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   Health & Fitness

 



HOME CARE IS GETTING HARDER TO FIND

 * Seniors often need home-based care after joint replacement or other
   surgeries. Stock Photo

 
By Teri Dreher
Posted8/28/2021 7:00 AM

Finding someone to provide home care services was always a challenge. The
ongoing pandemic made a bad situation worse.

Agencies that provide such services report great difficulty filling open
positions, leaving many vulnerable health care consumers in the lurch. Many in
the field abandoned their positions over fear of contracting COVID-19.

 

I've found a lot of frustration resulting from the lack of home care workers.
Families often turn to the only resource they have available: unpaid caregivers,
usually spouses or other family members, who undertake sometimes difficult
situations, such as managing a chronic illness or taking care of a dementia
patient. There is still a cost in the physical and emotional strains, along with
lost work hours.

When you're trying to find home health care, it's a good idea to first know the
rules of the road.

The main thing to know is that home care (unskilled private pay home aides that
help with personal care) and skilled home health care are different.

If ordered by a physician, Medicare will pay for about eight skilled home health
care visits per month, including nurses, physical therapists, occupational
therapists and speech therapists. The recipient must be very motivated to do
prescribed exercises even when the therapist isn't there. The patient must also
be certified by their doctor as homebound -- no going out except for doctor's
appointments.

Before you start getting your home health care, the home health agency should
tell you how much Medicare will pay. The agency should also tell you if any
items or services they give you aren't covered by Medicare, and how much you'll
have to pay for them.

by signing up you agree to our terms of service
                                                                                
                                                                                
                                                     
 

A Medicare-approved home health agency must also provide you a written copy of
your rights as a Medicare recipient. You have the right to:

• Choose your home health agency (unless you have a Medicare Advantage plan that
provides network agencies);

• Have your property and belongings treated with respect.

• Be given a copy of your plan of care, and participate in decisions about your
care.

• Have your family or guardian act for you if you are unable.

Note that Medicare-covered services do not include help with "activities of
daily living" (ADLs) or "instrumental activities of daily living" (IADLs).

ADLS include the ability to bathe, use the toilet, dress and move around. The
IADLs are more complicated but also are important to a patient's well-being:
preparing meals, transportation and shopping, companionship, household
management and medication management, to name a few.


                                                                                
                                                                                
                                                     

 

Most seniors living alone after major joint replacement surgeries will need such
home care to help them around the house until they can take care of everything
on their own safely.

In 2019, the average cost for nonmedical home care was $21 an hour, with a range
of $16 to $28 an hour. In the Chicago area, according to the 2020 Genworth Cost
of Care Survey, homemaker services for 35 hours a week cost more than $47,000 a
year, and for home health aides it's more than $48,000.

And you will be responsible for 100% of the cost, unless you have a good
long-term care policy. Check with your policy to find out what it will cover and
when coverage will begin, as there may be a waiting period.

A private individual can be hired for less, but they will not have liability
insurance or undergo background checks. If you are thinking about hiring a
private caregiver, first consult an attorney. You will become the caregiver's
employer, and there are laws you need to comply with as an employer, such as
minimum wage -- in Illinois, $11 an hour.



If you or a family member will be needing home-based care because of illness or
surgery, you can find assistance in a couple of places.

The Illinois Department on Aging (www.illinois.gov/aging) keeps a directory of
coordination of care agencies, which can link you to home care agencies. The
Illinois Department of Human Services (www.dhs.state.il.us) has home services
for individuals under the age of 60 who suffer from severe physical or mental
disabilities.

A patient advocacy agency can also provide assistance in finding care, along
with medication monitoring, keeping an eye on finances and other services. To
find an advocate, try resources such as www.advoconnection.com or the National
Association of Health Care Advocacy (www.nahac.com). A nonprofit I helped start,
SAGAS (Seniors Alone Guardian and Advocacy Services at www.seniorsalone.org)
provides help to low-income seniors and disabled adults.



Long-term care, whether provided at home or in a nursing facility, is a
challenge to set up, difficult to maintain and expensive to pay for. Don't be
afraid to ask for help.

• Teri Dreher is a board-certified patient advocate. A critical care nurse for
30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com).
She is offering a free, 30-minute phone consultation by calling (312) 788-2640
to make an appointment.




Comments

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Article Topics
Genworth Cost, Illinois Department of Human Services, National Association of
Health Care Advocacy, COVID-19, Advocacy Services, Illinois Department, Teri
Dreher
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