Home Health Care and Nursing Homes

With an emphasis on shorter hospital stays, many people today are turning to home health care for a variety of reasons. Home health care services include nursing care and physical, respiratory, occupational, or speech therapy; chemotherapy; nutritional guidance; personal care such as bathing or dressing; and homemaker care. Home health care can include health professionals who help you when you are bedridden with a long illness or housebound for a short period. They may provide blood testing or send a nurse into your home to administer medicines and other treatments. Home health care workers include professionals, trained aides who help professionals, and volunteers.

Check with your health insurance plan or your company's benefits officer to see if home health care benefits are covered. Don't hesitate to ask the agency you are considering hiring how much they charge for each service, and ask your insurance carrier what services will be covered. If you are covered by Medicare, some limited coverage may apply to you. These benefits apply only to those 65 or older or those under 65 who need kidney dialysis and/or transplants. Usually, Medicare home health care benefits are restricted to the homebound and bedridden. Veterans Affairs, the military, and worker's compensation can be other sources of help for home health care.

If full-time care is needed, an extended-care or nursing home is often the best option. If you are researching nursing homes, here are some good sources of help:

private or public case management social workers your local office on aging the county or state department of health your primary care provider your religious leader or pastoral counselor local organizations or law firms for the retired or elderly

It is important that you visit prospective sites. It is also a good idea to talk to friends, family, neighbors, or coworkers who have family members in nursing homes.

Nursing homes can be very expensive. There are four possible sources of payment: private insurance, Medicare, Medicaid, and self-pay or private pay. Different facilities ask for different types of payments. It is important that you understand what you get for the required fees. The admissions coordinator should provide details of regular monthly charges and exactly what they do—and do not—include. Ask if there is something specific you should know about that is not covered. Ask about how they routinely care for diabetes and how they handle acute situations related to high or low glucose values.

As an alternative to nursing homes, many people are turning to assisted-living communities or foster care homes. Many of these facilities are suitable for people who do not require full-time nursing care but who might enjoy the benefit of nursing staff and neighbors close at hand. Check to see what nursing or other services are provided before you choose an assisted-living community. There is a wide array of living situations, from communities that function much like individual apartments, to individual units that provide nursing services, to full-time nursing centers. Check to see whether any of these facilities might meet your needs.

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