Almost everyone wants to remain in their own home as long as possible. The best way to do this is to become knowledgeable about what services are available to help you maintain your independence at home. If you need help to maintain your independence and fail to obtain this help, you are placing yourself in a danger zone, where you jeopardize the very independence you are trying to preserve. Here is an overview of a number of home care services. Some are more readily available than others, and some have specific eligibility requirements. Consequently, not all services are available to all people.

A Medicare Certified Home Health Agency provides intermittent skilled care visits by nurses, physical therapists, occupational therapists, speech therapists, and social workers to individuals who are homebound. These services must be ordered and under the direction of a physician. The cost for services is covered by Medicare and most other insurances. Medicare will also cover a home health aide as long as one of the skilled services is needed. Many times these services are provided following a hospitalization, but they can be ordered by a physician any time there is a need for skilled care for a homebound individual. Once the skilled care need is met, Medicare and other insurances stop paying for the service.

Durable Medical Equipment (DME) companies provide medical equipment for use in the home, such as walkers, wheelchairs, hospital beds, and lift chairs. Some DME companies provide oxygen, respiratory equipment, enteral (tube) feeding supplies, and infusion (IV) supplies. Some equipment and supplies are covered by Medicare and other insurances when they are ordered by a physician.

Area Agency on Aging – There is a statewide network of 52 county-based agencies covering all of Pennsylvania. Each one develops a plan of services to fit the particular needs of the senior citizens living in its area. Most services are offered free or on a sliding-scale basis. Some services they have in common are: Information and Referral, Protective Services, In-Home Services, Family Caregiver Support, Legal Assistance, Ombudsman Services, Transportation, Management of Services, the Apprise Program, Senior Community Centers, and Volunteer Services. Due to financial constraints there may be waiting lists for some services. Cumberland County Aging and Community Services covers the Carlisle area and beyond. Their office is located at 1100 Claremont Road, Carlisle, PA, and the phone number is (717) 240-6110.

Home Care Agencies (Private Duty) generally offer non-medical help in the home, although there are some agencies which have LPNs and RNs on staff. Some agencies have a minimum service time, so it is smart to think of all the ways they can help you in the time that they are there. With the exception of some Long-Term Care Insurance Policies, the cost for this service is normally an out-of-pocket expense. For your protection, t is always wise to find out how a caregiver’s medical expenses and loss of income are covered if the caregiver is hurt while providing care.

Transportation services are designed to help people get to medical appointments, government agencies, social service organizations, and shopping. Some counties handle transportation through the Office of Aging, some counties have created a transportation department, and some counties contract with established companies to provide transportation services. For service from the Cumberland County Transportation Department, call (717) 240-6340.

Waiver Program – This is a program for individuals who meet both the financial and medical requirements for Medical Assistance (Medicaid) to pay for nursing home care. Under the Waiver Program, however, Medicaid pays for the care to be received at home instead of in a nursing home. It cannot pay for a caregiver to be in the home 24 hours per day, so not everyone who needs nursing home care can utilize it. The Cumberland County Aging and Community Services office can provide more detailed information.

LIFE Program – This program is similar to the Waiver Program and has the same medical and financial eligibility requirements, but much like an HMO, a single company coordinates all the needed care with the company’s own providers. The biggest difference between the Waiver and LIFE programs is that with the LIFE program, participants go to an Adult Day Health center for many services. Life Lutheran Services, Inc. plans to begin a LIFE program in Cumberland County in February, 2013.

Technology Devices – Presently, there are emergency telephone alert devices, medication monitoring systems, and telehealth services available, but the number of different devices and applications will mushroom in the future as the most cost-effective way of keeping Baby Boomers healthy and safe at home and out of expensive care facilities. The concept of telehealth is to check various aspects of a person’s health in that person’s home, but to have the results sent electronically to a trained individual to review. The hope is that medical problems will be identified sooner so they can be treated in the home, rather than in a hospital. Some of the types of health checks that existing equipment can perform are: blood pressure, weight, oxygen saturation levels, blood sugar, and pulmonary function.

Now that you have a better idea of what home services are available and a little information about how they work, hopefully, you will be able to avoid the danger zone and enjoy remaining in your own home.

John Reese
Elder Care Coordinator