Care In The Home

Need Care in the home? Who Ya’ Gonna’ Call?

Having spent my career in the health care field, I often get calls from people asking for my help or advice when they need care for a loved one at home.  Finding care in the home can be a difficult task. There are many different types of care one might need, which then dictates the actual service options. To compound the confusion, there is a broad range of costs and availability of personnel to consider.

Usually, people’s first inclination is that they want to hire a private duty nurse and ask me if I know of anyone they could hire. In most cases, it really isn’t a nurse that is needed – there are no complicated medications involved, no tube feedings, nothing needing a licensed RN or LPN to perform. What is needed is someone reliable to help with bathing, getting someone up and out of bed, or feeding and sitting with a loved one while the family member is away. These are tasks that can be carried out by an in-home aid or a Certified Nursing Assistant (CNA). But finding such a person to help is often challenging. With the current healthcare worker shortage, people willing to work “private duty” are few and far between.  In addition, you can expect to pay a good bit for this service. Statewide, per the 2020 Genworth Cost of Care Survey, the average rate for non-medical personal care is $20 per hour, and that survey is two years old, so the current rate is closer to $25/hr.

Fortunately, there are some options we have in our community. I talked with Teresa Dakins, who is the Community Outreach Coordinator for Trinity at Home. Teresa shared, “The most important issue for people who need help is to understand the difference between HOME CARE and HOME HEALTH. One way to understand it is to think of whether you need a doctor’s order – which would be HOME HEALTH or no doctor’s order – which would be HOME CARE.” Home Care is typically private pay, although some Long-Term Care insurance policies may pay for some services. With Home Care, there are a number of agencies in our community that provide those services and are typically tailored to meet the client’s needs. If you go through an agency like Trinity at Home, which is licensed by the state of NC, a nurse will come out initially and meet with the client and family and do an assessment. Needs that might surface could be medication reminders, personal care such as bathing and dressing, meal preparation and assistance with feeding, grocery shopping, light housekeeping, driving the client to church, appointments, or even taking them to a wedding. Teresa said her agency has provided help with six weddings this year by taking elderly clients and staying with them for the event.  Home Care agencies can be hired for ongoing care or can provide short-term “Respite Care” during which they may be hired as a one-time event while the family is out of town. Again, the rates for Home Care average about $25/hr and are not covered by Medicare and rarely covered by insurance.

Home Health is covered by Medicare with a doctor’s order but is limited in scope. Home Health is task-specific and may include nursing care such as administration of IV antibiotics, complicated dressing changes, or tube feedings. Medicare covers a limited number of visits, so normally the nurse teaches the family members how to perform these tasks. Other resources available with Home Health may include such therapies as physical therapy to help a client regain mobility, or occupational therapy to help a patient regain their ability to perform self-care. Home Health is normally short-term. Medicare supplemental plans or Medicare Advantage plans may cover some costs of Home Health beyond what normal Medicare covers but is highly plan dependent.” It is critical to understand your health insurance and what is covered”, says Teresa, and to know if your loved ones have a Long-Term Care policy.

As far as hiring someone to provide private duty care in the home, without going through an agency, is “Buyer Beware.” There is not really a reliable source to find private duty nurses or aids other than word of mouth, or social media. If you do decide to hire someone privately be sure to do background checks in all the places they have lived and also to require a drug screen. You lose the protection of an agency being insured and bonded when you hire privately. If you know the person, you may be fine with that. Also, you may want to ask for proof of vaccination statuses like flu and Covid, as well as ask for a negative TB test. The potential hire should be willing to provide those things as well as a copy of their CNA or RN license. When using an agency, you contract with them for coverage so that if there is a staffing problem, they will pull out all stops to see that it is covered. When you hire privately, if your caregiver calls out sick, you may not have a good backup.

We are fortunate in Rowan County to have the Rufty Holmes Senior Center which is a nonprofit organization providing resources for those over age 55. Rufty Holmes is a wonderful place to get information on up-to-date resources for seniors, including caregiver options.  

The following is an excerpt from the Rufty Holmes Directory of Services:

In-Home Services/Home Care

Advanced Home Care……………………………………………………704-639-1060

Angels at Heart…………………………………………………….…….704-762-9364

Bayada Home Health Care…………………………………….……….704-633-7213

CAPCare………………………………………………………………………704-210-5626

Comfort Keepers……………………………………………..…………….704-630-0370

Gentiva Health Services……………………………………………………704-636-3334

Home Health Connection. (Regional provider) …………………….….704-334-8141

Home Health Professionals. (Regional provider) ………………………704-633-7213

Home Instead Senior Care………………………………………………704-636-2010

Homewatch CareGivers. (Regional provider) ….……….…………….704-788-2353

Interim Healthcare… (Regional provider) ……….………………………704-658-0555

Personal Touch Care Team…………………………………………….704-630-0088

Senior Helpers. (Regional provider) …………………….………………704-490-4673

TenderHearted Home Care……….……….…………………………. 704-612-4132

Trinity At Home………………………………….……………………….704-603-2776

Veterans’ Home Care……. www.veteranshomecare.com…………1-888-314-6075

VG Home Solutions………………………………………………………336-290-5240

So, whether you need HOME CARE or HOME HEALTH, we have great choices for our loved ones in Rowan County!

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