Home Care vs. Home Health Care & What Caregivers Do
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Home Care: An Invaluable Resource

Mom has a fall and everything changes. If you haven’t had this experience, or one like it, chances are you will. Knowing available resources can make a huge difference. Home care can lessen stress, provide support, and speed up recovery. Home care can be your best friend.

The Terminology of Home Care

Non-medical home care goes by a couple of different terms. It is important to distinguish between non-medical home care and medical home health. Both can be critical to recovery and ongoing quality of life. Home care is also known by the terms: personal care, or private duty care. Medical home health typically goes by the term: home health.

What is Home Health Care?

Home health provides limited medical support covered by insurance. This includes nursing, physical and occupational therapy, speech therapy, aides and social work. A doctor’s order is required for home health to begin and certain criteria must be met.

When can you get home health care? Typically, a doctor will request home health under these conditions:

  • The person must be homebound. This means that leaving the home takes significant effort. If your parent or spouse is still driving, they probably will not qualify.
  • There has to be a skilled need such as nursing to manage medications, check blood sugar, blood pressure, or provide wound care to name a few.

How much home health care can you get? There are defined limits on home health care, depending on your location and benefits.

  • Time is limited except in certain circumstances. Some neurological conditions can qualify for unlimited home health. Typically, home health can provide services for a 60-day period.
  • The skilled services offered by home health rarely exceed two to three times a week per discipline.

People who can benefit from home health may need help managing a chronic medical condition. Or they may need help recovering from hospitalization, injury or illness. Here is one example:

Daniel has Multiple Sclerosis and is confined most of the time to a wheelchair. He lives with his wife who does what she can to take care of him. Over time, he develops a pressure ulcer on his backside due to inactivity. This wound requires a stay in the hospital and short-term rehab where his wound is treated, but not healed completely.

Once he goes home he qualifies for home health care. A wound care nurse visits him every week. She makes certain that the wound gets appropriate treatment and that Daniel does not sit too long. Since Daniel has a chronic neurological condition, the nurse can keep seeing Daniel for as long as is needed. A physical therapist also visits Daniel. She teaches Daniel and his wife the importance of regular position changes throughout the day so that Daniel does not get another wound.

What is Home Care?

Home care offers non-medical assistance.

The terms are so similar, it is easy to confuse them. Home health care is medical and prescribed by a doctor, but home care is non-medical and does not require a doctor's prescription.Let’s take a look at a typical scenario where home care can be a critical layer of support and encouragement.

Betty is a 91-year-old woman in good physical shape. She doesn’t use a walker or a cane. One day she loses her balance and falls against the railing of the independent senior living community where she lives and breaks a rib. She goes to the emergency room and is sent home with pain medication. Her mobility is compromised, and she is confused about her medications. Her husband has his own medical problems and is of limited help. She is provided three home health visits each week.

But this is not enough support for Betty, so with the assistance of the social worker from home health, she calls a home care agency. The agency provides a caregiver in the morning and evening, seven days a week. The caregiver makes meals and does some light housekeeping. The caregiver also encourages Betty to walk, do her breathing exercises, and stands by while Betty is in the shower. The caregiver also reminds Betty to take her medications. These have been set up in a weekly medication box by the nurse from home health.

As you can see in this story, a home care caregiver helps Betty recover more quickly, and more safely.

Home Care and You

Most people report they want to age in place. An AARP survey shows that 77% of people prefer to remain at home as they age, but only half think they will be able to do so. The fact is, as people age, they need help. With enough planning and home care, it is possible to age in place.

The main objections that many people have moving to a senior living community have to do with safety and autonomy. Outbreaks of COVID in senior facilities across the country have given people pause. Lockdowns and elimination of extracurricular activities have had enormous negative impacts on seniors and families. Home care is becoming a more attractive option.

When you think of home care, you probably imagine a myriad of tasks that professional caregivers provide. These tasks include assistance with bathing, dressing, cooking, hygiene, shopping, and cleaning. Looking beyond these activities of care are the fundamentals of what it means to be happy and healthy in the hands of a professional caregiver.

The Research on Aging at Home

A survey conducted by Home Care Assistance reveals some interesting findings that will probably resonate with you. The majority of seniors and their adult children agree that the two most important factors in receiving home care are keeping independence and maintaining control of everyday life. So, how do caregivers promote independence and control while providing care?

Independence

Dependence and independence connect in very critical and subtle ways. Let’s take a look at how caregivers provide safe care while promoting independence.

  • People want to do things on their own but aren’t always able to. Caregivers encourage a client to do what they can. It is the little tasks that make all the difference. If your loved one can do limited cooking, a caregiver encourages that activity rather than taking over all the meals.
  • Everyone has something they can do well. Caregivers focus on a client’s strengths and abilities, not just what they need help with.
  • Caregivers look for opportunities that maximize independence. Happiness and satisfaction come from the ability to do things for yourself.

Control

Maintaining control and autonomy are two keys to good mental and physical health. Control is the ability and belief that your decisions will have positive consequences. In recovery, disability, or illness, control is the driving force for positive and lasting change. Caregivers promote control by doing the following:

  • Caregivers give your family member choices. No one likes to be told what to do and when to do it.
  • Your loved one is in charge of their care. Being in control of care means being an active participant in your plan of care and identifying personal priorities. Caregivers give clients control by respecting their wishes.
  • Caregivers identify what is essential to the client and honor those choices. If your loved one enjoys going for daily walks or listening to the opera, a caregiver promotes and encourages this activity.

Dignity

The foundations of dignity are self-respect and self-worth. Depending on the caregiver and client situation, intimate tasks need to be completed with extreme sensitivity. But dignity involves other critical components as well.

  • A caregiver acknowledges your loved one’s worth regardless of how vulnerable they may be.
  • A caregiver recognizes your loved one’s unique attributes as a reflection of their values.
  • The caregiver client relationship is a partnership that honors the client’s beliefs, culture, and philosophy.

Successful Aging

Books and articles have written about what successful aging means and how to achieve it. There should be little doubt that a professional caregiver’s ultimate goal is to help your loved one achieve successful aging. These are the components of successful aging and a caregiver’s role:

  • Interests and hobbies bring joy, satisfaction, and purpose to people’s lives. A caregiver recognizes, honors, encourages, and facilitates those activities.
  • Cognitive stimulation helps individuals keep their minds active and vibrant. Caregivers work to help clients engage in mental activities for seniors that promote improved memory.
  • If you have a loved one who is isolated due to physical challenges or limited access to transportation, caregivers can help in several ways. Caregivers can provide transportation to preferred activities, whether it is to concerts, the theatre, or to visit friends. Caregivers can also engage in meaningful conversations and offer companionship.
  • Healthy habits include good nutrition, hydration, activity, and adherence to medical directives. Caregivers motivate clients to adopt and maintain healthy habits.

What Tasks Do Caregivers Do?

Home care can be a vital lifeline. Although "home care" caregivers don't provide medical services, there is so much more they can do:

  1. Companionship and Socialization

Loneliness has reached epidemic levels in this country. Loneliness and isolation in seniors can adversely affect physical and mental health. A caregiver can help end loneliness by being a nurturing and comforting companion. Research has shown that mentally engaging activities for seniors that a caregiver can provide can have a positive influence on people’s mood and outlook on life.

  1. Nutrition and Hydration

Nutrition and hydration are very important factors in recovery. A caregiver can make balanced, appetizing meals. They can encourage adequate nutrition, track fluid intake, and shop for groceries.

  1. Dressing, Bathing, and Transferring

Imagine you have broken your arm, shoulder, hip, rib, or leg. If you have had this experience you know how challenging it is to get dressed and to bathe. Not to mention cook, clean, and drive. A caregiver can assist with helping someone get dressed and out of bed. They can help someone take a shower, monitor their walking, and can also help with transferring a senior from the bed to the bathroom, or car.

  1. Movement

Studies have shown that people with dementia can improve their mood with increased physical activity. Physical therapists provided by home healthcare can get the senior started on the right track. A caregiver can help reinforce and encourage physical therapy activities when the physical therapist is not there.

  1. Recovery

Recovery for most of us means getting back to our previous level of functioning, But recovery in older adults generally takes longer. Returning to health can also be complicated by coexisting medical problems. A good care plan developed with the care manager, family, and client can encourage a safe recovery. The example below shows how a home caregiver helps someone build confidence in recovery.

Carol has been in good health most of her life. She is independent and self-reliant, having learned to manage without her husband who died several years ago. One day she falls on the ice and breaks her hip. After surgery she is sent to rehab. Carol is terrified of going home even though she is doing well in rehab. She has a heightened fear of falling again. Home health is ordered by her doctor. The home health staff begins working with her once she is discharged home.

Carol’s daughter Brenda notices that Carol’s lack of confidence in her abilities is hindering her recovery. Brenda hires home caregivers for daily visits to her mother. These caregivers work with the physical therapist to learn the exercises that Carol has been doing. This way they can reinforce practice and take extra walks with Carol. The caregivers assist Carol in the kitchen with making meals and doing light housekeeping. In time, Carol gains back her independent and confident spirit.

  1. Help with Medications

Medication mismanagement can be a big problem. This can include not taking some medications, missing doses, or taking medications at the wrong time. Professional home caregivers can provide a medication management system, check the medication pill box for accuracy, and report any problems to the family and/or nurse from home health. Caregivers can also pick medications up at the pharmacy.

  1. Transportation

Transportation is a vital part of being able to stay living at home. This includes doctor’s appointments, shopping, medication pick-ups, and other errands. Home caregivers can perform all of these tasks.

  1. Specialty Care for Alzheimer's, Dementia, Cancer, and Parkinson's

Types of dementias such as Alzheimer’s and Parkinsons, among other conditions, can have a devastating impact on families. A hired caregiver can provide mental stimulation, help with bathing, eating, and activity. Many agencies offer caregivers who are familiar with the unique needs of Alzheimer’s and Dementia care, Cancer care, and Parkinson’s care. In these cases, a caregiver can provide an added layer of care and companionship.

  1. Primary Family Caregiver is No Longer Available

What happens when the primary family caregiver is no longer available? Sometimes a caregiving spouse or family member will no longer be able to fulfill their caregiving obligations. A home care provider can step in and assume these duties, keeping a parent or spouse safe and stable with respite care.

How to Get Started

Arranging for home care is as simple as making a phone call. A physician’s order is not required. During the initial call you can describe the situation. Explain the needs of your parent or spouse, and the amount of time per day you want care. Whatever you arrange is flexible and subject to change based on individual needs. Home care staff can come to someone’s home, assisted living, memory care, or a nursing home. It is flexible, supportive, and tailored to meet your spouse or parent’s needs.

Resources

AARP: 75 Percent of Retirees want to stay put

About the Author(s)

Amanda Lambert is the owner and president of Lambert Care Management, LLC which provides care management for older and disabled adults. She is the co-author of, Aging with Care: Your Guide to Hiring and Managing Caregivers at Home (Rowman and Littlefield, 2018). She has worked for over 20 years in the senior-related industry including mental health, marketing and guardianship. She has a passion for topics related to health, wellness and resilience as we age.

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