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Which best describes their mobility?
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How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
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Ok. I use Medicare Home Health like my right hand.
1. go to Medicare..gov compare.
2. choose what service you need. In this case Home Health.
3. Put in your city state and the choices will appear.
4. call one or two of them. They will want to know your insurance info, your doctors phone and fax number and the situation. They will send someone to evaluate.
OR. Call the primary doctor and request.
5. The LO needs to be home bound. This is a condition where it is difficult to take the person out. They are on crutches, walker, cane or have dementia or some other reason that they aren’t easily taken out to a doctor. They can still go to church etc. they are not CONFINED to their home. They just can’t easily be taken out.
6. The person must need nursing services. The nursing services must be needed for less than 24/7. It is for intermittent nursing services. The nurse MUST do something for the patient that requires at least an LVN certification. Setting up the pill box qualifies. Monitoring meds, wound care, checking vitals, etc. They keep a log in the home where they record the visit, the vitals and any comments. Very handy to track weight, BP etc. (An RN is required to certify that the patient needs services. After that they may be seen by LVN or RN until next certification).
7. IF the person qualifies for a nurse, THEN the nurse can arrange for a CNA, bathing lady, aide, whatever you want to call her to come several times a week to bath the patient. In my mom’s case, they bathed her, did her hair, emptied her night commode, sanitized it, stripped her bed, ran the wash, remade her bed, sometimes heated her lunch. Some even came and had lunch with her.
In my aunts case when she first started with home health, she was still able to get in and out of the tub, preferred a tub bath and they helped her into the tub and visited with her through the door while they changed her linens, helped her out, dressed her, braided her hair and set her up with a cup of coffee and her remote. One even took her Christmas tree down for her one time.
I have known my DH aunts aide who was my mom’s aide for 15 yrs. The BEST decision I ever made was finding the service and sticking with them.
8. ALSO the nurse will arrange for PT and OT, Speech therapy as needed.
9. ALL of these services need a doctors order. The patient must have seen the doctor within a certain time frame. After that the HH will fax the orders to the doctor for signature to continue the services. My mom only saw her doctor once a year even the cardiologist at a heart transplant clinic. They worked with home health to do blood test etc to manage her CHF. When DH aunts doctor told me he was required to see her every quarter because she was on HH, I knew he was wrong. We changed doctors. That is when I found her geriatric specialist at a university hospital. We did telehealth with her after aunt became bed bound but otherwise saw her once a year.
10. This is all through Medicare Part B. Original Medicare. I have no experience on the advantage plans.
11. Since the HH service I used also had a hospice division, when aunt transferred to hospice it was with them. She now has the same hospice co and aide even though she is in a N.H.
My husband had such services when he was rendered unable to walk for a protracted period after an attack of shingles that affected the nerves in his spine leading to his leg. He had also recently been diagnosed with Parkinson's, but that was just a complicating factor and not the reason for needing the in home Medicare services. He had speech therapy (briefly--mainly checking his swallowing), OT, PT, visiting nurse twice a week initially then once a week, and twice weekly home health aides who were there for perhaps 2-3 hours at the most--mainly to help him with showering and dressing. He called them "the bath ladies." The OT worked with "the bath ladies" and me to show us the best way to help my husband who was almost completely unable to stand or bear weight for a while. He was wheelchair-bound. He had services for I think 3 months. He still needed extensive PT as he was just barely beginning to be able to walk with a rollator. But once he was deemed able to get out of the house (we rented a ramp) and into and out of the car, they said his in-home services would end and he was "graduated" to outpatient PT.
Long story short, getting home health aides paid through Medicare really does require a high level of "medical" need and not just a need for personal care from an aide. From what I understand, most such services are on a time-limited basis after some kind of acute event, surgery, or infection or if a person has a severe medical condition that needs skilled nursing care or close monitoring.
It is easier to get started if a person has just exited the hospital etc., because someone (discharge, social worker, etc) is setting it up BUT don’t assume a LO is not eligible because they have managed to stay out of the hospital.
After the hospital is the most commonly used HH and is covered by Part A. The intermittent nursing care is covered by Part B. Not all Home Health Companies seem to cover Part B.
Family members are sometimes so accustomed to caring for their LOs that they don’t realize there is help available or they feel the level of help isn’t sufficient. To me every layer of help is welcome. It all depends on the personal circumstances.
Patients who need therapy after they no longer need Home Health can still get it. You just go back to the doctor and ask them to order it. A therapist will come out and evaluate and then start the therapy. Some therapists ONLY work through home health, some are independent. Unlike the bath aide, you don’t have to have the nurse in order to have physical therapy.
My mom had OT 2-3 times a week for the last few years of her life. All paid by Medicare. Her right arm didn’t work w/o it. Her rotator cuff was shot.
DH aunt who has dementia was told by her neurologist it would be helpful for her. She had it almost nonstop until she went on hospice. it helped keep her stronger for transferring after she could no longer walk. It helped with her balance when she was walking with her cane and helped with using the walker and then rollator.
In your case Newbie, if you felt you needed home health at this point, I would call another HH for an evaluation. Some HHC do seem to only want to do Part A, after a hospitalization type care.
I have had folks here on the forum who once worked for a HH practically call me a liar when I told them my mom and then aunt have had HH for years. The company they worked for didn’t offer the same services is all I could imagine. It’s similar to hospice services. Some give very skimpy coverage. My DH aunt has a daily visit from her hospice aide. My Home Health company has really partnered with me in caring for my elders. But we all have different circumstances and experiences.
I see many people here on the forum who could benefit from this service. I always feel bad for them that they don’t realize how much help it can be.
Visiting Nurse Service (VNS) is probably the oldest and best known Home Health Care Agency.
My understanding from long ago with mom is that HHC is generally ordered as a follow-up to hospitalization and is usually limited to the time during which your loved one needs weekly RN visits. So yes, an MD order is needed.
Until recently (yesterday in fact) I had ZERO idea that Medicare gives ANY kind of home help other than hospice providers. Sure of interest to me. Would an MD have to order this? Surely we don't just give Medicare a ringy-dingy to get this started. Would be so interesting in hearing just how the steps go for getting this ordered for folks, whether for medications, BP checks, dressings, bathing or other.
I am just wanting to know point "A". Where to start. Am assuming it would be ordered by a discharging (from hospital or rehab) MD for most part?
Alva, I think you have mentioned that you don’t have Original Medicare. You would need to call your insurance provider to see what services they offer.
Your husbands primary might have some they like to work with. You can also find them on Medicare.gov compare. A personal referral is always good. If you know someone who was recently in the hospital or had surgery they may have worked with one when they were released that they liked.
We had a niece who worked for Home Health as a nurse yers ago. So we chose her company so we could have her be the nurse for my mom. Then we just stayed with the same company over the years. I now know the owner, the dispatcher, many of the nurses and aides, therapists. But you can switch companies if you don’t have a good fit like any other service. Call and speak with a few of them and you will be more comfortable with how they work. Your husbands doctor will have to have seen your husband recently or be planning to see him soon. Aunt has had doctors we just did Telemed on due to distance or her being bedbound. I think most people get started with HH when they come home from the hospital and a nurse comes out to do wound care or they need a little physical therapy. Some agencies just do that type care. They are private businesses. Some are large and have regional offices. Some are small and just work a few neighboring towns. They also go into nursing homes and assisted living facilities. They will sometimes leave their cards in doctors offices waiting rooms. They usually work with the primary doctors. You can just Google home health, your city and state and several will pop up.
Worried Home Health Care through Medicare is not an hourly care giver, it’s a once a week nurse to help with pills and vitals. The nurse will set up a CNA, certified nurses assistant, who will come two or three times a week to bath your husband. She will change the bed linens and do small things for the patient. The nurse will also send out a physical therapist to see if your husband can be helped with therapy. All of these people will only be there as long as it takes to do their activity. Nurses will do basically what you are accustomed to them doing at the doctor’s office. Wound care, blood draws, flu shot. Medicare covers the charges. My moms doctor and my DH aunts doctors worked very well with HH and eliminated most in person doctors visits.
I am a big fan of HHC. Are you speaking of the service covered by Part B for the home bound or the coverage from Part A after a hospitalization or rehab?
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
1. go to Medicare..gov compare.
2. choose what service you need. In this case Home Health.
3. Put in your city state and the choices will appear.
4. call one or two of them. They will want to know your insurance info, your doctors phone and fax number and the situation. They will send someone to evaluate.
OR. Call the primary doctor and request.
5. The LO needs to be home bound. This is a condition where it is difficult to take the person out. They are on crutches, walker, cane or have dementia or some other reason that they aren’t easily taken out to a doctor. They can still go to church etc. they are not CONFINED to their home. They just can’t easily be taken out.
6. The person must need nursing services. The nursing services must be needed for less than 24/7. It is for intermittent nursing services. The nurse MUST do something for the patient that requires at least an LVN certification. Setting up the pill box qualifies. Monitoring meds, wound care, checking vitals, etc. They keep a log in the home where they record the visit, the vitals and any comments. Very handy to track weight, BP etc. (An RN is required to certify that the patient needs services. After that they may be seen by LVN or RN until next certification).
7. IF the person qualifies for a nurse, THEN the nurse can arrange for a CNA, bathing lady, aide, whatever you want to call her to come several times a week to bath the patient. In my mom’s case, they bathed her, did her hair, emptied her night commode, sanitized it, stripped her bed, ran the wash, remade her bed, sometimes heated her lunch. Some even came and had lunch with her.
In my aunts case when she first started with home health, she was still able to get in and out of the tub, preferred a tub bath and they helped her into the tub and visited with her through the door while they changed her linens, helped her out, dressed her, braided her hair and set her up with a cup of coffee and her remote.
One even took her Christmas tree down for her one time.
I have known my DH aunts aide who was my mom’s aide for 15 yrs. The BEST decision I ever made was finding the service and sticking with them.
8. ALSO the nurse will arrange for PT and OT, Speech therapy as needed.
9. ALL of these services need a doctors order. The patient must have seen the doctor within a certain time frame. After that the HH will fax the orders to the doctor for signature to continue the services.
My mom only saw her doctor once a year even the cardiologist at a heart transplant clinic. They worked with home health to do blood test etc to manage her CHF. When DH aunts doctor told me he was required to see her every quarter because she was on HH, I knew he was wrong. We changed doctors. That is when I found her geriatric specialist at a university hospital. We did telehealth with her after aunt became bed bound but otherwise saw her once a year.
10. This is all through Medicare Part B. Original Medicare. I have no experience on the advantage plans.
11. Since the HH service I used also had a hospice division, when aunt transferred to hospice it was with them. She now has the same hospice co and aide even though she is in a N.H.
My husband had such services when he was rendered unable to walk for a protracted period after an attack of shingles that affected the nerves in his spine leading to his leg. He had also recently been diagnosed with Parkinson's, but that was just a complicating factor and not the reason for needing the in home Medicare services. He had speech therapy (briefly--mainly checking his swallowing), OT, PT, visiting nurse twice a week initially then once a week, and twice weekly home health aides who were there for perhaps 2-3 hours at the most--mainly to help him with showering and dressing. He called them "the bath ladies." The OT worked with "the bath ladies" and me to show us the best way to help my husband who was almost completely unable to stand or bear weight for a while. He was wheelchair-bound. He had services for I think 3 months. He still needed extensive PT as he was just barely beginning to be able to walk with a rollator. But once he was deemed able to get out of the house (we rented a ramp) and into and out of the car, they said his in-home services would end and he was "graduated" to outpatient PT.
Long story short, getting home health aides paid through Medicare really does require a high level of "medical" need and not just a need for personal care from an aide. From what I understand, most such services are on a time-limited basis after some kind of acute event, surgery, or infection or if a person has a severe medical condition that needs skilled nursing care or close monitoring.
After the hospital is the most commonly used HH and is covered by Part A. The intermittent nursing care is covered by Part B. Not all Home Health Companies seem to cover Part B.
Family members are sometimes so accustomed to caring for their LOs that they don’t realize there is help available or they feel the level of help isn’t sufficient. To me every layer of help is welcome. It all depends on the personal circumstances.
Patients who need therapy after they no longer need Home Health can still get it. You just go back to the doctor and ask them to order it. A therapist will come out and evaluate and then start the therapy. Some therapists ONLY work through home health, some are independent. Unlike the bath aide, you don’t have to have the nurse in order to have physical therapy.
My mom had OT 2-3 times a week for the last few years of her life. All paid by Medicare. Her right arm didn’t work w/o it. Her rotator cuff was shot.
DH aunt who has dementia was told by her neurologist it would be helpful for her. She had it almost nonstop until she went on hospice. it helped keep her stronger for transferring after she could no longer walk. It helped with her balance when she was walking with her cane and helped with using the walker and then rollator.
In your case Newbie, if you felt you needed home health at this point, I would call another HH for an evaluation. Some HHC do seem to only want to do Part A, after a hospitalization type care.
I have had folks here on the forum who once worked for a HH practically call me a liar when I told them my mom and then aunt have had HH for years. The company they worked for didn’t offer the same services is all I could imagine. It’s similar to hospice services. Some give very skimpy coverage. My DH aunt has a daily visit from her hospice aide. My Home Health company has really partnered with me in caring for my elders. But we all have different circumstances and experiences.
I see many people here on the forum who could benefit from this service.
I always feel bad for them that they don’t realize how much help it can be.
My understanding from long ago with mom is that HHC is generally ordered as a follow-up to hospitalization and is usually limited to the time during which your loved one needs weekly RN visits. So yes, an MD order is needed.
https://www.aplaceformom.com/caregiver-resources/articles/medicare-and-in-home-care
Sure of interest to me.
Would an MD have to order this?
Surely we don't just give Medicare a ringy-dingy to get this started.
Would be so interesting in hearing just how the steps go for getting this ordered for folks, whether for medications, BP checks, dressings, bathing or other.
I am just wanting to know point "A". Where to start. Am assuming it would be ordered by a discharging (from hospital or rehab) MD for most part?
I think you have mentioned that you don’t have Original Medicare. You would need to call your insurance provider to see what services they offer.
A personal referral is always good. If you know someone who was recently in the hospital or had surgery they may have worked with one when they were released that they liked.
We had a niece who worked for Home Health as a nurse yers ago. So we chose her company so we could have her be the nurse for my mom. Then we just stayed with the same company over the years. I now know the owner, the dispatcher, many of the nurses and aides, therapists. But you can switch companies if you don’t have a good fit like any other service. Call and speak with a few of them and you will be more comfortable with how they work. Your husbands doctor will have to have seen your husband recently or be planning to see him soon. Aunt has had doctors we just did Telemed on due to distance or her being bedbound.
I think most people get started with HH when they come home from the hospital and a nurse comes out to do wound care or they need a little physical therapy. Some agencies just do that type care. They are private businesses. Some are large and have regional offices. Some are small and just work a few neighboring towns. They also go into nursing homes and assisted living facilities. They will sometimes leave their cards in doctors offices waiting rooms. They usually work with the primary doctors.
You can just Google home health, your city and state and several will pop up.
What would you like to know about it? What type of situation do you have?
Home Health Care through Medicare is not an hourly care giver, it’s a once a week nurse to help with pills and vitals. The nurse will set up a CNA, certified nurses assistant, who will come two or three times a week to bath your husband. She will change the bed linens and do small things for the patient. The nurse will also send out a physical therapist to see if your husband can be helped with therapy. All of these people will only be there as long as it takes to do their activity. Nurses will do basically what you are accustomed to them doing at the doctor’s office. Wound care, blood draws, flu shot. Medicare covers the charges. My moms doctor and my DH aunts doctors worked very well with HH and eliminated most in person doctors visits.