As the baby boomer population continues to grow older, many of them are leaving the workforce. For the majority, being retired means spending more time at home, and since most boomers say they’d prefer to remain in their homes for as long as possible — i.e., “age in place” — the need for a full spectrum of age-related home health services is also on the rise. However, finding the “perfect” home health service provider for yourself or an aging loved one can be challenging. That’s why the experienced staff at HealthKeeperz, a family-run, faith-based home health agency headquartered in Pembroke, North Carolina, says that while facts and figures should definitely play a part in the selection process, to find the ideal situation, you must take human factors into account as well.
HealthKeeperz Guide, Step 1: Assessing Individual Home Care Needs
Home care is an umbrella term that encompasses a variety of services and levels of care. Also, as people age, their needs will likely evolve, which is why there is no one-size-fits-all answer to finding a home health care solution for you or a loved one.
HealthKeeperz advises that the first step in securing appropriate services is to determine which needs are most immediate and form a workable plan to see that those needs are routinely met in a professional manner, thus determining the scope of care required. For example, some home care regimens offer companionship and assist clients with instrumental activities of daily living, which includes such things as shopping, cleaning, and meal preparation, as well as help with physical activities of daily living, including feeding, personal hygiene, and mobility. These home services, while vital, are considered to be nonmedical and can therefore be administered by caregivers without advanced medical training.
That said, anyone caring for a senior should have at least a basic knowledge of proper wellness procedures and be able to deliver consistent, appropriate care. In this scenario, the benefits of employing a trained home health aide are twofold: They will directly care for a patient, and they can also help family caregivers better understand how to perform duties and maintain routines themselves.
Clients who do require medical treatments as part of their home care routine generally fall into two categories: those under a doctor’s care for short-term conditions, such as patients recovering from an illness or injury, or those recuperating from a hospital stay for whom Medicare-certified home health care, intermittent skilled care, or visiting nurse services are prescribed; and those suffering chronic (ongoing) or catastrophic conditions — be it an illness, injury, or disability — that necessitate long-term skilled nursing care that may include hourly or shift attendance, and require the administration of tracheostomy or ventilator protocols.
The level of care you or your loved one require will likely be determined during your initial consultation with a prospective home health provider. However, HealthKeeperz strongly urges those making the final decision to look ahead to ensure that as conditions change, the provider under consideration will be equipped to adapt to increasing and potentially more complex demands for care in the future.
HealthKeeperz Guide, Step 2: Understanding Out-of-Pocket vs. Covered Costs
Budget is a critical factor when selecting a home health provider. Ask the prospective health care provider what forms of insurance they accept and to detail, in writing, which expenses are covered by insurance or Medicare/Medicaid. They should also be able to apprise you of any routine out-of-pocket expenses you may incur (such as additional fees for special programs or services).
While it may come as an unwelcome surprise to seniors and their families, many age-related procedures and care regimens are either not wholly covered or covered at all by Medicare, Medicaid, or private health insurance. “Every elder has to prepare for four key ‘aging shocks’: uncovered costs of prescription drugs, the costs of medical care that are not paid by Medicare or private insurance, the actual costs of private insurance that partially fills in the gaps left by Medicare, and the uncovered costs of long-term care,” warned an August 2002 report from Health Services Research.
With more than three decades of experience dealing with Medicare, Medicaid, and private insurance companies, HealthKeeperz caseworkers understand that having an expert in their corner can be crucial to ensuring clients and their families get the most financial bang from their existing coverage. And by staying up to date with changing rules and legislation, caseworkers with Medicare and Medicaid expertise can also offer guidance with regard to obtaining possible benefits of which clients may not be aware, as well as directing them to local programs offering financial assistance for those who qualify.
HealthKeeperz Guide, Step 3: Vetting a Home Care Agency’s Credentials
History. A good place to start when vetting a potential home health care agency is to find out how long they’ve been in business. While there might be nothing wrong with a newer entity, if a company has a trusted history, and has expanded its scope of services and operations over the years, that can indicate that the agency is reputable.
Feedback. Community and consumer feedback is a valuable tool when assessing the pros and cons of a potential home health service provider. Ask for referrals from patients, caregivers, and community members. You can also check out agency ratings from the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey to learn which providers were awarded the highest patient satisfaction ratings.
Professional Licensing and Certification. Home health team members should hold professional licenses and training certifications pertinent to their field of expertise. Optimally, they should also participate in specialized training to keep them abreast of advanced techniques and technology to enhance the continued quality of care they deliver. Ask the prospective provider to show you relevant documentation on background checks, ongoing training programs, and current licenses and/or certificates relating to any and all personnel who come in contact with clients.
Medicare/Medicaid Certification. Agencies that are in good standing with Medicare and Medicaid offer assurances that they’ve met state and federal requirements for quality standards of care. Be sure to ask a prospective provider if they are Medicare/Medicaid qualified, and whether or not they undergo routine inspections from any outside regulatory organizations. If so, find out when the last inspection was conducted and what the results were. Don’t be afraid to ask to see paperwork to back up their claims.
Medicare/Medicaid Metrics. Care Compare is a service provided by the Centers for Medicare and Medicaid Services that monitors and reports on the quality of home health agencies. When vetting a potential home care provider, consumers can look them up on this index to compare their scores to the national average. However, it’s also a good idea to ask the agency how they measure quality and what steps they take to ensure their standards are met or exceeded.
Accreditation. Recognized accrediting agencies in the home health field include the Accreditation Commission for Health Care, the Joint Commission, and the Community Health Accreditation Program. While accreditation isn’t required, it’s highly desirable as it shows an agency’s commitment to providing the highest level of patient care.
HealthKeeperz Guide, Step 4: Scope of Services and Case Management — What To Expect
As stated earlier, the extent of care a patient requires will determine which services they will need, ranging from help with daily activities and/or skilled nursing, pain management, and treatment protocols, to physical, occupational, and speech therapy, to medical social work and even instruction for caregivers and family members.
Taking the client’s medical history into account, find out which services the prospective agency provides, and ask if that care includes necessary medical equipment to carry out treatment. Some agencies provide condition-specific care for patients experiencing sleep apnea, heart conditions, and respiratory ailments such as asthma and/or COPD.
Be sure to discuss the agency’s care management procedures. This includes information about how they schedule their services, which services will be performed, and which staff members will be providing specific services. Look into what each care protocol entails, what equipment/supplies will be required, and get an estimate of how long care staff is generally on-site in the performance of their duties. Keep in mind that emergencies can and do crop up. To be safe, find out if the provider is on call around the clock (including nights, weekends, and holidays).
HealthKeeperz Guide, Step 5: Sense of Community and Shared Core Beliefs
“Community has always been an essential strand in baby boomers’ DNA, an attribute that will serve them well in their later years,” wrote Lawrence R. Samuel, Ph.D., in an Oct. 28, 2021, article for Psychology Today. “Boomers’ natural leaning to create communities is in part a function of their being what was the biggest community in history.”
HealthKeeperz, which offers spiritual counseling for clients, family members, and their own staff, believes keeping seniors connected to their community helps them retain a sense of comfort and continuity that affords them the strength they need to move forward on life’s journey, no matter the obstacles, with peace of mind and in the grace of God’s love.
