Consumer Information & Resources
Homecare Offers a Variety of Choices
Homecare providers deliver a wide variety of health care and supportive services. These can range from professional nursing and home health aide services to physical, occupational, respiratory, and speech therapies. Providers may be for-profit, non-profit (VNAs), or hospital based.
Homecare services can be provided by:
- Companions
- Medical Social Workers
- Registered Nurses/Licensed Practical Nurses
- Family Caregivers
- Occupational Therapists
- Respiratory Therapists
- Home Health Aides
- Physical Therapists
- Speech Language Pathologists
- Homemakers/Chore Workers
- Physicians
- Volunteers
The alphabetized definitions below can help you learn more about homecare services if you're trying to decide what type of care to provide for a loved one, but you're unsure of what's out there.
Companions provide companionship and comfort to individuals who, for medical and/or safety reasons, may not be left at home alone. They may assist clients with household tasks, but primarily provide sitter services.
Home Health Aides assist patients with activities of daily living (ADLs) such as getting in and out of bed, walking, bathing, toileting, and dressing. Some aids have received additional training and are qualified to provide more complex services under the supervision of a nursing professional.
Homemaker and chore workers perform light household duties such as laundry, meal preparation, general housekeeping, and shopping. These services are directed at maintaining patient households rather than providing hand-on assistance with personal care.
Medical Social Workers evaluate the social and emotional factors affecting ill and disabled individuals and provide counseling. They may assist patients and their family members identify available community resources. Social workers also serve as case managers when patient's conditions are so complex that professionals need to assess medical and supportive needs and coordinate a variety of services.
Occupational Therapists (OTs) help individuals who have physical, developmental, social, or emotional problems that prevent them from performing the general activities of daily living (ADLs). They also instruct patients on using specialized rehabilitation techniques and equipment to improve function in basic household tasks such as eating, bathing, and dressing.
Physical Therapists (PTs) work to restore the mobility and strength of patients who are limited or disabled by physical injuries through the use of exercise, massage and other techniques. PTs also often alleviate pain and restore injured muscles with specialized equipment and teach patients and caregivers special techniques for walking and transfer.
Physicians occasionally visit patients in their homes to diagnose and treat illnesses just as they do in hospitals and private offices. They work with home care providers to determine services that are needed by patients, which specialists are most suitable to render these services and the frequency of services to be provided. They also prescribe and oversee patient plans of care.
Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) provide skilled services. Some of these services include injections and intravenous therapy, wound care, education on disease treatment and prevention, and patient assessments. RNs may also provide case management services. LPNs have one year of specialized training and are licensed to work under the supervision of registered nurses. The patient's medical condition and required treatment regimen determines whether care should be provided by an RN or an LPN.
Speech Language Pathologists work to develop and restore the speech of individuals with communication disorders, usually as a result of traumas such as surgery or stroke. They also retrain patients in breathing, swallowing, and muscle control.
Volunteers meet a variety of patient needs. Their services depend on their level of training and experience. Activities include companionship, emotional support, counseling and helping with personal care, paperwork, and transportation.
Definitions and Other Useful Information
Confused by some heathcare definitions? The information below will help you decipher the meaning of various homecare terms.
Approved Amount: The fee Medicare sets as reasonable for a covered medical service. It may be less than the actual amount charged. Approved amount is sometimes called "approved charge."
Durable Medical Equipment: Medical equipment that is ordered by a doctor for use in the home. These items must be reusable, such as walkers, wheelchairs, or hospital beds.
Centers for Meidcare & Medicaid Services (CMS) formerly known as Health Care Financing Administration (HCFA): The federal agency that runs the Medicare, Medicaid, and Children's Health Insurance Program, and works to make sure that the beneficiaries in these programs have access to high quality health care.
Homebound: Normally unable to leave home. Leaving home takes considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for nonmedical reasons, such as a trip to the barber.
Home Health Agency: An organization that provides homecare services, including skilled nursing care, physical therapy, occupational therapy, speech therapy, and care by home health aides.
Home Health Care: Skilled nursing care and certain other health care that you get in your home for the treatment of an illness or injury.
Medicare: A health insurance program for people 65 years of age or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD), (people with permanent kidney failure who need dialysis or a transplant).
Medicaid: A joint Federal and State program that helps with medical costs for some people with low incomes. Programs vary from State to State, but most health care costs are covered if you qualify for both Medicare and Medicaid.
Medically Necessary: Services or supplies that:
- are proper and needed for the diagnosis, or treatment of your medical condition;
- are provided for the diagnosis, direct care, and treatment of your medical condition;
- meet the standards of good medical practice in the medical community of your local area; and
- are not mainly for the convenience of you or your doctor.
Out-of-Pocket Costs: Health care costs that you must pay on your own because they are not covered by Medicare.
Plan Of Care: A plan written by your doctor that describes what kind of services and care you must receive for your health problem.
Provider: A doctor, hospital, health care professional, or health care facility.
Regional Home Health Intermediaries: A private company that contracts with Medicare to process claims and make checks of home health care.
Skilled Nursing Care: A level of care that must be given or supervised by licensed nurses and is under the general direction of a doctor. All of your needs are taken care of with this type of service, including giving direct services. Examples of skilled nursing care are: getting intravenous injections, tube feeding, oxygen to help you breathe, and changing sterile dressings on a wound. Any service that could be safely performed by an average nonmedical person (pr one's self) without the direct supervision of a licensed nurse is not covered.
State Health Insurance Assistance Program (SHIP): A state organization that receives money from the Federal Government to give free health insurance counseling and assistance to Medicare beneficiaries.
Sources: Walter Feldesman, Esq., Dictionary of Eldercare Terminology, 1997
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