California Home Care

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California Home Care (In Home Care): Common Terms, How to pay for Home Care, Licensing and Questions to ask

California is a sought out destination for seniors and retirees. The climate draws people from across the country to enjoy the year-round sunshine and laid back lifestyle. There are over 40 million people in California, and people 65 years and older make up about 16%. There are nationally recognized hospitals leading the charge of new healthcare technology and philosophy. As the number of aging adults continues to rise, it is likely many will require care at some point. Most of the time, when people think of senior care the first thing they envision is a nursing home. Nursing homes are not the only choice people have for their care or the care of a loved one. There are many different types and levels of care for our population of people 65 and older. Typically, people prefer to age in place as long as possible, rather than move into a senior living community – but the challenges of aging may cause living at home to become increasingly difficult. The focus of home care (in home care in California) is to keep people healthy and safe.

Because of the size of California and the population, the state has a large number of agencies providing care for seniors. California in home care is available in a vast number of cities up and down the state: Los Angeles, Sacramento, San Jose, San Diego, San Francisco, Santa Barbara, Santa Cruz, Anaheim, among many others.

What is home care in California?

In the state of California home care is referred to In home Care. In home care is suited for seniors who may only require some basic assistance at home. Care plans can be customized for each individual. Home Care may be an excellent care options for family members if they must leave town or just need a break from caring for their loved one. The Home Care aides bring a sense of personalization, providing companionship and socialization, a sense of connection. The home aides may support with activities of daily living (ADLs), which include medication reminders, assistance with bathing and eating.

Home care and aging in place

In home care services include assistance with activities of daily living (ADLs). These in-home aides may assist with personal care and monitoring like they would receive in a long-term care community. All while they remain in the comfort of their own home.

How do you know it may be time for Home Care?

What are the signs to look for?

Is your loved one forgetting things more frequently? Typically, people forget things sometimes, but if you notice they are forgetting simple tasks they normally perform regularly, this may be a a sign that assistance is necessary.

Have you noticed your loved one is spending less and less time managing their hygiene or personal appearance. They may stop brushing their teeth or let their facial hair grow in an unkempt fashion when they didn’t before. Are they going longer periods of time in the same clothing, or neglecting relatively scheduled eating habits? Grooming and hygiene live under the umbrella of ADLs, and as such a Personal Care Assistant may help with these tasks.

It is not uncommon for elderly adults to experience trouble walking, getting up from a seated position or need help getting in and out of bed. Signs like this can be dangerous. The risk of a fall increases as mobility declines. The aide of a home care caregiver may assist with moving around the house safely.

Did you notice your loved one’s home is in disarray? Have they usually shown signs of tidiness or regular cleanliness, and now the home is disheveled and dirty. In Home Aides may assist in normal household maintenance like dusting and sweeping, cleaning the kitchen or doing laundry.

What Assistance do In-Home Care Aides Provide?

In home Care Aides in California provide a variety of services and assistance. Depending on the individuals condition, elderly adults may require different types of care.

Services included in home care:

  • Companionship 
  • Socialization 
  • Cognitive stimulation 
  • Medication reminders 
  • Grocery shopping 
  • Transportation 
  • Respite for family caregivers 

Often times, people think of nursing homes or retirement homes as the only places for senior care. As we’ve discussed earlier, there are multiple care options. And even within in home care, there are levels of care suited for an individuals needs.

California in home care may offer a variety of services depending on the agency you choose.

What are the different In home care options? 

The various care services and options

Personal Care Assistant 

  • Companionship as well as assistance with activities of daily living, (non-medical personal care) toileting, dressing, grooming, and bathing.  
  • They can help with grocery shopping and meal preparation. 
  • A personal care assistant can help with family difficulties. If a family caregiver must leave town or be away from the home overnight the caretaker can stay with the individual and monitor and assist as needed. 
  • If a spouse is too heavy, a personal assistant can be a great asset in helping the individual move without risk of injury. 
  • These care assistants cannot perform any medical care. 

Companion Care 

  • These companions spend time with older adults. Providing companionship is especially relevant for people who live alone, or do not leave the house due to cognitive impairments or frailty.  
  • These companions are there to look after the person, keep a watchful eye, act as an extension of the person to help with mobility and general physic functions.  
  • They may drive the person to appointments, prepare light meals and snacks. They may even play games or read and listen to music together. 
  • Companion care is a great way to bring social interaction and assistance to a person who may otherwise spend long periods of time alone. 

Home Health Care

  • Home health is the only type of home care associated with skilled nursing or any therapy services.  
  • This type of care is of a much higher-level medical care and therapy. 
  • Home health aides must have a nursing degree or certification or go through specialized training.

Laws and regulations in California

Licensing

The objective of in home care is to provide people in need of care with the highest quality services possible. To ensure agencies are held to the highest standard, all in home care agencies are licensed and regulated by The Department of Social Services’ Home Care Service Bureau.

Grievances 

  • All agencies should have a plan in place for families to voice any grievances or complaints. The person receiving care has extensive rights pertaining to the provided services.  

The individual under care has the right to file a complaint with the agency: 

  • Regarding their treatment and care provided. 
  • The failure of the agency to provide certain care. 
  • The lack of respect for property and/or person. 
  • Individuals have the right to participate in and be informed about, and consent to or refuse care in advance of and during treatment.

How much does in home care cost in the state of California?

In home care in California typically costs $6,110 per month. This rate is about $1,000 more than the national average for in home care. On average, California is the most expensive state in the region for in home care.

  • California: $6,110 per month
  • Oregon: $6,010
  • Nevada: $5,200
  • Arizona: $5,550

The cost of in home care varies drastically depending on where you live within California. Some regions and cities may costs thousands of dollars more per month than other cities.

  • Santa Cruz: $6,900 per month
  • Sacramento: $6,300
  • Chico: $5,750
  • San Luis Obispo: $7,200

In home care in California is more expensive than assisted living ($5,250) but far less expensive than a nursing home (nearly $10,000).

How to pay for home care

Medicare: 

Medicare does NOT cover standard home care including: 

  • Companion services 
  • Grocery shopping 
  • Meal preparation 
  • Light housekeeping 
  • Transportation 

Medicare does NOT cover personal care assistance including ADLS: 

  • Bathing 
  • Dressing 
  • Eating

Medicaid: 

Medicaid does cover home health for seniors who are eligible. 

Each state has its own Medicaid programs in place. As a result, eligibility and services fluctuate state to state.  

  • Home care services may be covered by regular state ran Medicaid and may also be offered under the Home and Community Based Services Medicaid Waivers. 

State Medicaid: 

In-home personal care services (dressing, bathing, eating, etc.) are not federally mandated, some states may offer them via Regular Medicaid. 

Long-term care insurance: 

An individual’s private insurance may help with some of the cost of home care. This usually pertains to long-term care insurance. 

  • The purpose of long-term care insurance is to cover senior care, which includes home care. Though, be aware that coverage varies depending on the insurance provider, the specific policy, and other factors. 
  • It is common that long-term care insurance will only start to cover care when the person with the policy requires assistance with two or more ADLs. 
  • As a result of the above, individuals who only need companion care may not be covered by their long-term care insurance.  
  • Typically, purchasing long-term care insurance is not an option if you are at the point where you already need care. 

Veteran aid and assistance: 

This benefit is available to some military veterans or surviving spouses. 

  • A veteran may qualify for as much as $2,050 each month. 
  • A veteran with a sick spouse may be eligible for $1,600 per month. 
  • If a veteran has passed, their surviving spouse can qualify for $1,300 per month. 

Private pay: 

  • Many families pay for care with private funds. 
  • Private pay can be a combination of retirement funds, personal savings, and pension payments. 
  • Family members may contribute funds toward a loved one’s care. 

Questions and inquiries about home care

Agency Information

  • Is the agency RN operated?
  • Is the agency a franchise or locally owned and operated?
  • Is the agency licensed by WA State Department of Health?
  • Is the agency licensed for both home care and home health?
  • Does the agency have liability insurance?
  • Can the agency respond to you 24/7?

Caregiver Information

  • Are employees licensed, bonded & insured? Or are they independent contractors?
  • Does the agency test skills, conduct behavioral interviews and verify caregiver credentials?
  • Are caregivers required to have current certifications for First Aid, CPR, and TB?
  • Are caregivers provided continuing education/training?
  • Can authorized individuals monitor care and make requests online in real time?
  • Does the agency offer caregiver replacement when the “fit” may not be right?

Documentation and Supervision

  • Does an RN/MSW/Care Manager conduct a free home care assessment?
  • Does an RN/MSW/Care Manager create a home care plan?
  • Does an RN/MSW/Care Manager supervise the caregivers?
  • Do caregivers receive client orientation before arriving at a client’s home?

Policies and Cost

  • Can services be cancelled with a 4-hour notification?
  • Does the agency offer flexible scheduling, custom care plans, and  a continuum of care?
  • Does the agency have weekly or monthly minimums?
  • What is the hourly minimum per shift?
  • Does the agency offer home care discounts?
  • What is the required deposit?
  • Will the agency accept long-term care insurance?

Eldercare Locator is a nationwide service that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care or transportation, or a caregiver education or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living.

Medicare provides a search feature to find & compare providers near you, most senior housing and care providers are included on CareAvailability.com. Find & compare plans in your area. Determine if you qualify for premium savings.

Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources.

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support and research. Whether you are living with Alzheimer’s or caring for someone with the disease, information and resources are available. 

Hospice Foundation of America is to provide leadership in the development and application of hospice and its philosophy of care with the goal of enhancing the U.S. health care system and the role of hospice within it.

National Association for Home Care & Hospice is a trade association that represents the nation’s 33,000 home care and hospice organizations and the caregivers who provide in-home health and hospice services.

Area Agencies on Aging The California Department of Aging (CDA) administers programs that serve older adults, adults with disabilities, family caregivers, and residents in long-term care facilities throughout the State. These services are provided locally by contracted agencies. This webpage is intended for those who provide, or seek to provide a variety of aging services.

The Home Care Services Bureau is responsible for licensing Home Care Organizations including processing applications, receiving and responding to complaints and conducting unannounced visits to ensure compliance.

California Community Action Partnership Association (CalPACA) is there to support aging adults and provide services so that they may remain at home.

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Written by The Care Availability Team
Experts in the senior care & retirement living industries

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