Wednesday, November 19, 2008

Get the Facts

In her October 30, 2008 blog entry, More Caregiving Resources Move Online, Jane Gross, writing for the New York Times at, lists several government, business and illness-specific websites for caregivers. She asks, “Do you use these and other websites? Do they save time and ease decision-making?”

These are important questions to ask, given that (1) there are an estimated 44 million Americans providing some form of care for family, friends or neighbors (AARP Bulletin, November 2008); and (2) the right information at the right time can prevent pain and suffering for everyone involved.

The November issue of the AARP Bulletin also announced the launch of a new Medicare website for caregivers at This site is a must-visit for anyone who is now or will be caring for a senior, or who will one day be a senior. It provides an overview of information on senior-care topics, including the basic Medicare health insurance system, getting second opinions, dealing with billing, home health care, prescription drugs, nursing homes, hospice care, and more. This is the kind of information that families need to know.

The site is written in plain English. I was especially glad to see how clearly the writers spelled out the policy for home-care coverage. Many families make the erroneous assumption that Medicare pays for all home care. It’s worth quoting the exact policy:

Medicare may pay for home health aide and homemaker services only if the individual requires skilled nursing care or therapy. The individual must also be homebound, have a plan of care that is prepared and signed by a physician, and the services are performed by a Medicare-certified home health care agency. Your state Medicaid program or Medicaid waiver program may pay for home health aides and homemakers if you qualify. Private long-term care insurance may also pay for health aide/homemaker services.” (italics mine)

Home care is expensive. For-profit agencies may charge anywhere from $16 to $25 an hour, depending on the services provided. They usually have a two to four hour minimum. Hiring an independent contractor can be less costly, but it has its own complications and challenges. Families can experience sticker shock when charged $50 to $100 to provide one bath and a breakfast for mom, maybe with some dishes and a load of laundry thrown in. “How many weeks, months or years is mom going to need this kind of help?”

The time to look at caregiving sites is early in the game. Learning the facts can lead to asking important questions, and it can be crucial to starting helpful, possibly awkward, but necessary conversations.

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