There is no one-size-fits-all answer to the question of when is the right time for homecare, due to variations among individual health levels as well as in the abilities of the elderly to live on their own, performing routine tasks such as self-care or housekeeping. Some may need assistance sooner, due to an accident, surgery or debilitating illness, while healthy individuals may be able to live independently well into their 80s and beyond. Mental health issues often crop up late in life such as dementia or Alzheimer’s disease, making caring for elderly relatives even more challenging.
What is homecare?
The majority of homecare recipients, however, are the elderly, most of whom wish to “age in place” by remaining in their homes and whose needs range from simple assistance with light housekeeping to more extensive personal care, such as bathing, meal preparation or transportation. It should be noted that homecare is not the same as home health care, both in terms of the type of services rendered as well as Medicare’s reimbursement for providers.
A doctor must request home health care assistance, usually for a specified amount of time and for specific conditions. Homecare, on the other, needs no physician request, as it is usually limited to duties, such as housekeeping or meal preparation, of a non-medical nature.
Factors in determining homecare readiness
The following are good indicators of when it may be the right time for homecare evaluations and starting the conversation about getting extra help:
- The patient’s primary physician has previously performed an evaluation of their physical and cognitive abilities, in order to determine whether there is a need as well as type of care needed. If seeking Medicaid or long term care (LTC) payment assistance, these and other criteria are required.
- Does the patient require just homemaker services for housework, laundry and meal preparation or do they require more extensive assistance, such as bathing, dressing and other personal care tasks?
- Availability of family members or others with the training and ability to provide the level of care needed: many adult children and even some spouses are already employed outside the home with workplace obligations that reduce their availability to provide a high level of care. Holding down a job while providing care for an older family member can be physically exhausting as well as a major source of stress, which can eventually take a serious toll on a caregiver’s physical and mental health.
- If family members are already providing care, is there a backup plan, such as a homecare agency or reliable outside caregivers, able to take over on short notice if they are ill, traveling or otherwise unable to provide care?
- Finally, if the patient begins to experience increased frailness, including falls or mobility issues, clutter piling up, unsanitary conditions, wearing dirty clothes or not bathing, these are indications of the need for help. These may not necessarily indicate cognitive decline but simply a physical inability to handle routine tasks once easily performed.
Your loved one’s physician is in the best position to determine when is the right time for homecare by evaluating whether the person is a good candidate for remaining at home with care rather than in a long-term care facility, and if staying home, the kind of assistance needed.