Doctor’s Diary December 24, 2019: Home Health Care vs. Home Care – Aging in place

(Snippets from the frontline)

Home Health Care vs. Home Care:  Aging in place

You break your hip.  After hospitalization, Medicare provides 20 days of Home Health Care including nursing with physical and occupational therapy.  From day 21 to 100, 80% of costs might be covered.  After that, you are on your own.

Any routine Home Care, including those related to health sans hospitalization, but also cleaning, vacuuming, dusting, grocery shopping, food preparation, and transportation are not covered by Medicare.

The aging body diminishes our ability to work, drive, and even take care of our homes.  Being able to sustain our environment though allows us to age in place.

Because Medicare doesn’t pay for Home Care, it makes aging older adults susceptible to floundering in their living situation.  In jeopardy is not only personal hygiene, but adequate medication management, fall prevention, hydration maintenance, and nutrition.

Some seniors will be able to care for themselves.  But most will need the support of family and friends, or at times Home Care to keep them in their homes.  Presently, Medicare has models examining whether specific programs can keep older adults out of nursing homes.

Understanding Home Health Care vs. Home Care, and effective social planning in the future, will allow seniors to age in place.

Gene Uzawa Dorio, M.D.

1 Comment

  • Linda Merchant says:

    Agree with you Dr. Dorio absolutely that the vast majority of my patients do not understand what their Medicare, Medicare Advantage, etc pay for and how it works.
    However with strict Medicare following your example after a hip fx,, and probable surgery most patients are eligible for Rehab/SNF care for 20 days more or less, daily Therapies and Nursing as needed. THEN after those few weeks DC to home/Home Health Care Agencies and if properly Discharged with PT,OT, maybe a Bath Aide, maybe a Nurse. Medicare, unlike Medicare Advantage plans does not give strict Authorization for so many visits but they depend upon the Field Clinicians to honestly F/U with Skilled Intermittent care and then hopeful DC to Outpatient PT.
    Problems we see constantly are patients, after return to home, who do not have the funds to hire a CG to assist daily eg 4 hrs/day and have too much $$ to qualify for Medical/IHSS funded by the State. And, of course, as you point out in the SNF/Rehab setting if someone requires >21 days it becomes unaffordable for many.
    New to you site, love it and thank you….!!!
    Linda MSPT

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