Over time, you may begin to notice some changes in your loved one’s upkeep and realize they need help with their daily routine. For many, it can be difficult to tell what that help should look like. The below information is laid out to give you an idea of how to get started.

For many people needing help, moving to assisted living or long term care is the next step. Often times, it’s hard to tell the difference between these two types of senior care or know which is right for your loved one.

There are different levels of care options as you begin to evaluate your loved one’s needs. These options can vary by state and can vary by payer source too. The first step is to understand the different types of care options, evaluate how your loved one’s needs best fit into those options and then discuss it with a professional in the field, such as a Primary Care Physician or ElderLaw attorney.

The first decision is to choose whether to receive care at home or in a facility. Then there are different levels of care at home or within a facility and many levels can be performed with either choice, of course with some exceptions. The most important factor is which option will allow your loved one to remain happy, healthy and independent for the long term.  

Here is some basic information you need to know to get started:

Home Health Care:

Receiving some form of assistance at home.

Care at home can be delivered in 3 different ways, depending on the level of care needed: Licensed Home Health Care, Certified Home Health Care or Consumer Directed Personal Assistance. Here’s the difference:

Licensed Home Health Care: Provides safe and reliable independent living in the comfort of one’s own home, offering skilled or non-skilled but non-medical services performed by a qualified paraprofessional staff under the supervision of a medical professional, generally a registered nurse who obtains primary care physician orders.

What is a skilled/non-skilled non-medical need? They are known as ADLs – activities of daily living such as eating, bathing, dressing, etc. See below for more information.

For a listing of NYS LHCSAs, click here: https://health.data.ny.gov/Health/Licensed-Home-Care-Services-Agency-Registration-St/ra3v-zevu

Certified Home Health Care: Skilled medical care performed by a medical professional for homebound patients with high level of care needs to remain safely at home.

What is a skilled medical need? Care that requires a professional license to handle such as physical therapy, would care, IVs, catheters, Ostomy bags, etc.

For a listing of NYS CHHAs, click here: https://profiles.health.ny.gov/home_care/special_needs/%22

Consumer Directed Personal Assistance: A Medicaid program that provides services to chronically ill or physically disabled individuals who have a medical need for help with basic activities of daily living or skilled nursing services in their home. This program allows individuals to choose their own untrained caregiver rather than have an agency place them with a licensed caregiver.  

What can an untrained caregiver do? All the things you require, in a combination of skilled medical and non-medical listed above. You as the consumer (or consumer’s representative) teach the untrained worked to be specifically trained in your needs.

Each of these home care delivery models have their similarities, all can provide assistance with daily living activities for someone who qualifies. The difference is the level of care and resulting qualification of the individual providing that care.  

Facility Health Care:

Receiving some form of assistance in a facility

There are two different types of facility living, depending on the level of care needed: Assisted Living and a Nursing Home. Here’s what you need to know:

Assisted Living:  a system of housing and limited care designed for senior citizens who need some assistance with daily activities but do not require a high level of care.

Nursing Home: a public or private residential facility providing a high level of long-term personal or nursing care for persons (such as the aged or the chronically ill) who are unable to care for themselves properly.

If they sound somewhat similar, think of it this way: Assisted living is primarily a housing option that provides some supportive care. Nursing homes are primarily health care facilities that also provide housing.

How Do I Know Which Type of Care My Loved One Needs?

There are so many contributing factors to a person’s care than can make it difficult to tell which type of care is best. Compounded by an emotional factor when this person in need is a loved one, makes it even harder. So if you have a question about the type of care that is best for your loved one, you do not have to make a guess. Instead, turn to professionals to help you make a decision. Our team at Premier Home Health Care is standing by 24/7 to answer any questions that you may have. Your Primary Care Physician is also a great resource for these questions.

First, you need to evaluate your loved one’s needs and how they would fit into the options above. Below are the types of assessments that providers will conduct to understand a person’s level of care need. Do your best to make your initial evaluation and then always consult a professional.

Activities of Daily Living (ADLs) include:

  1. Feeding oneself
  2. Bathing or showering
  3. Using the toilet
  4. Getting dressed
  5. Ambulating or moving around
  6. Remembering to take medications

Instrumental Activities of Daily Living (IADLs) include:

  1. Paying bills
  2. Grocery shopping
  3. Cleaning the house
  4. Running Errands
  5. Accompaniment to apts

If your loved one needs help with one or more of the ADLs or IADLs, they may be a good fit for some paraprofessional help. Depending on how many needs they have and the severity of those needs, would determine which delivery of care if best for them.

Skilled Medical Needs incude:

  1. Wound care
  2. IVs
  3. Catheters
  4. Ostomy Bags
  5. Physical Therapy

If your loved one needs help with one or more of these skilled medical needs, they may be a good fit for a higher level of help.

To help put it into real life perspective, here are some examples of client needs and resulting appropriate choice for care:

  • For adults who are still very independent and want to remain in their homes – but still need some help with grocery shopping and light housekeeping, a Licensed Home Health Care Agnecy would be a great choice. For a few hours a week, this agency can send an aide to their home to help with these tasks. These secondary tasks are often still supported by Medicaid if your loved one qualifies, and always supported by Private Pay options.
  • For those who are somewhat independent but need help with meal preparation, light cleaning and some self-care – the best option for home care services would be a Licensed Agency and for a facility would be Assisted Living. Both allowing for a sense of independence but providing support in some areas of need. als can help with bathing, dressing, feeding, ambulating and more. Licensed Agencies accepted Medicaid, many Long Term Care Insurances and Private Pay while Assisted Living is generally only supported by Private Pay.
  • For someone recovering from an injury and in need of short term professional care, such as physical therapy or wound care, the best course of action would be a Certified Home Health Care Agency that can supply medical services. Often covered through Medicare as well.
  • For an older adult who is severely ill or even bed bound but wants to remain at home with another loved one or simply because they would rather age in place, a great choice in care would be a Licensed Home Health Care Agency. As long as there are no medical needs for the illness, certified paraprofessionals can help with bathing, dressing, feeding, ambulating and more. Licensed Agencies accepted Medicaid, many Long Term Care Insurances and Private Pay.
  • Nursing homes are the obvious choice for seniors who need a high level of both non-medical and medical care and constant attention. Nursing home accept Medicaid and Private Pay.

If none of these examples sound like your situation, try giving us or your PCP a call to discuss your specific scenario in more detail.

Premier Home Health Care Services Customer Service Line: 866-720-0124