Home health care provides an alternative to an assisted living home, enabling people to age in place. Who are the best candidates to benefit from home health care, and what types of services are available?

“Trends are pointing toward people wanting to stay at home or age in place, particularly after the pandemic’s disproportionate impact on residential care settings,” said Jonathan Davis, founder and CEO of Trualta, a training platform for family caregivers.

Davis cited an AARP survey revealing that 77% of adults over 50 would prefer to age in place.

Not all home health agencies provide identical services, so it’s important to research what each agency is qualified and approved to provide, according to Joanna Fuller-Crawford, a registered nurse and CEO and co-founder of Perfect Care Nursing, a home health agency providing personalized in-home care across Atlanta.

Unlike a nursing home or assisted living facility, where each caregiver may handle up to 20 patients, a reputable home health company offers a much more dedicated level of care.

“We have some clients who have been with us for more than 10 years. I enjoy building … relationships with our clients and seeing the outcomes we’re able to provide for people who need a special level of care,” she said.

In addition to standard long-term care, home health may offer additional types of care.

Pre- and post-op care

Some home health agencies provide pre-or post- operative care. This typically requires additional training and certifications for clinicians.

Dementia care

According to Cloud Conrad, an Atlanta certified dementia caregiver trainer and mentor, and author of “The Dementia Field Guide,” many dementia patients require inpatient care. But if the following circumstances apply, home health may be an option:

>> A home health assistant or loved one can be present to provide care coverage at all times.

>> A loved one can be present regularly, if not daily, to monitor living conditions and quality of care.

>> Groceries and other basic items are provided regularly for caregivers to prepare.

>> The patient has been denied admission to assisted living based on violent or threatening behavior.

>> The patient has few or no health risks requiring acute care.

Respite care

Home health agencies can be a helpful resource to give family caregivers a break from the rigors of caregiving.

“One important factor for selecting a service or facility for respite care is finding one that can provide consistency with the normal routine,” said Fuller- Crawford.

Respite care can be provided in the home via a home health agency, private provider or a facility such as a senior daycare.

Additionally, home health agencies may provide a traveling caregiver to accompany a family on vacation.

Hospital at home

Hospital at home is an emerging model of home-based care that brings hospital-level care into the home. Most home health agencies do not provide this type of service.

“Hospital at home … (uses resources such as) X-ray, EKG, IV Infusions, all at home. Hospital at home care is a studied model used around the world to bring hospital-level care for patients with serious or complex illnesses,” said Rami Karjian, CEO and co-founder of Medically Home.

Getting started

The options of agencies and caregivers can be overwhelming. How do you hire a reputable agency?

Fuller-Crawford said to start by checking reviews and references. Also, check with the state board to be sure the agency is in good standing and properly licensed, and that its license hasn’t been suspended or revoked.

For dementia home care, look for caregivers who specialize in dementia patients, said Conrad.

To finance the care, research all options for reimbursement from health insurers and gov­ernment programs. Coverage depends on your circumstances and health insurance. Fuller-Crawford said some of her clients have their care paid for by Medicaid and Medicare, while others are covered in part by private insurers. Some pay out-of-pocket.

Home health costs run about $25-$27 per hour, she said.

To stretch budgets, she advises families to work out a schedule that, if possible, involves a rotation of family members alternating with professional care providers.

Comprehensive plan

Once you’ve decided on a home health service, the agency will help you devise a comprehensive care plan that covers scheduling, services, preferences and needs of the patient — within your family’s budget. Every agency should have at least one registered nurse on staff to oversee caregivers and provide supervision when necessary, said Fuller-Crawford. This nurse, or a medical director or other senior clinician, should be involved in developing the care plan.