Many families take it upon themselves to provide care for aging and frail loved ones. Whether it’s a child, grandparent, aunt, uncle, cousin parent or spouse, there are many aspects of providing care that can be challenging for family members. Home care services can not only help by providing support, but in many cases can significantly improve relationships of those involved in the caregiving.

In America, forms of home care provided depends on reimbursement, regulations, care needs of the client and his or her ability to care for themselves. Home care can be for those who have healthcare needs and require some level of nursing care for changing medication, checking vitals and more. Care can also be for those who need help with activities of daily living like meal preparation, bathing or grooming. There is no “one size fits all” for the care provided, or the way for which that care is paid.

What Is the Difference Between Skilled and Non-Skilled Care?

Skilled Care:
Skilled care services are provided by licensed professionals, including nurses; physical, occupational and speech therapists; and mental health professionals. Skilled care services are ordered by a physician. Home healthcare agencies (those that provide Medicare reimbursed services) focus more on the skilled, medical aspects of care and the home healthcare aide (HHA) supplements this care. Regardless of reimbursement eligibility, Medicare will only pay for skilled care in the home for a limited period of time to treat an illness or injury.

Medicare was not designed as a long-term care solution, or for those who have ongoing chronic diseases. HHAs can provide a pre-authorized amount of personal care while under professional supervision. But that care must discontinue when skilled care needs are no longer justified. Individuals usually still have ongoing personal care needs even after skilled services (as defined by the Medicare regulations) are no longer required.

Non-Skilled Care, Non-Clinical Care, Custodial Care or Personal Care: 
Non-skilled care, non-clinical care, custodial care or personal care services cover a full range of activities including hygiene, meal preparation, cleaning, transportation, companionship and more. This care is typically ordered by self-referral or as part of an overall home healthcare plan. Beyond the nature of the services and who is administering the care, a primary difference is in how clients pay for services. Non-skilled care is not reimbursable under Medicare and therefore is paid for privately, or in some cases by private, long-term care insurance, Veteran’s Administration programs or community programs. A physician’s order is not required as the need for care is not deemed medically necessary, and there is no requirement for patient homebound status, as Medicare requires.. A professionally authorized and monitored care plan is helpful, but unnecessary.

How home care services can help any family. 
When a frail loved one shows signs that he or she may not be able to tend to their own care safely at home, a family member may step up and either care for them, encourage their loved one to move in with them or assist in finding alternative housing as care needs progress. When frailty causes someone to have care needs, it may soon prove difficult for a family member to meet those needs. The most embarrassing situations generally revolve around incontinence or needing help in the bathroom, whether for toileting needs or getting into or out of the shower. Many times it is difficult for a son or a daughter to help a parent with these activities, as it may be uncomfortable for both the parent and adult child.

Home care services can be an excellent solution for families who need additional assistance in caring for a frail loved one. A home care company can send a caregiver to the home when the family caregiver needs a break, or to assist with things that could potentially cause embarrassment or strain for the family caregiver or client. Care assistance may start as a few hours of care in the home each week or it could be full time.

These types of home care services can make a significant difference for any family. It’s not beneficial for specific clients or families or their ability to pay – this support is ideal for every family.