Debra Desrosiers

Since I work in home care, I see that the public is not always aware of what services are available and who pays for them.

What will happen if all of a sudden you cannot be left alone due to a physical disability and need help to the bathroom? Who will help you? Who pays for the services? How often will help be needed? Below is a guide I put together that will help people understand the differences in home care options.

Home Health Care — Temporary help in the home ordered by a physician. Services provided are nursing, physical therapy, occupational therapy, speech therapy, home health aide and social work services. Services are typically paid under Medicare or Medicaid guidelines and some health insurance policies.

Has the patient had an acute health care crisis such as an unexpected illness, injury, surgery, or diagnosis requiring very recent hospitalization?

Has the patient declined to the point they are homebound?

Does the illness, injury or diagnosis require treatment, or monitoring following hospital discharge?

Has the patient declined in functional status following hospitalization? Examples would be weakness, inability to walk or transfer safely, when they were fully functional prior to hospitalization.

Is a chronic illness being managed poorly, resulting in repeated hospitalizations or emergency room visits?

Does the patient have a primary physician who could write an order for home health care?

Has the patient just been diagnosed with a chronic illness that needs careful management and education, such as diabetes?

Is the patient preparing to be discharged from a rehabilitation facility, and is still in need of therapy? Remember the patient must be homebound.

Private Duty Home Care — Considered non-medical assistance in the home. The care is considered custodial care and does not require physician’s order and can be customized to meet the daily needs of the client. Services are designed to help the care recipient remain independent and safe in their homes. Services are mostly paid privately by families. Many families are now starting to benefit under long-term care insurance, veterans' benefits and Medicaid Waiver programs.

Have you or a family member had a recent illness, injury or surgery that left the patient less functional or independent?

Are you or a family member unsafe alone?

Do you have a family member experiencing noticeable memory loss or received a diagnosis of Alzheimer's or dementia?

Do you or a loved one spend most of their time alone, inactive and socially isolated?

Have you or an elderly relative had to give up their driver's license yet still likes to get out to shop, visit friends and family, attend religious services, get their hair done, or go to events or activities?

Do you need someone to assist with grocery shopping, or getting medications?

Do you or an elderly loved one want to remain in your home rather than move to a long-term care facility?

Is an assisted living where your loved one resides telling you they are unable to provide the care the resident needs, and you will probably have to move them?

Are you a family caregiver who is exhausted, stressed out, and at the end of your rope?

Are you a family caregiver with no time for yourself, and need respite?

Are you a spouse or adult child facing being a family caregiver for the first time?

Do you need to take off work every time your elderly parent has a doctor appointment or medical procedure?

Do you have an elderly parent who lives alone and is eating poorly or having problems taking the right medications at the right time?

Are you spending countless hours at the bedside of a hospitalized family member, without getting sufficient rest?

Would you like some extra help with an elderly family member for a special event, during the holidays or so you can take a vacation?

Has a physician or other medical professional told you your spouse, parent or loved one is not safe alone?

Hospice — Palliative or comfort care for patients diagnosed with a terminal illness. Services are paid mostly by Medicare, Medicaid and most health insurance companies.

Have you or a loved one been diagnosed with a terminal illness that has no or limited treatment available?

Have you or a loved one completed cancer treatments without any improvement and have run out of options?

Do you have an aging relative that has been diagnosed with failure to thrive or are experiencing significant weight loss, or a significant decline without any explanation?

Has a physician told you or a loved one there is nothing else they can do?

Do you have an aging parent or spouse with Alzheimer's or dementia that has also experienced a significant injury or illness?

Is your family having a difficult time with a loved one's terminal diagnosis?

Is a loved one suffering in pain related to a terminal diagnosis?

Do you need equipment or medications related to a terminal diagnosis that are causing a financial burden?

Would you or a loved one with a terminal diagnosis prefer to remain at home or stop dealing with doctors, hospitals, procedures and treatment?

Is your loved one in the hospital or long-term care facility dying and uncomfortable?

Debra Desrosiers is director of Visiting Angels, a home health agency with offices in Gilford and Auburn. To contact her, call 603-366-1993.

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