Finding home care can be a stressful process – especially after a fall, surgery, or other incident when nerves are on edge and families need to find and agree on a solution fast. Hospitals and rehabilitation centers have outplacement counselors who can help, but they are often carrying a large workload and may not take the time to really listen to individual needs and preferences or offer a variety of options for care. In fact, many hospitals own their own homecare companies, or work with a few preferred home care partners. It is easier, and sometimes financially in the organization’s best interest, to direct patients to the same tried and true home care agencies, rather than offering a variety of different, potentially less expensive options.
When my eighty-four-year-old father had cardiac by-pass surgery, the hospital gave him the name of a visiting nurse association to call for home care. He called the number and arranged for the services he needed. Only after he became very unhappy with the care he received did it occur to him that he might have a choice about the home health organization to use. He called his insurance company and found out that, yes, he did not have to use that company and could choose a provider he preferred.
There are two potential problems with this type of provider-directed approach to home care. 1.) Traditional home care agencies can be very expensive. If insurance isn’t covering the whole bill, families can quickly run out of money to pay for the care they need. 2.) Some people want more choice and control over their own care. They want to choose their individual caregivers, decide what level of care and services they need, and manage how and when their care is provided. Doing so allows them to feel more in control and ensures that their individual preferences and needs will be met.
Self-direction gives seniors and people with disabilities the power to choose to stay at home, decide what care they need, and select, hire, manage and fire their own caregivers or service providers as they see fit. Having more choice in their care helps them feel more in control and ensures that their individual preferences and needs will be met.
For those receiving services through Medicaid (MassHealth) or the Massachusetts Executive Office of Elder Affairs Home Care program, consumers have the right to self-direction, and can receive services, paid by the Commonwealth, to help them get set up as employers, obtain worker compensation insurance, and handle payroll for the hours of care paid through the program.
If you are looking to reduce the cost of home care, or you would prefer to find, hire, and manage your own caregivers and their schedules, self-directed home care may be the right option for you. Be sure to ask about your options and know your rights.