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What Should I Expect From Home Care Services?

Updated: Feb 7

Happy HHA caring for her client

Home Care services is a support service for individuals, young or older, in need of assistance in their home and what is expected truly does vary from client to client depend on a number of factors. To simply explaining what a client can expect when registering for home care services, we will focus on home care services covered by insurance such as Medicaid, Medicare or other private insurances, and Private Pay or Self-Directed Home Care Services.

To begin, let's focus on Home Care services covered by Managed Long Term Care Providers and your insurance. This type of service requires approval by your physician and a proven need for assistance with Activities of Daily Living which is typically comprised of grooming/personal hygiene, dressing, toileting/continence, transferring/ambulating, and eating. If approved to receive home care services, you are assigned to a Medicaid Funded Home Care Agency that works alongside the MLTC for coordinating your home care services. A Registered Nurse employed by the home care agency will schedule a visit to meet with you for an assessment to discuss and plan your services around your needs and total approved hours of care. During the assessment, the nurse will create a care plan which will guide the assigned caregiver on the tasks that are needed to be completed and the frequency needed per week.

For the most part, clients are able to request services on set days and hours of the week, as an example, you may request services be provided Mondays, Wednesdays, and Fridays 9:00AM - 1:00PM if you are approved for 12 hours of care per week. Your service days and hours are totally up to you, but they must also be hours that makes sense for the agency and the caregiver that will be assigned to you. This means, that you might prefer to have services begin at 12:00PM instead of 9:00AM to allow more rest time for your loved one or perhaps 12:00PM works best for the client because the client attends Adult Daycare in the mornings and is back home by 12:00PM. But, because most caregiver that are registered with home care agencies are usually assigned to multiple clients, most caregivers tend to be available either early mornings or late afternoons. So requesting services to begin at what some agencies might consider to be odd or difficult to cover hours, can result in your caregiver often arriving late or worse, cancelling last minute, leaving you without an aide.

When a caregiver is unable to work for any reason, most agencies are pretty good at finding a suitable replace with very little notice, as long as they are made aware of by the caregiver that he/she is unable to work for the day. In the event an agency is unaware that a caregiver is unable to work for the day or has not arrived to the client's home, clients should immediately reach out to the agency to inform them that the assigned caregiver has not arrived, or perhaps has informed the client that he/she is unable to work for the day. The sooner an agency is made aware that a replacement aide is needed, the more time they have to begin the process of finding a replacement aide for the day. If the agency has aides available for replacement, last minute assignments, clients will be notified of the replacement aide and provided an expected arrival time of the aide. If the agency is unable to find a replacement aide, the agency must inform the client and family member of the situation so that the family can get involved in ensuring safety for the client as needed. The agency must also work diligently to confirm an aide is available and assigned for the next scheduled visit.

Caregivers that work for Medicaid funded home care agencies are trained as Certified Home Health Aides. Training of the aides vary from school to school. This means that a Certified Home Health Aide assigned to you may have 3 months of in-school training conducted by a Registered Nurse, or can have as little as 1 week training. On paper, 3 months training seems like the ideal choice when considering which caregiver to hire, but in reality, most HHA training schools cover the same topics of caregiving, and home care agencies always provide orientations and in-service classes to ensure their aides are compliant and trained to care for their clients.

Home Care Services are coordinating by service coordinators who are employed by the home care agency to manage services for their caseload which can easily be hundreds of clients assigned to each coordinator. So it is important that service coordinators are organized, experienced, caring, and able to resolve unexpected issues and emergencies with little advanced notice in order to keep their clients safe and receiving care regularly. Service coordinators must also maintain communication and provide updates of any changes in services to the clients, their family members and Case Managers overseeing care for the clients at the MLTC's. The last thing any client wants to rely on inexperience or careless service coordinator to managing services for them and not being informed when an aide is unable to work and a client will be left without an aide for the day. Too many clients often go without proper home care services simply because the of the poor work ethics of the service coordinator assigned to manage services for them.

If a client ever experiences any level of dissatisfaction with the services they are receiving from a home care agency, it is extremely important that the client or family member reaches out to the agency to express their concerns so that the agency is aware and can work on correcting any issues to prevent any incidents or injuries. Maintaining communication is equally important for both the agency and clients they service.

Alternatively, clients that do not have Medicaid or that prefer to receive home care services without getting approval from a physician, or perhaps that wish to receive higher quality care, can request Private Pay Home Care services. Private pay home care services has become extremely popular for years but has taken an increase in demand since the Covid-19 pandemic. Private pay home care is paid out of pocket by the client usually by credit or bank cards, and allows the client to have more control of the services they receive. Clients are able to receive service the exact days and hours they need care because private pay aides are strictly assigned to that client, rather than to various clients. Clients also have more control of the care plan or daily tasks the caregiver needs to complete for the day.

Private pay home care services is extremely cost effective when comparing to the cost of a nursing home which can run several thousands of dollars per week. And with on-demand home care marketplace like AIDECAST, clients are able to find the ideal caregiver that lives in their community, and has the necessary skills and experience required for the assignment. Hiring a private pay caregiver through a marketplace allows clients to search to numerous service provider profiles to find a caregiver by location, skills, experience, availability, or hourly rate. This is especially helpful for clients that need home care services within their set budget.

Most caregivers that are register with a home care marketplace are very experienced and skilled for assisting clients that prefer a certain level of care. Many also offer domestic services like housekeeping, meal preparation, laundry services, home repairs, dog walking, and other related services. Those are just some added benefits of hiring a private pay caregiver. However, because a home care marketplace attracts service providers that wish to work independently to assist clients, clients considering hiring a caregiver through a marketplace must consider that not all service providers are certified home health aides. That may or may not be important to a client depending on the client's needs. As an example, if a client suffers from Dementia, the family member that is responsible for hiring a caregiver, should absolutely consider hiring a caregiver that is certified and trained in caring for clients living with dementia. The AIDECAST Marketplace allows clients to filter service providers by skills and requirements a client may need. This include language, devices like wheelchairs and hoyer lifts, and other skills and knowledge such as sign language or knowledge of kosher.

Clients that prefer to have services managed by a private pay home care agency can reach out to the agency for assistance in finding and assigning the ideal aide for the client. Having a private pay home care agency manage services for you or your loved will cost more than simply hiring a caregiver through a marketplace, but you can expect to receive VIP level of care from day one. This include everything from scheduling caregivers, making last minute changes upon request, keeping aides on standby for any last minute emergency or cancelations, and handling payroll for the aide.

To learn more about the AIDECAST Home Care Marketplace, you can visit


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