Home Health Programs Covered by Your Traditional Medicare Benefits
By Elizabeth Sukys-Rice, MSW
Home Health care is a popular choice. According to AARP, nine out of 10 seniors prefer to grow old in their own homes. We know that the population is aging and will need a variety of services to age with a good quality of life. In 2008, just 39.1% of older persons assessed their heath as excellent or very good.Older adults are hospitalized at a rate three times higher than the rest of the population, with average out-of-pocket health care expenditures of $4,605. It makes economic sense to provide services in the home, and the current trend is to increase in-home services instead of short-term rehabilitation stays. Home health companies offer several services. Here is an explanation of some of the programs available.
“Typical Home Health Services”
• For caregivers: The Alzheimer’s Caregiver Education Program aims to reduce caregiver stress by teaching caregivers how to manage behavioral disturbances. To provide a special service of caregiver education for patients with Alzheimer’s disease, staff are required in some states to attend initial and ongoing education programs to prepare them to assist caregivers of patients with Alzheimer’s disease. The training includes modules that offer caregivers a “tool box” of resources to deal with caregiver stress, difficult behaviors, communication techniques, and everyday activities.
• Bowel and Bladder Programs decrease the incidence of bladder incontinence in the home care population. The program may be as long as 12 weeks, initiated through direct physician referral or the admitting clinician’s assessment of incontinence. The program consists of bladder retraining, diet and medication education, provision and instruction of bladder diary and timed-voiding logs. Everyone involved, from the clinician treating the patient, to the patient’s caregiver, and especially the patient, plays an integral role in ensuring the success of the bladder integrity program.
• Renal Education Programs provide detailed educational materials that help patients understand the various stages of renal disease. The goal of this program is to assist in disease management and reduce the risk for hospitalization.
• Programs for the heart are geared toward patients with cardiac illnesses including CHF, COPD, HTN, CAD and atrial fibrillation. The focus of this program is to manage the disease process and keep patients safe and medically stable in their own homes. Some of the techniques used to manage the illness include telephone triage, front-loading visits by all involved disciplines, identifying patient’s risk level on admission, medication management, and signs and symptoms management tools. The goal is to assist patients in being aware of and responsible for their own care.
• Chronic Disease Management Programs help patients and their caregivers understand the risk factors for their specific chronic disease processes. They learn to recognize signs and symptoms, track vital signs and other indicators of exacerbation, and understand the appropriate interventions to take to reduce 911/ calls and visits to the emergency room.
• Simple Personal Wellness Programs provide the patient with home-care services to promote wellness and decrease the frequency of hospitalization. In addition to in-home clinical visits, an experienced registered nurse can contact the patient as needed to develop and maintain a personalized continuity of care. The nurse regularly evaluates cognitive status, assesses for continuing home safety, and monitors the patient’s risk for social isolation.The frequency of communication is based on individual needs. The focus is on reinforcing the education provided by in-home clinicians, and determining if the patient is retaining the information.
“Home Health Care Coverage”
Most home health care is covered under Medicare and most insurance programs, yet there might be certain times when home care is needed and can be paid for on a private pay basis. Private pay, in-home care, service programs provide homemaker/companions, personal care, nursing, and therapy services. Services are scheduled to accommodate the client and “fill in the blanks,” so they can remain living independently in their own homes. Clients purchase a block of time in advance and then schedule their services as needed. Examples of homemaker/companion services include light housekeeping, meal preparation, errand running, accompanying client to doctor’s appointments, letter writing, and companionship