Home Care

To qualify for Medicare home health coverage, you must meet all four of the following conditions:

• Your doctor must determine that you need medical care in your home and prepare a plan for your care at home.
• The care you need must include intermittent (not full time) skilled nursing care, or physical therapy or speech language pathology services.
• You must be homebound. This means you normally are unable to leave your home. If you do leave your home, it is with considerable and taxing effort. Absences from home must be infrequent, or of short duration, or to get medical care. You can still be considered homebound if you occasionally go to the barber or beauty shop or for a walk around the block or a short drive.
• The home health agency serving you must be approved by the Medicare program.

Medicare Services Covered

• Skilled nursing care either on an intermittent or part-time basis. Skilled nursing includes services and care that can only be performed safely and effectively by a licensed nurse.
• Home health aide services either on an intermittent or part-time basis. Home health aide services include assistance with personal care such as bathing, using the toilet, or dressing. These types of services do not require the skills of a licensed nurse.
• Physical therapy as often and for as long as it is medically necessary and reasonable. Physical therapy includes exercise to restore movement and strength to an injured arm or leg, and training in getting into and out of a wheelchair or bathtub.
• Speech language pathology as often and for as long as it is medically necessary and reasonable. This type of therapy includes exercises to restore speech.
• Occupational therapy as often and for as long as it is medically necessary and reasonable, even if you no longer need other skilled care. Occupational therapy helps you to achieve independence in daily living by learning new techniques for eating, dressing and performing other routine tasks.
• Medical social services to assess the social and emotional factors related to your illness, counseling based on this assessment, and searches for available community resources.
• Medical supplies like wound dressings.
• Medical equipment. Medicare pays 80 percent of the approved ammount. An example of medical equipment would be a wheel chair or walker.

Medicare Services NOT Covered

• 24-hour care at home.
• Self-administered prescription drugs.
• Meals delivered to the home.
• Homemaker services such as shopping, cleaning and laundry.
• Personal care provided by home health aides, such as bathing, toileting, or providing help in getting dressed when this is the only care you need. Medicare classifies this as “custodial care” because it could be provided safely and reasonably by people without professional skills and training. Medicare does not pay for “custodial care” unless you are also getting skilled care such as nursing or therapy and the custodial care is related to the treatment of your illness or injury.

• To choose your home health care provider for yourself (Medicare guarantees this right)
• A single point of contact at your Home Health Care Agency (known at Peninsula as your “Clinical Manager”) for key information
• Clear and ongoing coordination between your Home Health Care team and your doctor’s practice
• Respect of your privacy, your dignity and your home

Many of our patients and their caregivers ask us to explain the difference between Original Medicare and Medicare Advantage. Neither is a “one-size-fits-all” program, and each has benefits and liabilities worth considering. Here’s a quick overview. More information can be found on our site and at www.medicare.gov. Compare Medicare Part D and Medicare Advantage plans available locally on the PlanFinder section of the Medicare website.

There are many resources available for caregivers. In addition to those listed below, your local library is a good source of information. Many libraries offer disease-specific articles and publications, information about community resources, and access to the internet.

Organizations and Internet Resources:

National Family Caregivers Association
10400 Connecticut Avenue, Suite 500
Kensington, MD 20895
1-800-896-3650
Web: www.nfcacares.org

Friends Health Connection
PO Box 114
New Brunswick, NJ 08903
1-800-483-7436
Fax: 732-249-9897
Web: www.friendshealthconnection.org
Info: Links persons with illness or disability and their family caregivers with others experiencing the same challenges.

Well Spouse Foundation
30 East 40th Street PH
New York, NY 10016
1-800-838-0879
Web: www.wellspouse.org
Info: A national, not for profit membership organization which gives support to husbands, wives and partners of the chronically ill and/or disabled. They offer support group information for spouses.

AARP
601 E Street, NW
Washington, DC 20049
1-888-687-2277
Web: www.aarp.org

Children of Aging Parents (CAPS)
PO Box 167
Richboro, PA 18954
1-800-227-7294
Web: www.caps4caregivers.org
Info:CAPS assist caregivers of the elderly with information and referrals, a network of support groups, and publications and programs that promote public awareness of the value and the needs of caregivers.

Eldercare Locator National Association of Area Agencies on Aging
1730 Rhode Island Ave., Suite 1200
Washington, DC 20036
1-202-872-0888
Web: www.n4a.org
Info: Referrals to Area Agencies on Aging via zip code locator. Offers information about many eldercare issues and services in local communities.

The National Association of Professional Geriatric Care Managers
1604 Country Club Road
Tucson, AZ 85716
1-520-881-8008
Web: www.aginglifecare.org
Info:Geriatric care managers (GCMs) are healthcare professionals, most often social workers, who help families in dealing with the problems and challenges associated with caring for the elderly. This national organization will refer you to their state chapters, which in turn can give you the names of GCMs in your area.

Metlife Resources for Caregivers
This popular guide provides a list of resources for a variety of caregiving situations. You can download it at the following link (requires Acrobat Reader): www.metlife.com/WPSAssets. If you cannot download the file send an email to [email protected]

Additional Resources

Today’s Caregiver Magazine
www.caregiver.com

www.familycareamerica.com
Info:Offers varied resources to meet caregivers’ specific needs, in their own localities, provides support, solution sharing, and discussion forums. 

National Alliance for Caregiving
www.caregiving.org 

Family Caregiver Alliance
www.caregiving.org

Administration for Community Living
https://www.acl.gov/programs

Websites on Senior Care:
www.caregiving.com
www.careguide.com 
www.carescout.com

Senior Health Insurance Information Program:
SHIP educates and assists Medicare beneficiaries, those eligible for Medicare, and caregivers about Medicare, Medicaid, Medigap, pharmacy assistance programs, and other issues related to health insurance. 

Maryland:
(in state) 1-800-243-3425
(out of state) 1- 410-767-1100
www.mdoa.state.md.us/Services/ship.html

Delaware:
(in state) 1-800-336-9500
(out of state) 1-302-739-6266
www.state.de.us/inscom/eldindex.html

Respite Services – National Organization and Programs:

Easter Seals
230 West Monroe Street, Suite 1800
Chicago, IL 60606
1-800-221-6827
Web: www.easter-seals.org
Info: Provides a variety of services at sites nationwide, including adult day care, in-home, and more.

Shepherd’s Centers of America
One West Armour Street, Suite 201
Kansas City, MO 64111
1-800-547-7073
Web: www.shepherdcenters.org
Info: Provides respite care, telephone visitors in-home visitors, home health aides, support groups, adult day care, and information and referrals for accessing other services available in the community.

National Association of Adult Day Services National Council on the Aging
1901 L Street, N. W. 4th floor
Washington, DC 20036
1-202-479-1200
Web: www.ncoa.org
Info: Provides information about locating adult day care centers in your local area.

There are millions of caregivers across the nation serving the aging population, and many do not take or always have the time to care for themselves.

The old saying is true: ‘You can’t take care of others well unless you take care of yourself.’ It’s very important that Caregivers make sure they stay mentally, emotionally and physically healthy – for their loved one, but for themselves as well.

Here are some tips to help Caregivers not only survive, but thrive:

• Make your own health a priority. Eat well and get enough sleep.
• Accept help from others. People who offer genuinely want to help.
• Communicate effectively with doctors to avoid confusion and crisis.
• Seek support from other Caregivers in support groups, at your house of worship and/or with friends.
• Take time to recharge doing something you like – read, take a walk, workout or meet a friend for lunch.
• Organize medical information so it’s up to date and easy to access.
• Learn more about available caregiver resources in the community.
• Know what legal authority you have in case of emergency.

For more information, please visit the Maryland MOLST website:
http://dhmh.maryland.gov/marylandmolst/

DMOST (Delaware Medical Orders for Scope of Treatment) is an end-of-life directive created by doctors in conjunction with their patients. It provides a single document that outlines the patient’s medical conditions and their end-of-life treatment preferences, and travels with the patient wherever they go for easy access by medical professionals. For more information, visit: http://delawaremost.org/