Explaining “in-homecare” To Caregivers

Many of us speak of obtaining care for our loved ones or clients so that they can remain in their homes. This is the ideal setting for people in most circumstance.

The concept of “In home” care has gained universal awareness and acceptance. Indeed, the term “Home Care” has become a part of our vernacular or lexicon.

But here is the important distinction that caregivers need to understand: “Home Care” is a very specific type of care.

We use the term “Home Care” to represent all services that an individual may receive while living at home. But this is like saying that all facial tissues are Kleenex Brand or all cotton swabs are Q-tips.

When determining the appropriate type of care for home based services, the overarching question goes first to client choice and then, immediately to the payer source.

• Home Care is a fee for service, out of pocket expense which is the responsibility of the person receiving those benefits. Under a true Home Care plan, the Client, Patient (or their caregiver) is the person who decides when, where and how much service shall be afforded.
• Home Health Care is government subsidized care, typically through Medicare or Medicaid and, in some instances, some private insurance companies. Under Home Health Care, the “government” essentially makes the determination as to when, where and how much care a person will be eligible to receive before they are required to reach into their own pocket.

There are three basic levels of Care that are provided under In home services: Companion, Personal and Skilled.

• Companion Care is typically non-physical contact by the provider and is typically thought of as “sitting” services. Companion Care is provided by non-licensed personnel who receive basic training in care from the agency they are employed with. Services offered under this heading may include but need not be limited to: meal planning, lighthouse keeping, general companionship (Companion/Sitter)
• Personal Care includes all of the elements of Companion Care but may go further to include limited physical contact and work with Activities of Daily Living (bathing, dressing, grooming), transferring, stand by assist with walking. This level of care is typically provided by Nurse Assistants.
• Skilled Care is more invasive medical treatment. It includes general medical assessment and treatment. Typically, licensed providers are the only individuals providing Skilled care.

Michael Mackniak is an attorney, innovator and strategist. As a consultant for caregivers, decision-makers and fiduciaries, he is the nation's foremost speaker on the value of interrelated service systems and developing efficient methods for delivering resources to our most at need populations. Michael lectures across the United States demonstrating the effectiveness of proactive planning and avoiding costly interventions.