A Complete Overview of In-Home Care

In-home care, also called home health care, refers to medical care and treatments that are delivered to the patient in the patient’s home. In-home care is a good housing option if you would like to continue to live at home but need some help with activities of daily living, such as cooking and cleaning, using the toilet, bathing and dressing, eating, and managing medications.

Most in-home care is non-medical care, meaning that those providing care are either professional caregivers or certified nursing assistants, rather than registered nurses or physicians. In addition, it is common for family and friends to provide a certain amount of care in in-home care situations.

Home modifications for in-home care

In-home care takes place in the patient’s home. Depending on the patient’s medical situation and needs, certain adjustments or modifications may need to be made to the home. These adjustments can make caregiving easier and reduce accidents, and may include:

General home modifications:

  • Widening doorways to accommodate a wheelchair
  • Installing railings on stairways
  • Installing a stair lift or wheelchair lift on stairways
  • Installing ramps
  • Replacing knobs with lever handles on doors and faucets

Bedroom modifications:

  • Relocating a bedroom from the second-floor to the ground-floor
  • Replacing a standard bed with a hospital bed

Bathroom modifications:

  • Installing railings in the bathroom and shower
  • Installing a bench or seat in the shower
  • Installing a wheelchair-accessible shower stall
  • Installing slip-resistant bathroom flooring
  • Raising the height of the toilet seat for easier access
  • Installing handrails on a toilet

If you are considering making modifications to your home to accomodate in-home care, there are a number of companies that offer supplies for doing so. For a list of companies that might be helpful to you as you transition to in-home care, use our resource Guide: In-Home Care Supply Companies.

There are also a number of products that many seniors living at home commonly require. For a list of these products, see our resource Guide: Products for Seniors Living at Home.

Services

There are two main types of in-home care caregivers:

Home Care Aides (HCA): Home Care Aides are people who provide help with household duties such as:

  • Housekeeping and laundry
  • Cooking and grocery shopping
  • Personal care services, such as eating, walking, bathing, grooming, dressing, and assistance using the toilet
  • Transportation to medical appointments

In addition, Home Care Aides may provide companionship to the patient. This may include taking walks, reading aloud, having conversations with the patient, or simply looking after the patient. There is no state or federal certification required to be a Home Care Aide.

Home Health Aides (HHA): Home Health Aides have received formal medical training and are usually certified nursing assistants. Home Health Aides may provide basic healthcare services, such as:

  • Monitoring pulse, body temperature, and blood pressure
  • Managing and administering medications
  • Monitoring wounds and changing dressings

In addition, medical professionals such as registered nurses, nurse practitioners, physical therapists, occupational therapists, and physicians may all play a role in in-home care. Many medical professionals make house calls, and can administer to the patient in the home.

In-home care costs

The cost of in-home care depends on the type of care that the patient is receiving, including the number of Home Care Aides and Home Health Aides that are employed.

For the most part, Medicare, Medicaid, and private insurance will all cover some portion of in-home care services provided by home health agencies. In many cases the patient will need to provide evidence that the treatments and care he or she is receiving are medically necessary. As all insurance plans are different, there may be additional qualifications or criteria that the patient must meet in order to have in-home care covered by insurance.

Many insurance companies will not cover care provided by Home Care Aides alone, as this care may not always qualify as medically necessary.

In the case of home modifications, some insurance plans will cover some of the costs of modifications. The modifications usually covered are those recommended by a doctor and seen by the insurance company as medically necessary. In some cases, the products used for home modification will need to be ordered by the doctor for insurance to cover the cost.

For a more complete list of issues to consider for when deciding on in-home care, use our resource Checklist: Questions to Consider When Choosing In-Home Care.

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