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The Many Faces of Home Care

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istock_000014371816small_w640“Home care” is an umbrella term that covers different types and levels of care delivered in the home. In the United States, home care is a dynamic service industry that has been in place for well over a century. When Medicare was enacted in the mid 1960s, home care started to grow dramatically because it covered home care for the elderly. Today, home care is a multi-billion dollar business serving about 12 million people who receive care at home for acute or chronic illness, permanent disability or terminal illness.

Home care organizations include home health care agencies, home care aide organizations, hospices, and companies specializing in medical equipment and supplies, pharmaceuticals, and drug infusion therapy. Some of these enterprises are Medicare certified, which means they can bill Medicare for reimbursement. Some home health care agencies are also accredited by the Joint Commission, the same body that accredits hospitals nationwide.

In most situations, home health care is prescribed by a physician. Medical care is provided by registered Nurses (RNs), licensed practical nurses (LPNs) and licensed vocational nurses (LVNs). In some cases, a home health aide may provide personal care such as personal hygiene and meal preparation. Home health aides may also administer medication, but only under a nurse’s supervision. Other individuals providing care at home include social workers, physical and occupational therapists, speech pathologists, dietitians, homemakers and companions and drivers (who are often volunteers).

Sometimes home care organizations merge or collaborate to provide a variety of services through an integrated system. For example, Graceworks at Home comprises two separate agencies – Health at Home and Hands at Home – that provide services independently and in partnership as needed. Home care services usually are available 24 hours a day, seven days a week. Depending on the patient’s needs, services may be provided by an individual or a team working on a part-time, hourly or shift basis. Care is available to residents of Bethany Village.

Here is a description of different types of home care. For more information visit the National Association for Home Care & Hospice  and My Senior Care .

The term home health agency often indicates that a home care provider is Medicare certified and thus can provide Medicare- and Medicaid-reimbursed home health services. Individuals requiring skilled home care services usually receive their care from a home health agency. Due to regulatory requirements, services provided by these agencies are highly supervised and controlled. Home health agencies can coordinate a care giving team to administer comprehensive and efficient service.

Hospice care involves a interdisciplinary team of skilled professionals and volunteers who provide comprehensive medical, psychological and spiritual care for the terminally ill and support for patients’ families. Hospice care is based primarily in the home. Trained hospice professionals are available 24 hours a day. Most hospices are Medicare certified and licensed according to state requirements.

Homemaker and home care aide (HCA) agencies employ homemakers or chore workers, HCAs and companions who support individuals through meal preparation, bathing, dressing and housekeeping. Some states require these agencies to be licensed and meet established minimum standards.

Pharmaceutical and infusion therapy companies specialize in the delivery of drugs, equipment and professional services for individuals receiving intravenous or nutritional therapies through specially placed tubes. These companies employ pharmacists, who prepare solutions, and nurses, who teach self-administration in patients’ homes.

Durable medical equipment and supply dealers provide home care patients with products ranging from respirators, wheelchairs and walkers to catheters and wound care supplies. These dealers employ staff who deliver and, when necessary, install these products as well as instruct patients on their proper in-home use. Durable medical equipment and supply dealers that bill Medicare must meet federal minimum standards.

We will be posting more information on home care here. Check back to learn how to find and choose a home care provider. If you have a question, please write in the comment section below.

Written by Bethany Lutheran Village

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