Caregivers Confusion: Explaining "In Home Care" to Caregivers

Many of us speak of obtaining care for our loved ones or clients so that they can remain in their homes. This is the ideal setting for people in most circumstances.

The concept of “in home” care has gained universal awareness and acceptance. Indeed, the term “home care” has become a part of our vernacular or lexicon. We use the term “home care” to represent all services that an individual may receive while living at home. This is like saying that all facial tissues are Kleenex brand or all cotton swabs are q-tips.

When determining the appropriate type of care for home based services, the overarching question goes first to client choice and then, immediately to the payer source.

“Home care” is a fee for service, out of pocket, expense which is the responsibility of the person receiving those benefits. Under a true “home care” plan, the client, patient (or their caregiver) is the person who decides when, where and how much service shall be offered.

“Home health care” is government subsidized care, typically through medicare or medicaid and, in some instances, some private insurance companies. Under “home health care”, the “government” essentially, makes the determination as to when, where and how much care a person will be eligible to receive before they are required to reach into their own pocket.

There are three basic levels of care that are provided under in home services: companion, personal and skilled.

Companion care is typically non-physical contact by the provider and is typically thought of as “sitting” services. Companion care is provided by non-licensed personnel who receive basic training from the agency they are employed with. Services offered under this heading may include but need not be limited to: meal planning, lighthouse keeping, general companionship (companion/sitter)

Personal care includes all of the elements of companion care but may go further to include limited physical contact and work with activities of daily living (bathing, dressing, grooming), transferring, stand by assist with walking. This level of care is typically provided by nurse assistants.

Skilled care is more invasive medical treatment. It includes general medical assessment and treatment. Typically, licensed providers are the only individuals providing skilled care. Here is where we may see therapy and medications administered.

A comprehensive care plan must consider the specific care needed, services available through home health care and, finally, the supplementation of care through home care services.