In-Home Services
Because of a sudden illness or the effects of chronic disease, older people may find themselves unable to perform some basic activities of daily life (bathing, dressing, food preparation, shopping etc.). If you or your loved one needs assistance with these matters, you may want to arrange for help with these services.
Home Health Care
Most home health care paid for by Medicare is temporary and part-time. A nurse and/or nursing assistant (aide) will visit your home to provide the necessary care. When Medicare (or other insurer) determines that you do not need these services any longer, they will be discontinued. There are two kinds of home health care—skilled care and personal care:
Skilled care is a level of care that must be provided by licensed or certified staff. It is offered on a short-term basis. Examples of skilled care include intravenous injections, changing wound dressings, and physical, speech and occupational therapies. Skilled nursing care or therapy may be approved for payment by Medicare, a private health insurance company or through a long-term care insurance policy if the individual is found to meet the criteria for skilled care. The National Association for Home Care provides further information about home care services and how to choose a home care provider.
- Personal care is non-skilled care, usually provided by an aide. Personal care may consist of assistance getting in and out of bed, bathing, dressing, toileting, transferring and/or eating/feeding. An aide may provide these services while the patient is receiving skilled care services. Medicare will not pay for the personal care services if skilled care is not needed or after skilled care is discontinued. If you choose, you may pay privately for personal care services.
Check to make sure that the agency you use is appropriately licensed and bonded. Medicare has developed Home Health Compare, an on-line information source that provides information about home health agencies, including a listing of agencies and helpful guidelines to finding a home health care agency.
Services
Prescription Deliveries
Many pharmacies (independently owned as well as large chain stores) provide home delivery of medications. Some are free, while others charge a fee for the service. Be selective and do some homework. Get a list of the medications you or your loved one uses and ask for a price list from several pharmacies that provide delivery in your area. Those with “free delivery” may actually charge more for the prescriptions than another pharmacy and in the end you pay more than if you used the pharmacy that charges a delivery fee.
Housekeeping/Chore Services
Housekeeping, or chore services are provided by some home health agencies and by private companies that can be found under “Maid Services” in the yellow pages of your local phone directory.
Hair Care
Some licensed cosmetologists will make home visits to provide hair care services. You may want to ask your friends if they are aware of any individuals who provide this service. Some local news publications carry ads for cosmetologists who make home visits. Some beauty salons will also be able to make referrals. Be sure to check references, as this person will be entering your home.
If you or your loved one is unable to get out to shop for groceries, you may want to see if there are grocery stores that will deliver to your home. The local Senior Information and Assistance Office may have a list of stores that offer this service.
Sometimes the issue is not just getting the food into the house but also preparing it. If you or your loved one is not able to cook and unable to get out to purchase prepared meals elsewhere, Meals on Wheels delivers hot meals five days a week to individuals who are homebound. There is a charge for the meals, but subsidies may be available. In addition to the meals, the older person receives a friendly visit from a volunteer. That little bit of socialization can mean a lot.
Volunteers
There are programs throughout the state that provide volunteers who visit older persons in their homes and provide a variety of services. An example of such a program is Baltimore County's Home Team Program. This senior center-based program matches homebound individuals with volunteers who provide escort services, shopping assistance and more. For information about specific services provided in your area, contact the local Senior Information and Assistance Office.
Also in Baltimore County, the PEERS: Seniors in Partnership program trains volunteers (age 55 and over) to work with seniors who have mental health problems. The partnerships include: meal sharing, leisure activities, telephone contact, escort services, counseling and working through “red tape.” For more information about the PEERS program, call the Mental Health Association of Maryland at 410-235-1178.