Texas Home Care

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Texas Home Care: Common Terms, How to pay for Home Care, Licensing and Questions to ask

Retirees and our aging adult population enjoy the warm climate and low cost of living in the Lone Star State. The state of Texas is home to more than 3.5 million senior citizens, and the number is growing with each passing year. As our seniors continue to age, it is likely that some will require care at some point. When most Americans think of housing and care for our aging population, they think of nursing homes, but this is not your only option. Aging adults deserve the best accommodations when it comes to care, and Texas has a variety of senior care and housing that is not a nursing home to fit the needs and preferences of everyone. With the passage of time, challenges of aging may cause living at home to become increasingly difficult. Typically, senior citizens prefer to age in place as long as possible, rather than move into a senior living community. Texas Home Care (or In home Care) is designed specifically for aging adults who only require some basic assistance at home.

The state of Texas is one of the largest in the nation, and is home to several cities where senior citizens may receive excellent healthcare: Dallas, Houston, Austin, San Antonio, El Paso, Ft. Worth, among many others.

Home Care may also be called In Home Care in Texas

The two terms tend to be universal. Home Care (or In home Care) is suited for seniors who may only require some basic assistance at home. The home aides may support with activities of daily living (ADLs), which include medication reminders, assistance with bathing and eating. Care plans can be customized for each individual, however, in Texas home care agencies are not required to create care plans for clients. Home Care may be an excellent care option 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, and a sense of connection.

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?

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.

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.

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?

Home Care Aides provide a variety of non-medical services and assistance. Depending on the individuals condition and if they require a more in-depth level of care, elderly adults may require different types of care than in home 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 home care, there are levels of care suited for an individuals needs. The specific services offered in home care will vary state by state.

What are the different 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. 

Laws and Regulations

Licensing

Home care and in home care agencies ate licensed and regulated by the Texas Department of Health and Human Services. They monitor to ensure all clients receive safe and proper care.

Staffing

There are no laws in place requiring home care agencies to conduct criminal background checks upon employment of new staff. However, management must undergo background checks.

The agencies who participate in Medicare are required to only employ home health aides who have finished certain training criteria (75 hours of training, which includes 16 hours of classroom training and practical training)

Grievances

Suspected abuse in Texas may be reported to Adult Protective 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 home care cost in Texas?

The cost of in home care is less than the national average. A month of home care in Texas is $4,600. he national average is nearly $5,000. Texas is near the middle of cost when compared to neighboring states in the region.

  • National average cost of home care per month: $5,000
  • Texas: $4,600
  • Oklahoma: $4,875
  • New Mexico: $4, 625
  • Arkansas: $4,200

Because of the size of Texas, the cost of home care will vary between cities within the state.

  • Amarillo: $4,075
  • Houston: $4,600
  • San Antonio: $4,595
  • Dallas: $4,875
  • Austin: $5,200

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.

Benefits.gov is a resource to learn more about Medicaid eligibility for you or a loved one.

Texas Area Agencies on Aging is part of the Department of Health and Human Services, and intends to help aging adults navigate issues that may come up to promote safe and healthy living.

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

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