It will likely affect the children's family lives and their ability to continue with their full or part-time employment obligations.

Home Health Care includes a variety of services for occupational, physical, respiratory, speech therapy or nursing care.   Also included are medical social worker, home health aid, and homemaker services.   These are services a patient is able to receive in their own home or the home of a relative or friend during a period of convalescence or for a chronic illness or injury.

There are numerous types of care that can be received at home today and they can be very costly due to the fact that they can be extremely labor intensive. Taxpayers support Medicare and Medicaid and private insurance is supported by premiums so we all pay for Home Health Care either directly or indirectly. The balanced budget Act of 1997 caused severe cutbacks in the number and length of time allowed for Home Health Care visits. Long-Term Health Care is the real health care crisis.   Since patients no longer convalesce in hospitals they are released from the hospital "quicker and sicker".

(1)More than 90% of seniors say they have no intention of leaving the comfort of their own home or community to receive care. They all prefer to "age in place", they will take advantage of all services that become necessary in order to stay in their home. However, they are not making plans to guarantee that they WILL HAVE THAT CHOICE. So they will not!   It is unrealistic to expect care in your home if you have not planned for it in advance. With the health care system hemorrhaging from governmental cutbacks and increased cost of services we must assume personal responsibility for our own HOME HEALTH CARE.

Home Health Care today is paid for from private funds, very limited coverage under both Medicare and Medicaid, the home and community based services waiver and senior centers. Home Health Care can be very simple or very sophisticated and it is all covered, depending on the company and the policy, by Long-Term Care insurance. The policies that are being sold today are extremely comprehensive. They are actually designed to keep people out of nursing homes. The reality is that 90% of all people receiving Long-Term Health Care today receive it outside of nursing homes typically in their own home or that of a family member.  Family members pay for the care out of savings, or if the care recipient had the foresight to purchase Long-Term Care insurance an insurance company pays for the care. Long-Term Care insurance will pay for all levels of Home Health Care including Skilled, Intermediate, Custodial, and Basic care. Below are some examples of levels and types of Home Health Care services covered by Long-Term Care insurance.

• Care provided by a registered nurse, licensed practical nurse, and a licensed vocational nurse.
• Expenses incurred for therapies such as occupational, physical, respiratory, and speech therapy
• Services provided by a home health aid or personal care attendant for personal hygiene, and medication management and or dispensing
• Homemaker services including dressing and grooming assistance, meal preparation, laundry, homemaker chores such as housework and taking out the trash and even household repairs
• Other varied services that can be paid for by Long-Term Care insurance include, a caregiver training benefit, special meals, meals on wheels, nutrition services, home medical technology such as a mobile telemedicine unit with a video screen allowing a nurse or doctor to view and communicate with the patient, a medical alert system and an informal caregiver training benefit
• Unskilled homemakers, for assistance with what are referred to as "instrumental" activities of daily living such as assistance with shopping, telephoning and bill paying.
• Oftentimes home health care in conjunction with care at an adult day care center while the family members are at work is all the care that is required. Care in an adult day care center in a community setting can include transportation between the home and the center.
• Long-Term Care insurance will also pay for hospice care in your home.
• Benefits that are unique to certain companies and policies include: care co-ordination, developing and implementing a plan of care, care guidance and advisory benefit, a respite care benefit, monthly prescription drug benefit, and advance payment benefit, restoration of benefits, provider discounts, enhanced elimination period and an upgrade privilege.
  

Now that we have removed the mystique and clarified the importance of Long-Term Care insurance as a source of payment for both formal and informal care provided to patients in their homes why are people not taking responsibility for insuring themselves for Long-Term Health Care?

Lack of knowledge about Long-Term Care insurance - They think it is Nursing Home insurance.

• The assumption that their Health insurance will pay for it 
• Misunderstanding of Medicare- they believe it will pay for Long-Term Care
• Believing that their children will take care of them

(2)LTC Comment: According to the following two items, Medicare and Medicaid won't be much help with home health care services in the future. Private pay Long-Term Care

Insurance to the rescue!

These hard facts about hard truths should help cut through consumer myopia and inertia about LTC protection

(3)"If you're among the 23 million people who provide Long-Term Care to an aged relative or loved one, there's a message for you from Washington buried in the 1,000 pages of the new Medicare law:

"You're on your own."

"The measure, signed into law Monday, (December 8, 2003) by President Bush, continues the federal government's six-year retreat from funding in-home care for Medicare recipients, reducing expected funding increases for inflation to 2.5% from 3.3%. Home-Care programs, such as temporary nursing help, are especially important to family caregivers, who often make sacrifices to keep aged relatives at home.

"A halving of Medicare Home-Care funding since 1997 has slashed the number of patients receiving this help by more than one-third, to 2.2 million from 3.5 million. The numbers are likely to fall still more under the new law, especially in areas where nursing shortages make help more expensive, says Michael Heaney, a fellow at the American Political Science Association, Washington, D.C.

(1) US NEWS AND WORLD REPORT May 21, 2001
(2) LTC Bullets,Center For Long Term Care, December 19, 2003
(3) Excerpt from Sue Shellenbarger's, "Work and Family" column, in the December 11, 2003 Wall Street Journal.