Elderly Care – Medical Vs Non-Medical Home Health Care – Discover What You Need

Medical Home Health Care vs. Non-medical Home Health Care…if you are reading this, you are likely among the thousands of caregivers needing help caring for a loved one at home. What is the difference?

One significant difference is who pays the bill… you or insurance?

With a doctors order and insurance that is accepted by the agency and covers home care, these services are generally covered. Medical home care provides skilled medical services such as:

  • Registered Nurse
  • Physical Therapy
  • Occupational Therapy
  • Speech Therapy
  • Home Health Aid
  • Medical Social Worker

These medical personnel can only come to your home by an order from the doctor. This can be initiated by a trip to the doctor, a call to the doctor and sometimes a call to a home care agency explaining your difficulty. They can then contact the doctor.

Several questions need to be answered at this point to help you decide what you need.

  • Is the patient recently home from the hospital?
  • Is the patient falling at home?
  • Are you confused about what medications to give the patient?
  • Is there a significant change in functional ability or decline in activity level recently?
  • Is the patient frequently going to the ER?

Yes to 2 or more of the above questions may indicate a potential need for medical home health care.

Discussing your felt need with your doctor will help you understand the issues and the answers.

Non-medical home care

If you and your doctor have ruled out the need for medical home care but you still feel you need some help, consider non-medical home care. Non-medical care means just that. Non medical. These services are often referred to as companion services.

Your best bet is to Google “home health assistance” or the like. You can always call a business and ask if they provide non-medical home care assistance. Beware though, most medical home care company’s WILL provide solely a home health aid but at a ridiculous price. You may find better rates by hiring a company who provides only non-medical home care assistance. This is what they do best and they generally do it well.

Do your homework and use your phone. Ask the agency how long their workers have been there. Don’t be afraid to pay a little more if you feel you are following your gut. You are depending on these people to give you or your loved one the proper care and respect that they need and deserve.

You may qualify for home health care physical therapy under Medicare – it’s worth a look!

You may also want to consider how your care may be affected by the way your home care team is paid.

Home Health Care History

The early nineteenth century witnessed the initial stages of the home health care industry that offered qualified nurses to take care of the poor and sick in their homes. In 1909 when Metropolitan Life Insurance Company started to write policies that comprised of home health care, this industry became very popular. This company is credited for paying the first compensation for home health care industry. This gave rise to the birth of organized home health care.

The Great Depression in 1929 caused several businesses along with home care industry a lot of hindrances and struggle. This went on till the follow-up visits made by nurses after hospital discharge became reimbursable by the Medicare Act of 1966. The home care industry became most feasible and practical when Medicare in an attempt to reduce hospitalization costs set up DRG’s program (Diagnostic Related Group). This laid down that some disease or hospital practice needed a certain stay period. So the discharged patients were more sick compared to their DRG counterparts.

The story does not finish with DRGs. This in fact was the commencement of patient care vs. medical ethics debate. This subject shall be soon addressed in the present health care reform segment. The price of health care is the issue. Questions like how much does a human life cost and how long one should pay for keeping alive a person after he ceases to be a contributor to the society need to be addressed.

Home health care industry needs to answer these questions. The main intention of the DRG programs was to cut down the hospital stay in order to lower hospitalization costs. Thus this becomes a challenge to the agencies. But gradually home care started becoming expensive. The Balanced Budge Act of 1997 hand one major side effect. It limited the benefit days to the patients under home health care thereby lowering the compensations to the various home health care agencies. This resulted in many of these agencies going out of business.

The price to take care of a patient will always stay an issue. There was a growth of nosocomial diseases in hospitals that lead to heavy health care costs. Patients started getting discharged in a much sicker condition than before. This put additional burden on the family of the patient to make available good care once the family member is home. Also majority of the people were working. Home health care agencies that provide services were unable to discharge patients when they exceed their Medicare days if they are in a bad condition or its not safe to depart from them without any nursing services.

In case the home care agency declines admission of a patient who seems sicker than the number of reimbursement days allowed by the government, the patients’ family does not have too many choices. In case of the patient being discharged without any adequate follow-up care, the patients’ family can seek services of a qualified agency that could strain on emergency room visits and re-hospitalization leading to more compensation issues. Such questions are difficult to answer more so in cases where cost is to be taken care of. But, as time passes, such questions will continue to haunt till there are satisfactory answers to them.