Home health care has emerged as a popular alternative model that allows patients to age, recover and lead a dignified life within the comfort and privacy of a familiar environment.
It can be just as effective as the care delivered in a hospital or skilled nursing facility, and less expensive than inpatient hospital care.
In-home care is a broad range of healthcare services whose beneficiaries can be categorized into: seniors, individuals recuperating after an illness or surgery, and individuals with disabilities.
The type of services rendered will determine the job title and responsibilities of the caregiver. This post explains the role played by different home health care professionals in three distinct scenarios.
For individuals living with disabilities
Individuals with disabilities benefit from professional in-home care. Home health aides can be of valuable assistance to individuals with development disabilities, patients living with acute or chronic conditions, and adults with mobility issues or acquired conditions after a stroke or multiple sclerosis diagnosis.
In situations where a family member cannot get by on his/her own owing to a physical, neurological or cognitive condition, a certified home health aide (CHHA) can offer assistance and support in a number of areas, as listed below.
- Transfers, mobility, ambulating and fall reduction
- Medication reminders
- Personal care such as grooming, dressing and personal hygiene
- Driving patient to medical and social appointments
- Meal preparation
- Collaborating with patient’s physical, occupational and speech therapists
- Helping maintain a safe and independent home environment for the patient
- Providing companionship
- Assisting with light household tasks
Benefits of hiring a home health aide for a disabled family member
HHAs provide differently abled individuals constant care and attention in a way that assisted living or nursing home facilities cannot.
Nurse-to-patient staffing ratios can improve considerably, and some states have sponsored bills to improve safety and care in nursing homes. 
In-home care from a trained aide also benefits the disabled client’s family members. Even a few hours of in-home care from a professional can prevent family members from taking on an unreasonable amount of responsibility and reduce risk of burnout. Importantly, it enables family members to continue working and financially support their disabled parent, spouse or child.
Home health care can be personalized to the individual needs of the differently abled client. For instance, if a 90-year old client has age-related memory loss, then the HHA or insured home care agency can include memory care as a service.
Need specialized care for a family member with a developmental disability?
Developmental disabilities are a group of chronic conditions resulting from physical, language, behavioral or learning impairment. They arise during an individual’s early life, and are both severe and long-term.
Direct support professionals (DSPs) work with people living with development disabilities. Much of their responsibilities are similar to those of home health aides, with an emphasis on more intensive and specialized care. And although, like HHAs, no certification is required to become a DSP, on-the-job training is focused on special needs, and more extensive pre-employment background checks are conducted.
Note: CHHA services for special needs may be reimbursed by Medicare, Medicaid, a managed long-term care plan or private insurance.
Also explore the benefits provided under the Medicaid Waiver program in your state.
The program generally provides coverage for in-home support, transportation and respite care.
Home health aides can assist seniors in a number of ways, and are often hired to help older adults remain independent, physically active and mentally agile.
Here are some scenarios where the services of a HHA are extremely helpful:
- Your 80-year old mom is active, in good health, and manages household chores on her own. But since your dad’s demise, she feels lonely from time to time. A home health aide can provide your mom companionship and, with advancing age, drive her or accompany her to doctor’s appointments and community events.
- An elderly family member requires assistance with self-care after a major surgery. A non-medical home health aide can provide comprehensive assistance in all matters of activities of daily living (ADLs) and ensure a safe home environment around the recuperating family member.
- Your 70-year old aunt has mobility issues and a weak eyesight. Although she lives in the comfort of your loving home, it is getting increasingly difficult to devote time to her personal grooming needs while managing your personal and work life. A home health aide can replace you as the extra pair of hands, helping your aunt maintain as much personal independence as possible while going about her daily activities safely and confidently.
These are examples of non-medical home health care for seniors. If you spot the following signs, your loved one may do well under the care of a home health aide:
- Increasing social isolation
- Undone household chores
- Unopened mail and many unpaid bills
- Difficulty with personal grooming
- Drastic weight loss
For in-home medical care, you should engage a certified nursing assistant (CNA) or licensed practical nurse (LPN). Examples of home health services delivered by these professionals include drug therapies (ex: intravenous therapy), monitoring medical dosages, physical therapies such as mobility exercises, wound cleaning and dressing, and pain management.
Dementia is unique to adults; 7% of adults aged 60 years and older have dementia, while 30% of those aged 85 and above exhibit a loss of cognitive functioning and behavioral abilities to the extent that it can affect their day-to-day life and activities. 
Dementia care requires specialized assistance, and this type of care is usually needed full-time. A full-time, live-in caregiver is one option; some families may request a 12-hour night shift when the aide can watch over the patient during night hours.
- Make sure you ask about the aide’s experience working with dementia patients. A trained and experienced dementia caregiver will have an understanding of the moods and behaviors associated with various forms of dementia, and be able to note when the disease progresses. Aides and home health agencies offering in-home dementia care should be able to customize a service to your specific requirements.
- Program of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid program intended to keep frail seniors out of nursing homes and in their community. It is available to individuals aged 55 years and above who qualify for nursing home care. Please refer to this article to learn more about the PACE program.
For individuals recovering from injury or sickness
Depending on the patient’s post-surgery or illness requirements, assistance can be provided by a CNA or non-medical home health aide.
Where medical care is needed, a CNA can support the patient’s steady recovery through medication management, fall prevention and wound or ulcer pressure management, and thereby also avoid unplanned hospital admissions.
When requirements pertain only to activities of daily living, a non-medical HHA can steadily improve the patient’s quality of life up until he/she is able to manage on her own or with minimal assistance. For instance, the patient may be advised to be physically active to regain muscle strength and avoid deep vein thrombosis.
However, they will need to pace their physical activity, aligned to the plan created by their doctor or medical adviser. HHAs can assist patients in following the best ways to stand, move, lie and follow the recovery plan until they can manage on their own.
It is also possible that the patient may get frailer as their illness or disability worsens, which will call for long-term in-home care. Here, the HHA may assist patients with all aspects of their daily routine, including meal planning, mental stimulation and medication reminders.
Note: Most insurers will pay only for skilled home care, such as temporary/short-term nursing care. If you need a skilled nurse after a surgery or illness, a prescription from your doctor ordering the services is necessary even if your insurer is covering the costs. Insurers typically don’t cover non-skilled care, such as from a home health aide, so you will have to plan out-of-pocket costs. That being said, a home health aide will cost you a lot less than a nurse, contingent on other conditions such as your location, hours of service and extent of services provided.
An understanding of the individual needs of a sick, aged or disabled loved one will help you make an informed decision on the type and extent of in-home care required.
Whether you determine that an unskilled/non-medical home health aide can improve the patient’s quality of life or a skilled professional such as a CNA or registered nurse can deliver the medical care necessitated by the patient’s condition, conduct a thorough background check, ask for references, and don’t hesitate to ask questions that will help you make an informed decision.