Short- and Long-Term In-Home Care


Whether Dad just needs help around the house for a few weeks after he’s discharged from the hospital or Mom requires around-the-clock dementia care, in-home care can meet these needs and everything in between while enabling clients to live as independently as possible at home.

One of the biggest advantages of home care services is that they can be customized to accommodate a senior’s unique needs. This care option is extremely flexible and can be increased or dialed back as their condition declines or improves.

While the difference between unskilled and skilled care is an important part of deciding to hire in-home services, it is also useful to understand that home care can be provided with different timeframes in mind. Home care companies offer both short-term and long-term services so that individual care plans can be adjusted to meet a senior’s needs.

Read: The Difference Between Home Health Care and Non-Medical Home Care Services

Below are brief descriptions highlighting the differences between short- and long-term services that can help you decide the type of services a senior may need.

What is Short-Term Home Care?

Short-term home care services can last anywhere from a few days to a couple of months while someone is recovering from an illness, injury or surgery. In these instances, home care is a beneficial temporary solution. For example, some home care companies offer special short-term services to help seniors make smooth transitions from the hospital back to their homes.

Read: Professional Caregivers Ease Hospital-to-Home Transitions

Depending on the senior’s needs, one or more professional caregivers may be assigned. A “custodial caregiver” can provide unskilled assistance with activities of daily living (ADLs) and household tasks like bathing, dressing, mobility, laundry and preparing meals. Ensuring that a loved one is getting their medications and groceries and that they do not have to see to chores will help them recuperate faster.

Skilled care may be provided in the home for dressing wounds, dispensing medications, monitoring vital signs, or providing physical, speech, or occupational therapies. For example, following a stroke, a visiting physical therapist might be needed on a short-term basis to help a senior regain their balance and coordination. Once your loved one has recovered, these services will no longer be needed.

What Does Long-Term Home Care Entail?

Long-term services are generally for seniors with chronic and/or progressive conditions, such as Parkinson’s disease, a debilitating stroke, or Alzheimer’s disease and other forms of dementia. In these instances, regular assistance and care are required, and the client’s needs are likely to increase. “If somebody needs help over the long term, the question is, are those needs going to remain relatively consistent or will they increase?” says Val Halamandaris, President of the National Association for Home Care & Hospice. “If the situation is becoming more complex, you will need to gradually add more services.”

Most family members have no experience or training in caring for a chronically ill person at home. Bathing Mom or Dad is one thing, but changing a colostomy bag, suctioning secretions from a tracheotomy tube or monitoring a ventilator is more than most family caregivers can safely take on. In these particular cases, skilled home care is hired on a long-term basis until the senior’s needs exceed what can be provided in the home. Around-the-clock supervision and higher levels of care and training may become necessary, therefore home health care may no longer be the best option. Services usually conclude when the elder moves to an assisted living facility or nursing home.

Hiring Home Care

The best solution is to do your homework, ask lots of questions and know as much as possible about the type of care your loved one needs. After you have done some research online or sought referrals from physicians, friends and family members, you'll want to begin the interview and in-home consultation process with providers in your area.

Read: How to Select a Home Care Company

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Dad is almost 95, lives alone and for the most part does well alone. My concern and his doctor's concern was his diet and his hygiene. He doesn't drive and his diet consists of cereal, milk, a banana and coffee cake for breakfast, He takes his 4 daily pills with his breakfast. No real lunch, but he goes through Nestle Crunch bars and Pepsi like you wouldn't believe and dinner is always a deli bought container of tuna fish and sweet green relish that he puts on white bread. Throw a cookie in for dessert and that's his meal plan for the day. He does not cook, never did, and does not shower. He changes clothes every few days, but he doesn't have a washer/dryer in the house and I question how his underwear is getting washed. He tells me he washes it in the sink. Not so. I am all he has. It's me who goes to the store, the bank and pays his bills and have been taking him for a ride several days a week. I'm not young, I'll be 72 soon and have bad knees, shoulders and neck. The doctor recommended home health care which I put off until recently. I'll be moving soon, about 35 minutes away. I can come to help him 1, maybe 2 days a week. I looked into home health care and found a company owned by a local doctor and his family. Due to the name, I chose them. They came to the house to see dad, walked around and said that 3 hours a day 2 days a week would be a good start. Dad has dementia,but it's mostly his memory that is the problem. It was set up for "George" to come out. He would be a "perfect fit" for dad. So, I start telling dad George will be coming on Tuesday and Friday from 11 to 3 to help him. He will take him to the store, for a haircut, etc. Monday night I get a call that George's schedule won't permit him to come, so they were giving the case to Ryan. Ryan would be a "perfect fit" for dad. So, Monday night I tell dad Ryan will be coming tomorrow at 11 to help him. Evidently he kept telling Ryan that he could go home, he didn't need help. Then he started me asking if I'm coming to take him for a ride. No, you have Ryan there to help you. Let me speak to Ryan. Ryan offered to take him to the grocery store but dad told him that his daughter would come do it. No, I am not coming, Ryan will take you. This went on for an hour. Finally Ryan took him to the store. They come back and he tells Ryan he can go now. I have to call to tell him that Ryan will be there until 2 PM. We get through Tuesday. I talked to the agency and all in all they said it went well for the first time. Ryan was due back Friday. I get a call Thurs night that Ryan will be coming around 12;30 and it would be his last day. He didn't feel that dad wanted him there. I asked why. They told me all in all it went well the first day. Ryan got a full time job. At first they told me Ryan had a full time job and that the 6 hours spent with my dad each week was just extra money for him. Ok, now we're sending Amber on Tuesday. We think she will be a "good fit" for dad. I'm preaching Ryan to dad, how he's going to help him etc, now I have to tell him no more Ryan, now Amber. After thinking about this, I decided to terminate my association with this agency. Dad needs stability in his schedule, that's what keeps him going. Now I'm looking into another agency. Am I wrong to expect 1 caregiver for at least a few months?
Good article, but people need to remember that Medicare and Medicaid won't pay for everything. Medicaid will pay for long term home care, but will determine the amount of home care a person will receive. It took 7 months for long term home care to kick in, and I was left taking care of my mother by myself. Since I was taking her home from a nursing home as they said my mother was unable to be weaned off her ventilator, I was trained on how to monitor her ventilator and suction her. I also had access to the company that provided the machine. Also Medicaid is very stingy with the supplies you may need in the home. As my mother is incontinent, she needs diapers, wipes and gloves. I receive 1 box of gloves a month, no wipes are provided and the diapers gave her an infection. I buy a better brand of diapers, and Target has great adult wipes for a cheap price. I also buy Balmex to avoid broken skin and infections. Medicare will pay for the hospital equipment, but it's not as user friendly as what is at the hospital or nursing home. Also, if you need physical therapy services, there is a limit on how many sessions you can receive, under Medicare and Medicaid. I work with a long term home care agency, and I have to fight for everything. It took 2 months to obtain a wheelchair for my mother. Even if you are entitled to short or long term home care, based on your parent's financial situation, it can take months for home care to kick in, so anything not covered prior to the date of coverage will be your responsibility. You will also end up paying for some supplies out of your own pocket. As I have been told several times, due to people abusing the Medicare/Medicaid system, the rules have been changed so in the end the people who really need the services are penalized.
Home health care also has a right to report you if you cancel your relatives appointments and the relative does not cancel them. Before entering into any home health care agreement please read the privacy practices and even do a more extensive background check than the agencies themselves have done. If the nurses CNA's or APS can find a way to take belongings that are not of much worth but they can sell them and get charge of your relatives living will they will do so. If you enter into an agreement and not let them into the house they can use that as passive neglect when you are taking care of your relative. They can also try to alienate heirs in the will or POA by telling you not to speak to them on certain matters or tell you that the POA is working with APS when it is one of them working with APS. You could get called on by APS just for leaving to go to the gym up the street if there is no one in the house but your relative says that they are fine to be left along. When home health care arrives the first day safety in numbers. These people want what belongs to you your belongings and they are ruthless enough to become POA if need be to get it. So, don't sign anything until a lawyer sees it first. If there is a portfolio with records that stays in the house make sure it stays in the house. Some nurses tend to take it a bit far and say I have to take this (Portfolio) the patients record don't let them take it. Have a police officer present if they try to fling mud or accusations against you. Just whatever you do don't let them take the folder. Nurses can doctor records up to make it seem like they were not there when they were. If your relative is sick or ill the morning of their care tell them to call in not yourself you could get into trouble for that and get possibly charged or worse.