home, but needs ongoing care that cannot easily or effectively be provided solely by family and friends. As their physical and cognitive abilities diminish, a growing number of elderly are electing to keep living independent, non-institutionalized lives by receiving care at home. Most senior citizens want to age independently while not burdening their families. Professional in-home care makes that possible. Families, meanwhile, are provided with peace of mind and assurance that their loved ones are well-cared for and comfortable in their own home.

What Is Non-Medical Home Care?

In-home, non-medical care services include supervision and help with personal care (see Activities of Daily Living, or ADLs, below), as well as help in the home with tasks such as meal preparation, medication reminders, laundry, light housekeeping, errands, shopping, transportation, and companionship. While there are differences in the terms describing aspects of in-home care or home health care, in reality, most older adults needing one type of care, will eventually need both as they continue to age.

What is the Difference Between Skilled Home Health Care and Non-Medical Home Care?

Skilled Home Health Agency vs Non-Medical Home Care

The most familiar provider of medical home care services is the skilled home health agency. The main purpose of this type of agency is to provide skilled, professional care for medical treatment or rehabilitation services to homebound patients. Home health care professionals must strictly adhere to a physician-approved plan of care.

Services provided generally include:

  • Medical and/or Psychological services
  • Wound care
  • Pain and medication management
  • Disease management
  • Nursing care services
  • Oxygen services
  • Medical supplies and equipment
  • Physical therapy
  • Speech therapy
  • Occupational therapy
  • Other basic home health aide care

The same agency may deliver different kinds of home care services through registered nurses, therapists, social workers, home care aides, medical equipment and supply dealers, and volunteers. Some agencies limit their services to nursing and one or two other specialties. If care is needed from more than one specialist, the home health agency will set up a team to provide care that covers the patient’s needs. Because home health agencies hire and supervise their personnel, they assume liability for their services.

Skilled home healthcare services generally are available 24 hours a day, 7 days a week. The home health agency is state-licensed and usually Medicare and Medicaid (Med-Cal in California) certified and may also accept other third party health insurances. Medicare certification means that the agency has met specific federal guidelines and criteria.

Many are also accredited by independent third-party review organizations such as JCAHCO, CHAPS or HHC. Services are generally paid for by Medicare, Medicaid, and private health insurance and patients must meet strict criteria for participation and payment authorization. However, some medical agencies also offer their medical home care services on a private duty or private pay basis. There are approximately 14,500 licensed home health agencies operating nationwide.

While the main focus of these agencies is medical care, some also offer a dedicated non-medical, in-home care service. Individuals often have ongoing personal care needs even though skilled home health care services are no longer required. With this home care component, the same agency can continue to provide personal and custodial care to their patients, but it will usually be on a private pay basis.

What are the Main Types of Senior Care?

Companion Care

Just as the name states, companion care offers seniors the comfort of companionship. The primary focus of this type of care is to provide emotional support and companionship for seniors who are healthy, generally speaking, but would prefer to to remain independent at home. It can include a wide range of non-medical services, aimed to help make a senior’s life more manageable. To give you an idea, here are some of the most common companion care services: Medication reminders, assistance with Activities of Daily Living (ADLs), light housekeeping, cooking and meal prep, transportation, and help with planning, scheduling and keeping appointments. In addition, companion care often includes encouraging exercise and planning social activities.

Personal Care

Personal care services essentially provide seniors with assistance in completing everyday tasks, such as eating, bathing, dressing, grooming and oral hygiene. Furthermore, this type of senior care generally entails performing home safety evaluations to prevent avoidable accidents.

Transitional Care

Transitional care refers to the care provided following hospitalization, or a stay in a rehabilitation facility. This type of care plays a key role in optimizing the health and well-being of the senior, all while significantly reducing the risk of hospital readmission. Once released from the hospital, a caregiver will tend to the recovering senior, relieving them of many day-to-day responsibilities. The senior can rest and recuperate, while having peace-of-mind knowing household chores, medication management and fresh meals are being taken care of.

Skilled-Nursing Care

As the aging process continues, health-related issues often become more prevalent. Skilled-nursing care helps reduce the stress that both seniors and their family members experience when a loved one is sick, or diagnosed with disease. The clinical care these nurses provide, make the lives of their senior clients easier, and in-turn increase a seniors quality of life. Skilled Nursing Care services include: high-tech nursing, assistance with medical machinery (including ventilators), administration and maintenance of catheters, PICC line dressing changes, drawing blood, performing injections and more!

What are Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) and Why are they Important?

Activities of Daily Living (ADLs) refer to six specific tasks of basic self-care:

  • Personal hygiene including bathing, grooming, nail care, and oral care.
  • Dressing: choosing appropriate clothing and being able to physically dress and undress oneself.
  • Transferring i.e. being able to move from one body position or location to another.
  • Toileting: the ability to get on and off the toilet and cleaning oneself
  • Eating, meaning the ability to feed oneself.
  • Ambulating: walking or otherwise being able to get around independently (for example with a wheelchair).

Instrumental Activities of Daily Living (IADLs) are more advanced activities related to independent living:

The number and severity of a person’s ADL and IADL needs are used to determine the level of assistance required, as well as to determine eligibility for long-term care insurance benefits. Insurance companies require justification and documentation that the insured individual needs help with at least two (sometimes three) ADLs in order for the benefit to be effective. The new