HELP LINE: Shop around when looking for in-home care

NOW, WHERE DID we stop last week?

Right: Go get last week’s column that you cut out and stuck on the fridge (it’s under the past three drawings from the grandchildren) and review it.

OK? Ready?

We were talking about non-Medicare-certified home health agencies, but let’s back up just a touch: Why would someone want in-home, skilled medical professionals, such as nurses, therapists, etc. if Medicare wasn’t going to pay for it?

Well, for one thing, a person might need/want skilled medical services at home, and that person isn’t on Medicare, as they’re younger than 65.

Or maybe some other kind of insurance is going to pay all/part of it (Note: Do Medicare-certified home health agencies accept other kinds of insurance? Of course.)

And there are probably several dozen other reasons.

And here’s something that I’ve seen happen, sometimes: Mom takes a spill or has something happen and she needs a little help for a while. The family, who is spread out across three states in two time zones, freaks and says “OMG, she needs 24-7 care. By a nurse.

Why do they think that?

Because they love their Mom and want the very best for her.

Does it make any sense?


Obviously, it just depends upon what kind of help Mom really needs and how often.

If she has a wound and/or is post-surgery and/or requires professional therapies, etc., then, it probably does.

But if what Mom really needs is somebody to help with housework or getting to bed or getting up or shopping or anything else like that, then, Mom probably doesn’t need (or, likely, want) “24-7” care. (And let’s try to remember that Mom still has a say in all of this, right? Thank you.)

So this all takes us back to the question that we posed at the end of last week’s column: Will these folks vacuum, do dishes, etc.?

Well, I’m pretty sure that the nurses and therapists won’t, but there might be other staff from the same agency that do.

You see, some home health agencies (Medicare-certified or not) might be part of a “homecare agency.”

Homecare agencies are just what they sound like: Agencies that recruit, train, employ and supervise folks who will come into a home to provide whatever level of in-home assistance (from vacuuming to very personal care).

Generally, they meet with Mom/family, assess what needs to be done and what the customer wants, then devise a plan to provide that assistance.

Some of them accept various forms of insurance (remember, it won’t be Medicare), but often these arrangements are made on a private-pay basis.

There are numerous homecare agencies around, which allows you (if you have the time and inclination) to go shopping and ask questions: What’s the hourly rate? Is there a minimum amount of time per visit, e.g. two hours? What’s the likelihood of Mom getting the same caregiver/aide consistently? (Remember, people bond with people, not agencies — so will Mom).

I think you get the drift.

So, to go all the way back to the beginning, let me pose the rhetorical question: Does Mom need 24-7 care or do you need 24-7 reassurance?

And I don’t say the latter facetiously.

It’s perfectly natural to worry about your mom, who’s in McCleary when you’re in Richmond.

One way that a lot of folks attempt to cover both of those needs is via the use of a personal emergency response system.

That’s the formal name for what many of us think of as those “panic-button gizmos:” (“I’ve fallen and I can’t get up.” Yes, I hate those commercials, too, but we all know what I’m talking about.)

They hang around your neck, or as a bracelet, and allow the wearer to summon assistance if they need it and they’re alone.

I’m actually a big fan of these things.

I’ve seen them save a lot of people a lot of misery, not to mention lives.

And the technology has come a long way, which can include cellphone/off-site use, GPS tracking, medication reminders, etc. ad infinitum.

In fact, some of these things will do just about everything except bring you breakfast in bed.

The question is: Do you need all of that?

And, do you want to pay for all of that?

If yes to either, please proceed, but if money is an object, than you might want to do some serious shopping, because the prices/rates for these things vary dramatically from double-digits to close to $1,000 per month.

And they all work pretty much the same way, so you decide.

And, while we’re on the subject of Mom (or Dad or whomever) home alone, let me remind us all of something: It’s easy to get lost in all of this insurance/long-term care/in-home care/medical/non-medical stuff with telephone calls, paperwork, forms, web-based monitoring and billings, etc.

Do you know what’s most statistically likely to hurt Mom, big time?

Falling over.

Yes: falling over.

That will put more of us away than several major medical conditions plus Alzheimer’s combined.

I’m not kidding, because it isn’t funny.

And there are 10,000 things that could make any of us fall, but I’ll tell you one real good place to start, especially if Mom has more than one prescribing professional: “Do all of these meds really go together?”

Because if there’s anything that Mom does not need, it’s a whole new meaning to the phrase, “Getting out of bed.”


Mark Harvey is director of Clallam/Jefferson Senior Information & Assistance, which operates through the Olympic Area Agency on Aging. He is also a member of the Community Advocates for Rural Elders partnership. He can be reached at 360-452-3221 (Port Angeles-Sequim), 360-385-2552 (Jefferson County) or 360-374-9496 (West End), or by emailing [email protected].

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