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Understanding In-Home Care

There are a variety of services available to provide older adults with the support and care needed for them to remain safe at home.  In addition to the programs listed below, many primary care programs offer routine medical care in the home. 


Homecare (Homemaker, Attendant Care, Companion Care, Personal Care)

  • Programs that assist people with non-medical tasks such as bathing, feeding, grooming, walking, preparing meals, light housekeeping, running errands, medication reminders, companionship, and encouraging exercises or activities. 

  • The older adult or their family determines the schedule.

  • Services are provided through an agency or by a private individual. Depending on the state, Medicaid may pay a family member to be the homecare provider. 

  • Many states do not regulate homecare agencies and homecare workers, while others require homecare agencies to be licensed.  

  • Homecare is most commonly a private-pay service.  Medicare does not cover the cost of homecare.  Long-term care insurance, Medicaid and the VA may pay for homecare services.


In-Home Respite

  • Respite is short-term relief for family caregivers so that they can take a break from caregiving.

  • Respite includes the same services as homecare and is private pay with a few exceptions:


Home Health Care 

  • Home Health care is a medical service that is ordered and overseen by a physician.

  • Generally short-term in nature (must be recertified every 60 days) and most frequently ordered after a hospitalization, skilled nursing stay, or change in health condition.

  • Examples of services include education, monitoring of health, wound care, injections, physical therapy, medication review , and home safety evaluation.

  • Care is provided by a licensed home health agency whose team includes a nurse, physical therapist, occupational therapist, speech therapist, medical social worker and home health aid.

  • Frequency of visits varies, usually 1 to 2 times per week unless wound care is involved.

  • Medicare, Medicaid and private insurance will pay as long as home health is medically-necessary.

  • You can find information on Home Health Agencies at Medicare's Find and Compare.


Private Nursing Services

  • In addition to providing homecare services, a nurse can assist an individual with skilled needs such as injections, medication administration, and wound care on an ongoing basis.

  • To hire a nurse, check local nurse concierge agencies or registries.

  • Services are private pay.


In-Home Hospice

  • Hospice care focuses on quality of life and comfort care at end of life instead of curative treatment and is ordered by a physician .

  • Care is provided by a licensed hospice agency whose team includes a doctor, nurse, spiritual advisor, medical social worker, hospice aid, volunteers and therapists. 

  • Frequency of visits varies depending on the need; however a nurse is available 24/7.

  • Medicare, Medicaid and most private insurance will cover the costs of hospice. 

Please refer to Mellie’s Hiring In-Home Help document for additional information

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