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Senior Citizen's Guide to Indianapolis

Home Care and You

As all of us age, interest in home care increases. As a consumer, you need to know the types of home care services and how one pays for these services. What are you going to need? Are you a frail elderly person just needing assistance with activities of daily living or are you ill or disabled requiring the skill services of a registered nurse, a physical or occupational therapist or a speech – language pathologist and a home health aide? Or   you or a family member may be terminally ill so hospice care is needed.

Indiana is fortunate that providers of home care must be licensed by the Indiana State Department of Health. This mandate assures that providers must meet specific standards and you as a consumer of home care have the right to make complaints about your care to the Indiana State Department of Health.

Personal Service Agencies provide non-medical services that could be performed by an individual if the individual were not impaired and enable the impaired individual to live in the individual's home and community rather than in an institution and to carry out functions of daily living, self-care, and mobility. These services include assistance with walking and moving between bed, chair, wheelchair, personal care such as bathing, dressing, toileting, medication assistance, and housekeeping. Though many individuals privately pay for these services, Indiana does provide payment for those persons of limited income under Indiana's home and community based services program. Long Term Care insurance also pays for these services. Personal services do not require an order from a physician. A person or the family can contact a personal services agency or use the case management of the Central Indiana Council on Aging or a private geriatric case manager.

Home health agencies provide medical services under the order of your physician. Nurses, therapist, social workers, and home health aides provide those services that return most individuals to independence. Nursing services may be needed to teach you how to care for your self during a specific illness or the nurse may monitor your health condition.  The nurse may also provide specific treatments such as wound care. Therapists develop exercise programs so that you regain your strength so you are independent and safe at home. The social worker assists with family and financial issues that occur with an illness. The home health aide provides those personal care services that are required during your recovery.

Home health services require the order of your physician.  Many referrals are made by a hospital's discharge planning department under the request of your doctor or directly from you doctor's office. However, if the services are to be paid by either Medicare or Medicaid, you have the right to choose the home health agency that will be coming to your home. A few home health services such as medication set up are paid for by the individual or family. Nevertheless, most of the services are paid by Medicare or Medicaid.

For Medicare, patient specific criteria must be met. The Medicare beneficiary must be under the care of a physician, homebound, and have a skilled nursing or therapy need. Most Medicare services are intermittent; meaning the home health agency staff makes visits to your home to provide care. Medicare does not pay for care that a patient or family may want for many hours each day.

Individuals whose health care is provided under Indiana Health Coverage Program (Medicaid) and who require extended home care services may receive those services in the home. However, these services are reserved for the seriously disabled or ill and must be approved by Medicaid before services are rendered.

Though the words, "terminally ill" seem insensitive and scary, hospice care allows the individual and family to live one's final months to the fullest. Hospice care includes physical, emotional, and spiritual support services. Medications and home medical equipment that are related to the terminal illness are also part of hospice care. A physician or family may contact a hospice to discuss hospice services. After the patient's death, the hospice provides bereavement services for the family. Medicare, Medicaid, and private insurance pay for hospice care.

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