Needing care at home for dementia and visual impairment to help with meds, showers, meals and getting dressed. Is there a certain form or plan of care form I could ask the doctor for?
If your mom has BCBS Medicare advantage you will need to call them to see how they handle this. If she has original Medicare, she can probably get help under Medicare Part B, intermittent skilled nursing needs for those who are home bound and not easy to get out. There is a sweet spot where it helps. If your mom needs help setting up her pill planner that can justify a nurse. But they won’t be there daily to give her the pills. Then if she needs help with showers, a cna can come in for that. Usually only a couple of times a week and they will help her change and might even change her bed sheets and start the washer.
PT and OT can also provide needed services. Meals would need to be ordered from meals on wheels. I have had CNAs bring my mom a burger or heat her lunch but that isn’t a routine thing.
There are other services but first find out what insurance she has. I’m not familiar with advantage plans but have 10-12 years experience with original Medicare covering this for my mom and then my DH aunt. Aunt has dementia and has transitioned from home health to hospice now with the same agency. Under Medicare.gov you can find agencies in your city, state. Call a couple and see if they take your insurance. Have them come for an evaluation. They will have the doctor sign the forms they need if they can help your mom.
Oh and mom will need to allow the help although they will work with her to gain her trust. It helps if you are there the first few times so that your mom is at ease.
There was a poster who said she was able to get ""intermittent care" for her Mom and Aunt. May want to check this out. On the whole though, Medicare does not pay for aides.
Call your Office of Aging to see if they can help. Check with her secondary insurance. If she has a Medicare Advantage call them.
I think you will find that MediCARE will NOT be paying for inhome health care for anything custodial care. Meals, bathing, hygiene, getting dressed are all activities of daily life (ADL) and viewed as custodial care. MediCARE won’t pay but your states Community based Medicaid programs may if she’s if eligible both medically and financially for a community Medicaid program. Just what is out there is totally on your state as each state runs it’s Medicaid program uniquely but under overall federal guidelines. Medicaid is very much an “at need” system to ever be eligible & the “need” varies by state.
Now MediCARE will pay for - time limited in home health if it is directly related to a discharge from a hospitalization. So if mom was hospitalized for hip surgery and then she is discharged to her home rather than to rehab at a facility, MediCARE will pay for therapist, etc visits for a period of time as they would in a rehab facility. AND - for in home hospice care. She would have to be evaluated to need hospice.
If your mom is beyond befuddled in taking her prescriptions and if she also has black box type of RXs or meds that need compounding, she may be viewed as “at need” for “skilled medication management”. This is often used as part of the criteria in getting them eligible medically “at need” for skilled nursing care LTC Medicaid placement aka they become a resident in a LTC facility like a NH. But if it’s more mom cannot tell the difference between Losartan and Lipitor and when to take them, that’s the type of medication management that an private pay AL can do and adds a surcharge onto her monthly bill.
Usually, a home health care agency coordinates the services your doctor orders for you so ask your physician. To understand what Medicare does and does not cover, go to https://www.medicare.gov/coverage/home-health-services
If she has original Medicare, she can probably get help under Medicare Part B, intermittent skilled nursing needs for those who are home bound and not easy to get out.
There is a sweet spot where it helps. If your mom needs help setting up her pill planner that can justify a nurse. But they won’t be there daily to give her the pills. Then if she needs help with showers, a cna can come in for that. Usually only a couple of times a week and they will help her change and might even change her bed sheets and start the washer.
PT and OT can also provide needed services.
Meals would need to be ordered from meals on wheels. I have had CNAs bring my mom a burger or heat her lunch but that isn’t a routine thing.
There are other services but first find out what insurance she has. I’m not familiar with advantage plans but have 10-12 years experience with original Medicare covering this for my mom and then my DH aunt. Aunt has dementia and has transitioned from home health to hospice now with the same agency.
Under Medicare.gov you can find agencies in your city, state. Call a couple and see if they take your insurance. Have them come for an evaluation. They will have the doctor sign the forms they need if they can help your mom.
Oh and mom will need to allow the help although they will work with her to gain her trust. It helps if you are there the first few times so that your mom is at ease.
Call your Office of Aging to see if they can help. Check with her secondary insurance. If she has a Medicare Advantage call them.
Now MediCARE will pay for
- time limited in home health if it is directly related to a discharge from a hospitalization. So if mom was hospitalized for hip surgery and then she is discharged to her home rather than to rehab at a facility, MediCARE will pay for therapist, etc visits for a period of time as they would in a rehab facility.
AND
- for in home hospice care. She would have to be evaluated to need hospice.
If your mom is beyond befuddled in taking her prescriptions and if she also has black box type of RXs or meds that need compounding, she may be viewed as “at need” for “skilled medication management”. This is often used as part of the criteria in getting them eligible medically “at need” for skilled nursing care LTC Medicaid placement aka they become a resident in a LTC facility like a NH. But if it’s more mom cannot tell the difference between Losartan and Lipitor and when to take them, that’s the type of medication management that an private pay AL can do and adds a surcharge onto her monthly bill.