Seniors over 65 may be wondering what kinds of home health care benefits are covered under Medicare.
If you're a senior who struggles with maintaining your health and well-being on your own, you might be considering the help of a home health aide. Seniors over 65 may also be wondering what kinds of home health care benefits are covered under Medicare. Below we will break down who is eligible for Medicare coverage of home health services and actions you can take to get the care you need.
Eligibility, Medicare and home health
According to the Centers for Medicare & Medicaid Services, home health services have become increasingly popular for Medicare recipients, as they typically cost less and offer the same high level of care. Many home health services focus on preventative care to also reduce acute care costs and help seniors become more independent.
As a result, Medicare does allow seniors to attain home health coverage, but you have to be eligible to receive these services. Here are a few requirements you'll need to receive home health care, according to CMS:
What exactly is covered under Medicare's home health policy?
If you meet these requirements, you will not be expected to pay for home health care services per Medicare's policy, according to CMS. Additionally, Medicare will cover 20 percent of the amount approved from Medicare to be put toward durable medical equipment used while at home. Regardless of your home health needs, each agency should explain in full detail what is and what's not covered under these policies based on your condition, also known and the "Home Health Advance Beneficiary Notice."
Skilled nursing care is also covered when administered on a part-time or intermittent basis. Skilled nurses are defined as registered nurses and licensed practical nurses. Some of the treatments you may expect from these medical professionals include changing dressings, informing you about your prescriptions or diabetes treatments, administering IV drugs or shots, as well as tube feedings, if necessary.
Skilled nursing care is covered under Medicare if on a part-time or intermittent basis.
What isn't covered under Medicare's home health policy?
CMS also stated that the home health policies under Medicare only direct revenue to the services you need from your chosen agency. However, doctor visits and other routine appointments are generally already covered by existing Medicare benefits. Meals, 24-hour care, housekeeping services like cleaning, shopping, and personal care like bathing and dressing, generally are not paid for under Medicare policies.
You have the right to appeal
CMS also indicated that once covered home health plans come to an end, Medicare recipients have the right to a fast appeal. During this process, a quality improvement organization (QIO) will review your treatment plan and determine if you still require home health services. Under Medicare policy, the home health agency will send you a written notice at least two days before your home health treatment is scheduled to end, and it will also give you a breakdown of how you can appeal.
Home health services are a part of your care plan as a senior if you need them, so it's important to understand what is and is not covered under your Medicare plan. If you need more information about home health services and Medicare, be sure to contact your doctor or home health agency.Read in 3 minutes
The frightful night of Halloween is quickly approaching. If you're a grandparent, you've likely been thinking about fun activities to do with your grandkids.
The frightful night of Halloween is quickly approaching. If you're a grandparent, you've likely been thinking about fun activities to do with your grandkids. Whether you're at home or an assisted living facility, there are plenty of ways to make this spooktacular one to remember. Here are a few ideas to get started:
Spooky and sweet treats
Trick or treat? We say treat! Baking sweets with your sweeties is a great way to teach them kitchen skills, pass down family recipes and have fun. For little ones who aren't quite at the stage of measuring out ingredients, opt for desserts that you can decorate. Kids can easily top sugar cookies and cupcakes with icing and sprinkles - just pick festive Halloween colors like purple, green and orange. Or, these googly eye pretzels featured on the Lauren Kelly Nutrition blog are easy to assemble - even for little kids.
For grandchildren who are a little older and can follow directions, spend the afternoon creating an edible haunted house, like the one here featured on Woman's Day. Made with cookies, Golden Graham Cereal, candy and cookies, this dessert is to die for!
Watch a scary-ish movie
During this spooktacular holiday, it's all about balance. You can enjoy a night of hair-raising excitement without giving the little one's nightmares if you pick the right movies. It can be hard knowing which flicks are good for kids unless you've seen them, so we've created a list of family-friendly recommendations.
Don't forget the popcorn!
Read thrilling tales
You likely have fond memories of reading to your kids before bed, and now you get to do the same with your grandkids. As with the movie selection, it's important to find a book that isn't too scary. That means you'll have to leave Stephen King on the shelves. Instead, consider diving into these tales come Halloween:
Halloween is fun for all ages, from the young to the young at heart. Whether you watch a movie or gather around the fireplace for story time, spend this special holiday with your grandkids.Read in 3 minutes
Do you move your aging mother to an assisted living community, or do you hire a home health aide so she can stay at home? Discover the benefits of aging in place.
We only want what's best for our senior loved ones, but all too often, we are just unsure of what that really entails. Do you move your aging mother to an assisted living community, or do you hire a home health aide so she can stay at home?
The latter option, called aging in place, is often the preferred choice. According to a 2011 survey from AARP, about 90 percent of adults age 65 and older said they want to stay in their homes as long as possible. Plus, this long-term care route has plenty of advantages:
It's more affordable
While the price tag shouldn't be the only factor swaying your long-term care decision, it's important to consider what options you have within your budget. According to 2010 data from the U.S. Department of Health and Human Services, using home health aide services costs $21 per hour on average. Meanwhile, the mean monthly payment for an assisted community is $3,292.
You would need home health aide services for 40 hours per week to come close to that price. Depending on your loved one's health status, you may only require this type of care a few hours per day or when you're not around. Additionally, this reduction in cost has extended benefits, the executive director of the National Aging in Place Council, Marty Bell, told The Nation's Health.
"There are a lot of people who argue … that if enough people could be taught to age in place, and it's available to them, that it can really bolster the sustainability and strength of the Medicaid and Medicare program," Bell said. "So it's kind of a win-win for the individuals and the society as a whole."
Aging in place provides a sense of community
Your aging parent has spent a lifetime building family relationships and likely years bonding with neighbors. Removing older adults from their long-time homes can make them feel like those connections have weakened. According to research published in The Gerontologist, the majority of seniors want to age in place because of the attachment and familiarity they feel with their home and communities. While moving to an assisted living community provides opportunities to make new friends, older adults may rather maintain already-existing relationships.
It fights isolation
That sense of community provided through aging in place does more than make seniors feel comfortable. It is also integral for fighting feelings of isolation, a dangerous trend among seniors. Researchers from the University of Chicago found a link between loneliness and high blood pressure in older adults. The study authors noted that feelings of loneliness can occur even when a senior is surrounded by people - such as at an assisted living community. This further demonstrates the importance of the familiarity and sense of community provided through aging in place.
This is not to say that assisted living communities aren't a great option for long-term care. It all depends on your senior loved one's personality and needs. Have an open discussion about long-term care options so everyone's voice is heard.
CATEGORIESRead in 2 minutes
Your home is your safe haven, but for seniors, a house can all too easily turn into a maze of hazards. Fall-proof the space with these tips.
Your home is your safe haven, but for seniors, a house can too easily turn into a maze of hazards. In fact, according to the National Institute of Health, 60 percent of falls occur at home, but these incidents may be preventable. If you're caring for an aging parent, there are steps you can take to create a sound living environment for your loved one. Use this checklist as your guide for making modifications for a happier, healthier home:
Ensure home has adequate lighting
No matter how good your eyesight is, maneuvering in the dark is next to impossible. Keep the senior safe by equipping the home with adequate lighting. Go around the house and check for burned-out bulbs and replace them as necessary.
Additionally, consider the overall lighting structure. Walk through the house at night with the lights on, and see where the home could use some brightness. Perhaps one hallways is particularly dark, or you have to walk upstairs before being able to turn on the second-level light. In this case, you might benefit from bringing in an electrician who can install light fixtures in these spaces.
Fall-proof the bathroom
The bathroom is one of the most common places for falls due to activities like climbing in and out of a tub and stepping on wet surfaces. According to the U.S. Centers for Disease Control and Prevention, the older someone is when they slip in this room, the greater their risk for injury.
It only takes a few modifications to make the bathroom a little safer. Consumer Affairs advised installing grab bars near the tub and toilet. Remember, towel racks are not a replacement for grab bars, as they are not as sturdy and could easily dislodge from the wall under a person's weight.
To prevent falls in the shower itself, use non-slip bath mats or considering placing a shower chair in the tub. The latter option is especially beneficial for seniors who have trouble balancing.
This simple task holds a lot of importance. Straightening up a home by clearing clutter, tucking away electrical cords and bringing stools back next to the table they belong to can go a long way in reducing the risk of tripping. The National Safety Council also advised wiping up spills as soon as they occur to prevent the senior from slipping on a wet surface.
Throw rugs are also a common cause for falls, as seniors may trip over their raised edges. Make sure rugs stay flat to the ground, or get rid of them altogether. You can certainly make someone feel accepted in your home without a welcome mat!
Some seniors may need assistance with daily living tasks to stay safe at home, even with these modifications. In this case, considering hiring a home health aide who can assist with bathing, dressing, eating and other duties.Read in 2 minutes
Hiring a home health provider for your senior loved one can be an intimidating experience.
Hiring a home health provider for your senior loved one can be an intimidating experience. You want to ensure that you have the best person for the job, which means they need to meet certain qualifications. Beyond having the right credentials - that is, the appropriate education and certifications - they should also have the necessary skills and personality traits. Here are a few to look for during the hiring process:
How well does the candidate convey his or her ideas? If you find you're more confused after asking a question to the home health aide than you were beforehand, he or she may not be the best at effectively communicating. Don't overlook this detail - the home health aide may have to relay information to you or your loved one's doctor. Doing so in an effective manner can ensure the senior gets the best care possible.
For example, imagine if the home health aide didn't speak up about a concern regarding the senior's lack of appetite. You could go for far too long without realizing there was a problem!
You no doubt want the senior in your family to spend time with someone who shows empathy and emotional support, so don't hire a cynical home health aide! Consider the candidate's demeanor during your initial conversation. Does the individual smile and shake your hand? Did you two make small talk before diving into the interview? Those interpersonal skills are crucial for making the home health care experience positive for everyone involved.
According to the U.S. Bureau of Labor Statistics, integrity is an important trait among home health providers. After all, these individuals are helping the senior with personal activities like dressing and bathing, and you want your loved one to feel comfortable during this process. Plus, you want peace of mind knowing you're leaving older adult with someone who will always be honest.
This trait can be hard to spot - everyone will say they're trustworthy, after all. To really evaluate whether candidates are the right fit, ask them to describe a situation in which they came to an ethical dilemma. How did they overcome the situation?
Able to work under pressure
While most shifts spent caring for your senior loved one may involve leisurely afternoons at the park or helping with daily living activities, others might not be as smooth sailing. Be sure that the home health aide you hire can work well under pressure so he or she will be ready to act in an emergency. Always ask what steps the individual would take if your loved one falls or becomes seriously ill. This will give you a more realistic picture.
As long as the home health provider's resume checks out and he or she has these traits, you should be in good shape!Read in 2 minutes
Saving money is an integral part of enjoying a comfortable lifestyle, but many seniors in retirement have gone far too long without doing this.
Saving money is an integral part of enjoying a comfortable lifestyle, but many seniors in retirement have gone far too long without doing this. In fact, this financial issue has become somewhat of a crisis in the U.S. According to a report from the National Institute on Retirement Security, the median savings for older adults on the cusp of retirement is only $12,000.
For those who haven't put away enough quite yet, there are still ways to get by later in life. This is even true when it comes to healthcare, which often comes with a hefty price tag. Check out these three money-saving tips for seniors:
1. Pick the right prescription drugs and pharmacy
You shouldn't have to choose between your medications and a meal, but for many seniors, that's a decision they face on a regular basis. According to a study published in the Journal of General Internal Medicine, 8 percent of older adults without any prescription drug coverage will skip doses or come off entirely. This, of course, can have serious ramifications for one's well-being.
Beyond reviewing your health insurance options, you can also use certain strategies to save on medications. For one, always opt for generic versions of drugs when possible. Making this simple request with your doctor can significantly cut healthcare costs. A report published by the Generic Pharmaceutical Association found that this alternative approach resulted in $92 billion in savings for seniors in 2014 alone.
Additionally, as you might have already discovered, the cost for prescriptions varies between pharmacies. This is due to differences in businesses expenses, like overhead costs and profit margins. To find the best deal, shop around at both your privately-owned local pharmacies and retail chains.
Get flu shots for free.
2. Know what you can get for free
You don't have to pay a single dime for certain components of your wellness plan. For example, did you know many preventative services are free with Medicare Part B? This includes some vaccines, like the flu, hepatitis and pneumococcal shots, in addition to various screenings such as those for cardiovascular disease and lung cancer.
Certainly, a free flu shot is cheaper than getting sick and paying for doctor's visits and hospital stays. In fact, a 2010 study published in the journal Health Affairs found that the increased use of preventative services in the U.S. can lead to an annual average savings of $3.7 billion!
"Preventative services can save $3.7 billion annually!"
3. Consider aging in place
Many seniors require long-term care, and there are plenty of options at their disposal. Those looking to remain cost-efficient might consider "aging in place," a phrase used to describe when older adults utilize home health services instead of assisted living communities. Not only does this allow you to remain in the comfort of your own house, but it can also save you a lot of money.
A semi-private room in a long-term care facility costs a monthly average of $6,235 while home health aides charge about $21 per hour, according to U.S. Department of Health and Human Services. Calling on these home health professionals for even eight hours each day would still cost less per month than seeking care elsewhere.
In addition to coming up with a wellness strategy that doesn't cause pain for your wallet, be frugal in all areas of life. That is, stick to a budget and cut out unnecessary expenditures to ensure you always have enough money to take care of your health.Read in about 3 minutes
For older adults and their caretakers, safety should be top-of-mind during summer.
Summer is here, which means it's time for fun in the sun and some much-needed relaxation. For older adults and their caretakers, safety should be top-of-mind as well. After all, depending on where you live, you could see temperatures skyrocket to well over 100 degrees!
According to the National Institutes of Health, seniors are especially prone to hyperthermia, which occurs when the body can't adequately respond to increases in temperature. This can result in conditions like heat exhaustion, fatigue and stroke. To ensure the season is enjoyable for folks of all ages, stay cool with these following tips:
1. Dress up in cool clothes
Many home health providers have to help their senior clients with getting dressed each day - an especially important task in the summer months. After all, an older adult who is not prepared to perform this daily task may end up in a sweater and coat when it's sweltering outside.
While tanks and capris are great for cooling off, they won't protect the senior from the sun. Ensure the individual is wearing sunscreen when you head outdoors, and consider having him or her wear a hat. The head wear will create a little bit of shade to help shield the body from harmful UV rays. Also, if it's cool in the morning, opt for layers so the senior can remove them throughout the day.
A hat can help protect the senior's skin from the sun.
2. Take water everywhere
Always have a cold bottle of water on hand, and keep track of how much fluid the senior consumes and with what frequency. This will help stave off dehydration, which can lead to anything from a minor headache to decreased blood pressure. The latter symptom should be considered a medical emergency, according to the Mayo Clinic, and it's best to avoid getting to that point altogether.
If the older adult is reluctant to sip on plain water, flavor the beverage with pieces of fruit. Just be sure to avoid alcoholic beverages, as this can increase the risk for dehydration.
3. Find fun indoor activities
The best way to beat the heat is to not go out at all. While caretakers should still spend time outdoors with the seniors during summer, indoor activities might be better on especially hot days. For example, check out the latest movie at the theater for a morning matinee. Otherwise, arrange a day to scrapbook and look through old pictures!
As a home health provider, it is important to keep your senior clients safe this summer. With these tips, you can help the client avoid heat-related illness while still enjoying the season.Read in 2 minutes
There may never be one defining event that alerts you to schedule a tour of an assisted living community, but there are often more subtle signs that can let you know you're heading in that direction.
In life, there really is no "ideal" time for what matters most. Whether you're trying to find the perfect moment to get married, have kids, relocate or switch jobs, there won't be some ringing alarm clock letting you know when to make your move.
The same concept applies to determining when to move a senior parent to assisted living. There may never be one defining event that alerts you to schedule a tour of the surrounding senior communities, but there are signs that can let you know you're heading in that direction. Here are a few to watch out for:
1. Your senior parent needs assistance with daily activities
If you've gone to your parent's house and realized he or she is still wearing pajamas at 4 o'clock in the afternoon, this is an indication that the senior needs help with daily living activities. As the National Institutes of Health explained, assisted living communities help residents with tasks like dressing, eating and bathing. However, the seniors still maintain some level of independence.
While wearing the same outfit twice in row isn't the end of the world, this habit has implications for the senior's hygiene and overall well-being. You want to ensure your parent has fresh clothes and bathes regularly to remain healthy. Additionally, being provided with monitored meals may allow your parent to eat more nutritional foods. According to the NIH, a well-balanced diet can help seniors stave off conditions like Type 2 diabetes, anemia, heart disease and bone loss.
"Falling is the No. 1 cause of traumatic brain injuries in seniors."
2. Your loved one has fallen
When kids fall, they may end up with scraped knees, but they can usually hop right back up. Older adults can't recovery quite as quickly, and taking a tumble comes with serious risks. According to the U.S. Centers for Disease Control and Prevention, a serious injury, like head trauma, will occur in 1 in 5 senior falls. In fact, falling is the No. 1 cause of traumatic brain injuries in adults age 65 and older.
Falling doesn't only cause problems for a senior's well-being; it can also inhibit his or her lifestyle. As the CDC noted, older adults may be afraid to fall again, so they avoid remaining active, which can lead to further health decline.
Assisted living communities are built with seniors in mind. That means there will be less of a risk for tripping over clutter in the hallway, and bathrooms are often equipped with railings. Not only might this help prevent the issue from recurring, but it can also offer peace of mind. You certainly don't want your parent sitting inside all day out of fear of getting injured.
3. You've noticed the older adult may need memory care
Many assisted living communities offer memory care, which can be beneficial for seniors experiencing cognitive decline. Remember, serious forgetfulness is not a normal part of aging. That is, leaving their phone at home while running to the grocery might not be cause for concern for older adults, but repeatedly asking the same questions or inability to focus generally raise red flags.
Assisted living communities are beneficial because they can prevent the dangerous repercussions of some of dementia's side effects. For example, those with this condition may wander. The Alzheimer's Association advised families of at-risk individuals to keep a close eye on the senior or put devices on the doors that alert you when they are opened. Assisted living communities can provide both supervision and security.
4. The older adult wants more social opportunities
One of the greatest perks for residents of assisted living communities is the opportunity to socialize. Often, seniors at home are limited to whom they can interact with - perhaps a few friendly neighbors if they're lucky. Assisted living communities, on the other hand, organize exercise classes, outings and community events in addition to supplying a space for residents to hang out.
Spending time with friends and participating in fun activities don't just enhance a senior's quality of life but can also protect their well-being. According to the University of Rochester Medical School, staying social may reduce older adults' risk for heart disease, osteoporosis, rheumatoid arthritis and some cancers.
5. You've become stressed as the caregiver
Your well-being is important, and being a stressed-out caregiver isn't doing your loved one any favors. You might have hesitations about putting your parent in an assisted living community. However, it's important to look at the big picture of the situation. Consider all the benefits your loved one gains by moving and how your family dynamic will change for the better.
You love your parent and want the best for him or her, and keeping all your options open will help you do just that. Assisted living communities provide the perfect balance of care and independence.Read in 4 minutes
Everyday occurrences can easily lead to everyday negativities. And everyday negativities can just as easily lead to unnecessary frustration for you and for the person in your care. Why not try speaking positively?
Caregivers, have you noticed how often what you say may be demeaning to the person in your care, even though you don’t mean to make them feel bad? Everyday occurrences can easily lead to everyday negativities. And everyday negativities can just as easily lead to unnecessary frustration for you and for the person in your care.
Here are some examples of how to incorporate Positive Speak into your daily conversation that will lift the spirits and self-esteem of the person in your care (or at least keep them from feeling bad):
It’s easy to refer to adult diapers by their brand names, or to actually call them diapers. Imagine how they feel about needing to wear them. Instead, try saying this:
The person in your care may not realize that their favorite clothes need washing. It’s possible that the exercise of changing their clothes can be taxing on them. Instead try saying this:
The person in your care may not be in the mood for what you served, or they may not really be hungry. Try asking them how you can get them to eat by saying this:
When someone is dependent upon you for their every need, they oftentimes cause a lot of clutter through no fault of their own.
The person in your care didn’t get to where he or she is overnight. Their current situation comes with their history, and it’s not hard to remind them of the negative aspects of their personality. Try to embrace their stubbornness by deflecting their behavior.
What other ways can you engage in positive speak with the person in your care to encourage a brighter situation?Read in about 3 minutes
Caregivers, if you live a short distance away from the person in your care and not under the same roof, it can be difficult to know exactly what you need to do and when to do it. You may also be confronted with resistance to your help by the person in your care.
Caregivers, if you live a short distance away from the person in your care and not under the same roof, it can be difficult to know exactly what you need to do and when to do it. You may also be confronted with resistance to your help by the person in your care.
To be sure you’re doing everything that person needs, take a moment to create a plan that will help both of you.
Chances are the person in your care is someone you dearly love, and it’s easy to overlook that fact when you’re rushing around perhaps stopping by after work or in between picking up the kids from school and getting them to music lessons to practice. Make the most of your visits by going beyond just dropping in from time to time. Instead, sit down and visit with them. Tell them how much you appreciate what they’ve done for you in the past. Describe events and moments where you felt your cup overflowing with their love. This exercise will be a reminder to you of the person he or she once was and, despite their situation, still is.
Be sure you have frequent conversations with the person in your care about what’s going on with them. Have there been any changes in their level of pain, emotional stability and medications? Ask them how these things are affecting them. Discuss options for easing pain, whether more frequent visits will help with emotional stability, or whether medication adjustments are necessary. If you find yourself arguing because they are resisting your suggestions, validate their feelings. Tell them that you understand how difficult their situation must be. Ask them what they think will help.
While you’re at it, talk about what’s going on with you. Let them know how you’re feeling both physically and emotionally. You’d be surprised at how much they care about you and welcome the opportunity to help ease some of your burdens.
Pay close attention to changes in the person in your care. Pick one day a week and write down your observations in a journal so that from week to week you can compare your notes to alert you to subtle changes that are occurring. Is it taking longer to eat, dress, or walk from one room to the other? Are they eating well? Is their hearing diminishing? Are they showing signs of memory loss?
If you determine the person in your care needs more help, make arrangements. Schedule doctor visits to address medical and emotional issues. Readjust your schedule or enlist the help of others to spend more time with them. Line up meal deliveries, visiting pets for “fur” therapy, physical therapy/massage appointments and visits by relatives and friends.Read in 2 minutes