How to Select a Care Agency
What Level of Home Care Do You Need?
Figuring out how to select a care agency can be a little confusing because they differ in the level of care they provide. Non-medical in-home care agencies (usually referred to as “in-home care” or simply “home care”) provide companionship and supervision (especially important for the elderly with alzheimer’s disease or other mental impairments). They also offer in-home assistance with activities of daily living such as bathing, as well as offer help with meal preparation, housekeeping, and transportation.
Home health care agencies provide skilled nursing care for patients in need of significant medical attention. Other home health providers include specialists in hospice care, physical therapy, pharmaceutical and infusion therapy, and home medical equipment.
The Right Care for Your Loved One
(Does Someone in my Family Need Home Care?)
Knowing the ADLs and IADLs and looking for patterns of behavior and neglect within those areas can help determine the level of care needed. The IADLs (managing finances, transportation, shopping, meal preparation, housework, communication and taking medications) are usually the earliest to suffer, so look for difficulties with those first.
Watch for trouble with ADLs (personal hygiene, dressing, transferring, toileting, eating, ambulating) and for other warning signs including increased isolation and changes in attitude or in cognitive abilities.
Knowing exactly which activities you need help with will make it easier to choose the appropriate home care provider.
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Non-Medical Home Care Agencies
These agencies are also referred to as personal care, custodial care, senior care, homemaker, companion, and private duty agencies. A professional in-home caregiver helps the care recipient with the activities of daily living (ADLs):
ADLs
These agencies are also referred to as personal care, custodial care, senior care, homemaker, companion, and private duty agencies. A professional in-home caregiver helps the care recipient with the activities of daily living (ADLs):
- Personal hygiene; bathing
- Dressing
- Transferring
- Toileting
- Eating
- Ambulating
IADLs
In addition these caregivers assist with the instrumental activities of daily living (IADLs) which refer to tasks that enable an individual to keep living independently in their home:
- Managing personal finances
- Transportation; running errands
- Shopping for food, clothing, and other necessities.
- Meal preparation
- Housework and home maintenance
- Managing communication
- Taking medications
Care is provided by certified nursing assistants (CNAs), home health aides (HHAs), or personal care attendants (PCAs) also referred to as personal care aides, homemakers, caregivers, sitters or companions.
Unskilled care is usually paid for out-of-pocket, or in some cases by private long-term care insurance. Medicare sometimes covers non-medical care if certain conditions are met and the care is ordered by a physician. Licensure requirements and regulations for non-medical care agencies vary from state to state, unlike federally-regulated, Medicare-certified home health agencies.
Non-medical home care agencies play an increasingly important role, filling gaps in home care services that are not provided or covered under skilled care. Un-skilled home care services such as personal care assistance or cooking and cleaning help is often what is needed most in order for individuals to keep living in their own homes.
When hiring a non-medical caregiver there are several options, each with their pros and cons: hiring a caregiver privately, going through a referral agency, or using a full-service in-home care agency.