Personal Care and Home Health Care are two types of support services you can receive in a private residence. Home care – also called Private Duty Home Care, Non-Medical Home Care, Custodial Care, Personal Care, Companion Care, Certified Eldercare – includes assistance with tasks such as: bathing, dressing, grooming, toileting, ambulating (moving from one place to another), meal planning and preparation, light housekeeping and laundry, grocery shopping and errands, transportation, medication reminders (but not medication set-up or administration), exercise, planning events, social engagement, spiritual support and companionship.
‘Personal Care Aides’ (PCAs) are those who provide personal care services to the frail elderly or other temporally or permanently bedridden persons. Increasingly Personal Care Aides are educated and certified to provide these services. Until recently PCAs did not have formal training, aside from First Aid and CPR training. Home care services can also be provided by “Certified Nursing Assistants” or “Home Health Aides”, who have gone through a training course, internships and are certified by the State. They are the more expensive alternative to a PCA, and can step in when a registered nurse orders that they provide care for a person, or when private families or individuals ask for them.
Home care is not always covered by Medicare or private insurance, though it is generally covered to an extent by long-term care insurance. Services are typically available from 2 hours per day up to 24 hours per day. Rates vary depending on the number of hours needed. Currently there is a trend across the country for education and certification requirements for PCAs and certification requirements exist at the federal level and in some states currently.
Home Health care is ordered by a physician, usually at the time of discharge following a hospital admission or stay at a Skilled Nursing Facility. It is medically-focused and it is typically covered by Medicare and/or other private health insurances. Home health care is usually short term, is prescribed as follow up care or to monitor a health problem. It usually involves a Nurse, Physical Therapist or Occupational Therapist and sometimes a home health aide. They are able to provide wound care, injections, medication management, bowel care, Intravenous therapies, rehabilitation and other medically-focused services. In order for one to qualify for Home Health, a physician must deem that the individual is considered homebound and can’t receive these services at an outpatient medical facility. All Home Health agencies are licensed by the State and undergo audits or surveys every 3 years.
Rates charged can depend on the type of Home Care agency one chooses. You want an agency that supervises and monitors their workers, provides quality at home care and has quality assurance checks performed on an ongoing basis. Some Agencies do not perform background checks, drug tests, check references, secure Workers’ Compensation and Liability insurance, pay payroll taxes for the staff, supervise staff, and will charge less… but come with a bigger risk for the client. To ensure the highest degree to safety for yourself or your loved one, be sure the home care agency bonds it’s staff, have insurance, have background screenings and drug test performed and have references checked.
Often, Home Care and Home Health services are provided together. Home Health comes for short visits and Home Care is there for several hours or all day. Whichever type of care is needed, it is important to ask questions about type of care that will be provided, the 24-hour contact information for the agency and who will be delivering the care.