Home Care Versus Home Healthcare
By Stephen Zimmerman
Home Care versus Home Healthcare
How to Plan for the Cost of Home Care and/or Home Healthcare
Home care and home healthcare are two terms that are used frequently when discussing seniors who wish to age in their own homes and require care to come to them, but there’s actually a big difference between the terms.
Home care is a non-medical service. An individual in need of home care can directly hire and manage a personal caregiver or opt for an agency to manage the employment process and send a caregiver. Activities a home care provider can do include household chores such as light cleaning, getting someone ready to go out, making and serving meals, running errands and driving. Home care professionals can only assist with non-medical requirements. So, if someone falls, they can try to help them to their feet or call 911, but they can’t administer any other form of medical procedure. They can ask an individual to take their medication, but they cannot force someone to do so. Anything medically related requires the use of a home healthcare provider.
A home healthcare service employs certified nursing assistants and other medical professionals. Home healthcare services are typically prescribed by a doctor.
Many seniors have a Medicare/Medicaid supplement with commercial health insurance. Supplemental commercial health insurance will work with an individual to establish and define a care plan. For example, if an individual is discharged from hospital but needs physical therapy, insurance will cover that, but nothing else. If there’s a wound that needs a change in dressing, supplemental insurance will send a care provider to the house for that but won’t help in other ways. Again, the home health care will not go on for an extensive period.
Hospice care fits under the home health care umbrella. Hospice care helps with medications and hospice care home health nurses check in on a homebound patient, but, again, they won’t stick around 24/7/365 – unless the patient is experiencing a medical crisis. In some cases, a registered nurse will stay on premises for 12 hours and then reevaluate. If the person stabilizes, the nurse will stop coming. In this case, people oftentimes supplement hospice care with home care.
Alternative and/or Addition to Medicare & Medicaid
In the event Medicare or Medicaid do not cover the type of home care an individual may need, they can purchase long-term care insurance, which, as the name implies, covers long-term services and personal/custodial care in a home or facility. The policies cover the costs to help individuals with daily activities, including eating, bathing and dressing. These policies have a range of care options and coverage limits. Some long-term care insurance packages include both home care as well as home healthcare.
Long-term care policy costs are typically based on the age of the person when the policy is purchased, and outlines the maximum amount per day, the maximum number of days/years the policy will pay and any optional benefits.
It’s important to note, individuals already in poor health or already receiving long-term care services may not qualify for long-term care insurance. Also, the longer someone waits to purchase long-care insurance, the more it costs. The best time to apply for long-term care insurance is when the individual is in their mid-50s.
According to the American Association for Long-Term Care Insurance, $10.3 Billion in claims were paid last year by the nation’s long-term care insurance companies. Over seven million Americans currently have a long-term care insurance policy. According to the 2019 Long-Term Care Insurance Price Index, a couple in their mid-50s purchasing new long-term care insurance coverage can expect to pay just over $3,000 a year for a potential combined benefit of over $770,000 in coverage should they begin needing care at age 85.
For those who don’t like the idea of paying for this insurance because they may never use it, some insurance companies offer policies that include life insurance as well. So, if a policy holder passes before touching the long-term care benefit, the beneficiary will receive a higher payout.
Bottom Line: Home Care is Expensive
Whether you pay for it yourself or through insurance, home care is expensive. Hourly rates in the Bay Area start at approximately $20 per hour and go up to approximately $40 per hour. When going this route, look at the bare minimum amount of time needed for an individual’s care. Can they get by with four hours a day? Maybe two hours, a few days a week? When evaluating a home care service, make sure the time fits within the defined budget. Also make sure the service under evaluation is fully licensed, which means the caregivers are trained and their backgrounds have been checked. Also make sure the service has workers comp insurance, is bonded and has sufficient oversight over the caregivers. Do they offer a backup in the event an assigned caregiver can’t make it to an individual on a given day? Caregivers also get sick, and when someone needs homecare, backup care must be available.
When it’s Best Not to Stay at Home
While home care and home healthcare may satisfy an individual’s needs for wanting to remain at home in their later years, there are times when it may make more sense to evaluate an assisted living community or memory care facility.
Assisted living provides housing, nursing care, housekeeping and prepared meals as needed. Residents are independent but get help with specific personal assistance handled by trained, caring and experienced staff. Assisted living offers seniors a chance to focus on the living that’s most important to them and get help with life’s more burdensome chores.
Memory care offers many of the amenities of assisted living but in a specially designed building that incorporates a delayed egress area (to help prevent wandering) for those suffering from Dementia or Alzheimer’s disease. Memory care also provides a dedicated and fully licensed care staff 24/7/365.
People typically opt for assisted living when the cost of living at home becomes too great. For example, if the house requires numerous expensive repairs and/or renovations to better accommodate an individual and make the home structurally safe, it may make more economical sense to move into an assisted living facility. Others opt into assisted living when they become lonely, even with semi-regular visits from family or a caregiver, as assisted living offers a great community experience. And others will move into assisted living if their heath deteriorates to the point where regimented care is critical. Living at home or moving into assisted living is a personal choice and both can enhance a senior’s life.
Plan Ahead
The best thing to do when figuring out home care, home healthcare costs or if a move into assisted living makes more sense, is to figure out what those costs are going to be as early as possible and build a plan. Planning for any type of home care is like planning for a child to go to college when they graduate high school. It’s not optimal to start socking money away when they’re already 17. Same logic applies when planning for home care, especially since most people will need it.
Finally, because there are many important decisions to be made, individuals should consult a trusted financial adviser who can help determine the best options to meet a specific budget.
Bio: Stephen Zimmerman is COO at AEC Living, a group of independently operated senior living communities and a Medicare-approved rehabilitation agency designed to serve the needs of seniors in the East Bay. Each organization compliments the others to provide a continuum of services designed to promote quality of life, and help every resident and client achieve the greatest level independence.
