Home Care
Two kinds of aides are available to help people in their homes who have difficulties with the day-to-day activities of living:
Home health aides help those who have skilled nursing needs, such as physical therapy, occupational therapy, wound care and instruction and assistance in taking medications. Visiting nurses or therapists provide the skilled nursing care, while home health aides provide skilled day-to-day care.
Personal care aides help those who do not have skilled nursing needs, but do have difficulty with personal care or maintaining their homes.
Both home health aides and personal care aides can help with:
• day-to-day tasks, such as walking, dressing, bathing, maintaining personal hygiene, transferring from a bed to a wheel chair, eating and escort to doctors’ appointments and other events
• and house-keeping tasks, such as light cleaning, laundry, shopping and preparing meals
In most cases, home care aides work a minimum of 4 hours a day (although some agencies do provide aides that work 2 to 3 hours a day). Visiting aides can work up to 12 hours a day. Live-in aides provide 24-hour-a-day care. They can work 1 to 7 days a week.
How to Pay for It
Home care costs between $8 and $25 and hour. There are four ways of paying for it:
1. Private pay: either through a home care agency or by finding and hiring independent aides. It often costs less to hire independent aides, but finding, replacing and supervising them can be difficult. Some people hire private geriatric care managers to do these tasks. For information about geriatric care managers, click on the category on this blog How a Private Geriatric Care Manager Can Help You. People usually use a home care agency that provides and supervises trained and certified aides. For information about and a listing of home care agencies, go to: http://www.nyshcp.org/content.aspx?id=56&linkidentifier=id&itemid=56.
2. Medicare, some private insurance and long-term care insurance will pay for limited amounts of home health care for someone with a skilled nursing need. Long-term care insurance will also pay for limited amounts of personal home care. A referral from a doctor for homecare is necessary for insurance to pay for home care. For information about Medicare go to http://www.nyc.gov/portal/site/nycgov/menuitem.c066bd98b2125fe6a62fa24601c789a0, http://www.medicarerights.org or http://www.ins.state.ny.us/caremain.htm.
3. Various government-funded and privately funded programs sometimes provide limited amounts of home care at no or reduced cost. Federally funded caregiver programs will sometimes pay for limited amounts of home care; see http://www.nyc.gov/html/caregiver for the caregiver program that serves your area. The Alzheimer’s Foundation website lists programs that provide limited amounts of free or low-cost home care to qualified people or their caregivers; go to http://www.alznyc.org/resourcedb and click on Respite Services or telephone them at their 24-hour helpline: 800.272.3900. New York State, through the New York City Department for the Aging, will sometimes arrange to pay part of the costs of home care, based on an applicant’s income and expenses; for information, go to http://www.nyc.gov/html/dfta/html/home/home.shtml and pick “home care” under the services for your zip code or borough.
4. Medicaid will pay for up to 24 hours of home care 7 days a week for those who need it, but cannot afford it. Someone who truly needs Medicaid can get it, no matter how large their income or assets. For information about Medicaid and how to apply for it, click on the category on this blog: Medicaid—If You Need It, You Can Get It.
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