Many types of extended care services and post hospital care exist to help keep individuals living in their own home. These include meal delivery, transportation services, personal care services such as assistance with bathing and dressing, assistance with household chores, physical or occupational therapy, nursing care, and care for someone who is dying, also known as hospice care. If the illness or condition is under control and able to be managed by the individual and/or caregiver then by all means he/she can live at home.
 
Community-based services that help individuals stay at home safely may be available through the local Department of Children and Families or Area Agency on Aging. Following are the types of services that can help individuals stay at home:

Home Health Agencies provide intermittent medical services at home. Services may be provided by a nurse, occupational, speech, or physical therapist, social worker, or home health aide. In some cases a counselor or other mental health professional may be provided for mental health services.

Hospice services are a concept of care that involves health professionals and volunteers who provide medical, psychological, and spiritual support to terminally ill patients and their loved ones. A principal aim of hospice is to control pain and other symptoms so the patient can remain alert and comfortable as possible.

Adult Day Care Centers can provide activities, medication management and administration, as well as personal care services during the day. For some, using adult day care services allows an individual to still live at home, but receive care and oversight during the day while the caregiver works.

Respite care can be provided at a nursing home or in an assisted living community for short periods of time, typically up to 30 days. This means than an individual who would normally be taken care of at home is taken care of at a nursing home or assisted living center so that his/her caregiver can have a break or go out of town. The individual will go through the same assessment process and receive the same types of services as any other full-time resident of the community or facility.

Care in the home is typically paid for using private funds. Other sources of payment may include Medicare, the Veteran’s Administration, Health Insurance companies, Medigap, and Long-term care insurance. Each may offer in-home health care and/or personal care services if certain requirements are met or in the case of insurance, if such a benefit exists.

Medicare covers care in an individual’s home, but only when certain conditions apply. An individual must be a US citizen and be over 65 years of age, have had a qualifying hospital stay (usually at least 3 days), and must require skilled nursing care at home, as indicated by his/her doctor. Skilled nursing care is provided by a registered nurse and includes procedures such as care for a wound and administration of IV’s or other medications. If an individual is homebound – unable to leave home, or leaving home is a major effort - he/she may also qualify for Medicare coverage of in-home care and services.

If not covered by your insurance or you do not qualify for benefits under Medicare in home care can be expensive. Therapists such as physical or occupational therapists as well as nurses typically cost anywhere from $80 to $100 per hour per visit. A visit might be anywhere from ½ hour to 1 ½ hours. A caregiver or aide that can help with any non-nursing or non-medical function such as assistance with bathing, dressing, light meal preparation, or companionship may cost on average from $10 to $15 per hour. Some will require a minimum number of hours/dollars per visit, such as 4 hours per visit, or $50 or $60 per visit.

Some services are available to only those who are low income. To learn more about these services and whether you can obtain them in your local community, contact your local Department of Children and Families or Area Agency on Aging. You will need the zip code of the area in which you live to locate the nearest office. When you call, ask if there are services available in the area that can help keep someone living at home independently and safely (such as transportation assistance, meals on wheels, assistance with housework, etc.)

Whether one can stay at home or not depends on the amount of care and oversight that is required, the ability to be able to keep the individual and the caregiver safe and comfortable and well taken care of, and the ability for the individual and family to pay for the required care and services. Once these factors have been considered, the individual and his/her family can decide whether it is possible and best for all concerned to care for someone at home, or consider a community setting. A community setting might include an assisted living community, board and care home, or if 24 hour nursing care is required, a skilled nursing facility.