What do you do when an elderly family member suffers an illness, or an injury and they need round-the-clock care?
How do you help an older loved one remain independently in their own home?
Where can you find a professional caregiver that you can trust when all you’ve heard are horror stories about expensive nursing homes and inattentive care?
We know firsthand the stress and anxiety that comes with finding supportive care for your loved one, especially if this is your first-time looking for care. As a caregiver-owned home care agency, we believe in empowering the people we serve–both caregivers and clients–with the information and knowledge they need to make the right decisions. We hope this simple resource guide will help you as you compare your options for care and make the decision that feels right for you and your loved one.
How do I make sense of great options for home care in New York City?
Types of Home-Based Care
Before we explain your options, it’s helpful to understand some common terms and concepts.
First, there are important distinctions between
- private duty nursing,
- home health care,
- personal care,
- and companionship.
Often these different levels of care are captured under the umbrella terms Home Health Care or Home Care, but they are quite different, and can vary by state. Here are some simple definitions:
Private Duty Nursing:
Long-term, hourly nursing care at home for adults with a chronic illness, injury, or disability — Care is typically provided by a Certified Nursing Assistant (CNA)
Home Health Care:
Short-term, physician-directed care designed to help a patient prevent or recover from an illness, injury or hospital stay — Care is provided by a Certified Home Health Aide (HHA)
Help with non-medical, everyday activities (Activities of Daily Living- ADL’s) like toileting, bathing, dressing, grooming, meal preparation, and household tasks to enable independence and safety — Care is typically provided by a Certified Personal Care Aide (PCA)
Companion care is in many ways similar to personal care, but it does not include physical assistance with activities like dressing, bathing, or toileting. Rather, companion care is focused on light housekeeping, meal preparation, support with running errands, and as the name would suggest, providing companionship to seniors or people with disabilities who may otherwise be socially isolated.
How do I pay for home-based care?
Next, as you begin reaching out to potential home care providers you will undoubtedly be wondering how you will pay for the care you select. There are multiple “payer types” that you will likely be asked about and should be aware of:
Out of Pocket Pay/Self Pay:
You, the family member needing care, or some combination pay for care services out of household income, savings, or other assets. If you will need to rely on out-of-pocket pay, you will want to carefully consider the level of care needed and your ability to pay, and you may want to consult with a financial advisor for advice.
Long-Term Care Insurance:
Long term care insurance policies can typically be utilized to reimburse home care costs. If your loved one has a long term care insurance policy, you will want to call the provider early in your process to understand what level of coverage you have and whether there are limitations on the types of coverage or the agencies you can employ.
Medicaid Long Term Services and Supports:
For individuals with low income and assets, Medicaid may be able to assist with home care payments. To qualify, you will need to reach out to your local Medicaid office to determine eligibility and understand what level of care your loved one qualifies for. While the process of applying for and receiving benefits can be long and cumbersome, Medicaid support can be incredibly helpful for those who cannot afford to pay out of pocket. In some cases, individuals may also begin by paying out of pocket, but then over time transition to Medicaid as they spend down their assets.
If your loved one served in the U.S military, you may be eligible to access financial support from the VA for home-based care. Services and benefits vary by location, so you will want to reach out to your local VA office to understand what benefits are available.
State or City Programs:
In addition to Medicaid and Veterans Affairs, many states and cities also have long term care programs that support seniors and people with disabilities to remain in their homes. Often programs provide funding to individuals who do not yet qualify for Medicaid but are not in a strong financial position to pay for home-based care out of pocket.
To understand what types of programs might be available to support your loved one, contact your local Area Agency on Aging or Aging and Disability Resource Center for support.
3 Important questions to answer as you decide on a care plan
Now that you understand the different types of home-based care, and the different ways to pay for that care, you are well on your way to finding the right fit for your loved one. As a final step, we recommend asking and answering these three important questions:
1. How much care does my spouse/parent, grandparent really need?
While financial considerations will weigh heavily on your mind, try to answer this question honestly. Is it safe for them to remain at home? Do they full-time care when family is not available, or is the help they need minimal, but important to ensure they stay safe and are not isolated.
2. What kind of care do they need–private duty care, home health care, personal care or companionship?
Using the guide above, consider what level of care your loved one needs, which will impact the type of companies you reach out to and the costs.
3. What are my goals for home-based care?
In addition to the hard realities of what your loved one might need in terms of support with self-care, quality of life is an equally important consideration. Perhaps your loved one doesn’t need a high-level of care for safety reasons but could really benefit from regular companionship. Does your loved one have a primary language, enjoy time outdoors, or have hobbies that bring them joy?
What are the bottom-line needs you and your loved one need home care to attend to? Really consider, why you are selecting home based care and what hopes and dreams you have for that care. Having a clear understanding of your needs, motivations and goals for home-based care will help you navigate conversations with providers and find the best possible fit that also matches your budget.
If possible, involve your loved one in the conversation. Understand that the idea of home care may be scary or emotional to them. No one wants to lose their independence! But the more you can have an open discussion about the options upfront, and what it may mean to access home based care (or not) the better the experience will be for everyone involved.
What are my options for Home Based Care?
Finally, as you move forward in your search, it is also helpful to know that there are many different types of home care companies to choose from–from franchises and national chains to mom-and-pop shops and worker-owned home care agencies. To learn more about the types of home care companies and the important distinctions between them check out our blog here about worker-owned vs. franchise-owned home care.
We hope this guide is helpful to you as you consider your home care options and search for the best home care in Bronx, Manhattan and Brooklyn for your loved one. As a caregiver-owned home care agency we are committed to providing the best possible jobs to our caregivers so that we can provide the best possible care to our clients. You can learn more about our services HERE. Whatever you choose, we wish you the best of luck in your home care journey!