Home Care - The Key to Aging in Place?
By Joe Fleming
According to a 2018 AARP survey, over 75 percent of adults over 50 want to remain in their own residence as they age. Less than 50 percent, however, actually believe that they will be able to. While long-lived communities provide a social network and support system by which you can benefit, oftentimes physical ailments and age-related limitations can rob you of the ability to live independently.
Common reasons older adults end up moving out of their homes:
- Home cannot accommodate aging needs;
- Diminished mobility, coordination and flexibility;
- Reduced eyesight or hearing abilities;
- Frequently falling;
- Increased risk of accidents (i.e. due to balance problems, bone loss, etc.);
- Loss of strength and endurance;
- Cognitive decline and memory problems;
- Hospitalization and rehabilitation; and
- Medication mix-ups.
Instead of moving to an assisted living facility or sharing a home with a family caregiver, more and more older adults are turning to home care services, especially if they themselves don’t require extensive medical monitoring.
What is Home Care?
It’s all in the name - home care is literally care services that are provided in the home in which you reside. Skilled or home health care covers services that are typically doctor-ordered, like physical therapy, occupational therapy, speech therapy and wound care. General or custodial home care, on the other hand, covers services that assist with daily activities.
Activities of daily living (ADL’s) can be sorted into basic and instrumental categories. Basic ADL’s include:
- Maintaining personal hygiene;
- Safely transferring in and out of a chair and walking; and
- Maintaining continence.
Instrumental ADL’s involve more thought-processing at times, however, are not necessarily required on a daily basis.
- Sorting through mail;
- Paying bills and managing finances;
- Refilling prescriptions and medication management;
- Arranging transportation;
- Preparing food;
- Tending to housework, like laundry and cleaning (even with ease-of-use tools);
- Shopping; and
- Using the internet or phone.
Custodial home care aids are service workers who assist with both types of activities that help keep older adults safely living in their own homes. Home care services also provide family caregivers peace of mind, helping offload some of the care burden, as well as address potential problems, like an aging parent who is more and more socially isolated or seems to be struggling to manage their medicine schedule or bills.
Not only does successful, safe and independent living promote longevity in older adults but so does engaging in meaningful activities and sharing conversation with other individuals, both of which a good home care worker can provide.
Is Home Care Covered By Insurance?
While home health care is mostly covered by Medicare or Medicaid, general home care services are not typically covered by insurance. What does this mean for aging adults and their families? Paying out of pocket for hired care providers to supplement the family caregiving tasks that help you or your loved one age in place.
You can tackle your search either with formal queries to local licensed home care agencies, or you can look online or get personal referrals from friends and family for individuals looking for this type of job. For financial assistance, start your search with local aging organizations like area Agencies on Aging, as well as eldercare planners, social workers and public benefits counselors.
Not only can they connect you with home care resources, but they can discuss options with you for coordinating the financial side of retaining home care services, as well as qualifying for state-funded programs, grants and veterans benefits.
Tips for Choosing Home Care Aids
If you and your family have decided that a home care attendant would be beneficial to help you age in place, don’t forget these important tips during your search:
- Consult your doctor, friends, faith community and local aging organizations for referrals to top-rated home care agencies.
- Check trusted reviews online for home care agencies or individual workers.
- Ask how much you can afford and set a budget.
- Don’t want to go the agency route? You can post your “job” online on websites like Care.com to recruit individual providers.
- Clarify the job description and include every task or duty you expect to be completed.
- Be picky. Thoroughly interview, check references and experience, and verify training and background checks.
- Verify their ability to transport themselves to and/from work, as well as provide a back-up in the event they cannot make it.
- Learn about your liability and responsibility as an employer in regards to insurance, taxes, etc.
- Confirm a pay rate, set a contract and establish a schedule.
When it comes to inviting a homecare worker into you or your loved one’s home, you want to pull out all the stops to make sure you reap the most benefit from your investment. Be cautious, smart and safe in making your final choice!