THE DILEMMA WHEN HEALTH ISSUES INCREASE

Thoughts about home health care and related options for helping parents age well were triggered when I read The Huffington Post, Huff Post 50 (online) 8/8/13 post, “Home Health Care: Peace of Mind for Long-Distance Caregivers.” The writer heads Partners in Care, an affiliate of Visiting Nurse Service NY. Most caring children, living far away or not, think about the time when parents’ health issues increase, making living alone problematical. Is home health care the answer for our peace of mind and our parents’ enjoyment of life?. 

 “Is it better for my parents, or better for me?” is one of this blog’s key thoughts

There are helpful ideas in the post.  Yet, having spent my adult life with elderly parents living on the West coast and now an almost 100-year-old m-i-l in the Southwest, the post “gives me pause.” First, Why the pause? Second, What should we keep in mind?

1. Why? Expense and Intrusiveness. Home Health Care can be expensive and possibly intrusive. It would be the latter for Sr. Advisor, R,  (my m-i-l). But then, she has caring neighbors, decent mobility, and a good mind.

Sr. Advisor, R has repeatedly and adamantly said “NO” to any suggestion of help in her home–beyond the 4-hour day, once-a-week cleaning woman. Many of R’s contemporaries  with a “companion” (including one with major vision loss) complained throughout the years that it was intrusive: the companions liked to have conversations in the “down time” and these elders didn’t feel they wanted to “entertain” someone who was supposed to make their life easier. R has mentioned assisted living as an option, if necessary.

At Home in Assisted Living

Of course assisted living charges for every “extra,” making it more expensive as people’s health issues increase. For example, my cousin, about whom I’ve previously written, has a big bed covered with large pillows and a beautiful, heavy-looking spread. Commenting that it looks lovely, then asking if it took her 45 minutes to get the bed made up. Her reply, “I pay someone to do it each day.” Yep! Assisted Living extras…and we haven’t discussed charges for dispensing medications, bathing……. and, oh yes, we must very carefully select the assisted living facility as we learned from the PBS documentary: Life and Death in Assisted Living.

At Home With Health Care

I phone Partners in Care in NY. I’m told it’s “private pay–no Medicare or HMO insurance accepted, but some long-term care insurance qualifies.” I ask about fees for home healthcare in New York City (thinking it would be more expensive than anywhere else in this country), so we have a comparison. This is my understanding from an impressive, extraordinarily helpful person who took my call:

1. When a family needs “a lot more help than family members can provide” and staying at home is the goal, home health care becomes an option.
2. An assessment–usually by a geriatric nurse and/or social worker–is $200. After the assessment care recommendations are made.
3. Care management (as opposed to in-home-care) is $175 for 15 minute increments if booked through PIC. Parents remain in their home and licensed care managers–usually former nurses or social workers–do well whatever you ask them to do. (Care management is especially helpful to busy people or far-away-living children.)
4. Fees for a home health aide: minimum 4-hour day: $86 They do light housework, help people bathe, prepare light meal, take grocery shopping etc. (Check for specific “duties.”)
5. Bath service only (2 hours) $44 (bathing,  grooming, dressing, perhaps prepare light meal).
6. Home health aides can’t perform nursing duties, can’t give medications, can’t lift.

Using New York’s Visiting Nurse Service is less expensive . It’s not “private pay.” A physician must request the individual assessment and supply many particulars about the older person on a special form. Medicare and insurance coverage is accepted (Check type of insurance accepted.) Assessment cost: $95 for, I believe, people who recently came out of the hospital (within 30-90 days). Check for other specifics including whether Medicaid is accepted and definitely ask: “Is there anything else I should know about cost coverage?”

If you missed this excellent Mayo Clinic item in Newsworthy (right sidebar) re: questions to ask when considering home care services, check it out now. This was post was written before Newsworthy was a feature of this blog.

Always check Newsworthy (right sidebar) for the latest research and information from highly respected institutions–to help parents age well.