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Non Medical In-Home Care and In-Home Health Care Services for Seniors

Along with modifying and possibly remodeling the senior's home, another step that can make the difference between whether the senior is able to continue living in his or her long term home is employing non medical in-home care and in-home health care service providers.

Agencies that provide in-home care fall into one of two categories.

Non medical In-home Care Services:

Non medical in-home care agencies provide help for seniors who desire to stay in their own homes and yet need help with their day-to-day activities.

These services can be basic (for example, help with meal planning and preparation, monitoring one's daily regimen of prescription and over-the-counter medications, light housekeeping, cooking, shopping, and transportation services etc.) or more personal (activities of daily living including feeding meals, dressing, bathing, getting in and out of bed, moving around the house, etc.)

In home Health Care Services:

In-home health care agencies that provide services including nursing, physical, speech and occupational therapy and other health care services under the direction of a physician. Home health care often involves helping seniors recover from an illness or injury. The care agency has to be certified by Medicare and Medi-Cal in order in order to be paid for services provided.

There are also agencies that provide a combination of both in-home care and in-home health care services for seniors. Staff member of these agencies include registered nurses, certified nursing assistants, and home care aides to accommodate a wide range of health and personal care needs.

In-Home Care and In-Home Health Services Vary:

You will find a wide range of in-home care and in-home health services and fees.  Payment options are based on what kind of care is needed with health care being more expensive than home care.

There are significant differences between these types of providers. Understanding these differences will help in the selection process of determining which type of provider is needed.

Not-For-Profit Community Agencies:

Not-for-profit community based agencies often provide services including free community meal delivery and free transportation services. These agencies may be supported by volunteers, local, county, or state governments, churches and/or community centers and organizations.

For-Profit Agencies:

The majority of in-home health care services other than basic food delivery or transportation are generally provided by for-profit agencies.

State regulation:

California does not currently license or regulate non medical in-home care.

In-home health care agency employees including registered and licensed vocational nurses, certified nursing assistants and physical, occupational and speech therapists have to be licensed by the state.

It would be wise to use agencies that have insurance and bond their employees. The agency should perform an extensive background check prior to hiring an employee. Ask the agency for a detailed description of their pre-employment background check procedures. Discuss the nature of the training and supervision of staff that provide in home care.

Some of the areas of concern include the potential for theft by a caregiver involved with in home residential health care of seniors and the elderly because someone has relatively free access to one's home. Therefore, be sure to fully investigate before making a final selection.

A good place to start your investigation is with the Better Business Bureau. Also ask for references (clients not friends or business associates!) and call them. It's also a good idea to check out the history of the business and do a background check.

Additionally, ask the business for a copy of their policy for hiring new employees. This policy should specifically describe how the agency screens its employees thoroughly before hiring them, verifying their references and training stated in their resumes. Background criminal checks should also be part of this policy.

You will also want to find out what procedure is used should there be a lack of compatibility between the client and the health care provider sent out. And finally, you and the senior should be allowed to meet with the assigned care provider before any services are rendered.

Health vs. Non-Health Care for Seniors and the Elderly:

The services that in-home care agencies provide are determined by what type of care is needed. Some individuals require care that includes health and medical care and others require only personal care services.

In-home health care agencies provide services based on the orders of a physician that may include visits from a registered or licensed vocational nurse, physical, occupational, and speech therapy and social services.

Individuals may also have the option of the services of a home health care giver / certified nursing assistant who provides services for the entire day or only a portion of the day.

Non medical in-home care for seniors, which is typically not covered by insurance, refers to services of personal aides commonly referred to as companions, homemakers, and home health aides; however, non-medical care can also be provided by certified or non-certified nursing assistants who provide assistance with bathing, and other activities of daily living, etc.

Typical Costs:

Payment for in-home health care services for senior citizens may be covered by Medicare, Medicaid, and private insurance if those services are ordered by a physician and if they are deemed medically necessary

Some long-term care insurance policies may cover some aspects of this type of care.

Extent of Care:

When considering the option of in-home health care, it is important to consider the extent of the care the individual will require. Oftentimes, when an individual is in need of health care, he or she will also require personal care assistance. This means that many of the services provided will not be covered by insurance and must be paid for out of pocket.

Paying for daily in-home healthcare can become expensive very quickly. Be fully informed of the agencies services and rates and understand which of these services are reimbursable by insurance.

Like remodeling the home to make it senior-friendly, the costs for the services not covered by insurance in home senior residential healthcare can be prohibitive.

To help save money, you may be able to have meals and transportation provided by non-profit community organizations. A good place to find out what's available is to call or visit the local senior center or community center.

Finally, weigh the cost of staying at home against the options such as assisted care living and nursing homes - and where the senior will be happiest, while not foregoing safety and good care - from health and personal care to companionship.