I need an HHA—or a CNA or a PCA, oh, whatever . . . CAN YOU HELP ME?

Companion Home Care, Affordable Home Care, Elder Care in Minnesota, Respite for Caregivers, Non Medical Senior Care, In Home Senior Care Providers, At Home CaregiversMuch confusion exists about the kinds of in-home help available for seniors.  It is not uncommon for me to take an inquiry call, and the person on the other end of the phone will say, “I need a PCA.”

I’ll ask, “What do you need the PCA to do?”

“Oh, maybe change my bedding and do my laundry, help me keep up my house—you know, that kind of stuff is just too difficult for me to do any longer. I can take my own shower and stuff.”

“Oh, I think you mean you need a homemaker,” I reply.  Then begins the process of explaining the difference between the various levels of homecare licensure, what the workers are called, and the kinds of tasks they are able to do.

There are three main levels of home care services for seniors.  I will try to explain each level in a basic way.

The highest level of care is called a Class A license.  This level of care is overseen by a registered nurse who may delegate medical or nursing services or tasks.  Home Health Aides (HHA’s) fall under this category.  The tasks they perform are of a medical nature.  For example, they do administration or set-up of medications, body positioning or transfers, feeding clients, bowel and bladder assistance, and skin care, to name a few of their tasks.  This care can sometimes be covered by Medicare or insurance, depending upon the situation.

Class B Licensure, the next level of care, employs workers who are called Personal Care Assistants (PCA’s) or Home Care Aides.  At this level of care, the in-home workers assist with dressing, grooming, bathing or showering, and oral hygiene, if the client is ambulatory and has no serious acute illnesses or infectious diseases.  Under certain circumstances, these workers may also perform household chores in the presence of technically sophisticated medical equipment or episodes of acute illness or infections. They are also able to prepare modified diets, such as diabetic or low sodium diets, provide medication reminders, and help with performing exercises.

Home Management Registration includes services that are not listed in Class A or Class B.  Workers at this level are often called homemakers, companions, or caregivers.  These workers assist with non-medical senior care tasks in the home, such as general weekly housekeeping, meal preparation, shopping and errands, respite, and companionship.  They can also assist with safety supervision, medication reminders, and standby assistance in the bathroom.  Many clients can stay in their own homes and apartments indefinitely with this kind of help, provided they are safe and that is where they want to be.  Homemakers and companions are not covered by Medicare or other medical insurance because they are not medical services.  Some long-term care policies will cover this type of care, depending upon the policy and the client’s diagnosis.  Other entities, such as the Veterans Administration, the MS Society, or the Parkinson’s Foundation, may have financial resources for this type of care in certain situations.  If a person is low income and eligible for county waivered services (Alternative Care or Elderly Waiver), these programs also provide some resources for home management services.

It is not uncommon for our clients to start out needing service just a couple of hours a week, or even every other week, for routine housekeeping assistance.  The things that most elderly people are physically unable to do include vacuuming, changing bed linens, mopping floors, and cleaning out the bottom shelf of the refrigerator.

As needs change over time, other elderly home care services can be added.  For example, if a person’s condition changes so that he can no longer bathe or shower himself, services for that can be added to the homemaking services already in place.

If you are unsure of what type of services your elderly parents are in need of, don’t hesitate to call our office at 952-854-6122. We can help you sort through your options for home care in Minnesota!

Julie Ellingson, LSW

June 8, 2012


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