Ask The Expert Questions answered by
Paula Foster RN BSN CMC
Question: Could you give me some information on respite care, hospice care and what is covered by insurance?
Submitted by Claudette of Coventry
Hospice is quality, compassionate care for people facing life limiting illness. It is an interdisciplinary team (physicians, nurses, therapists, social workers, clergy, home health aides and volunteers) approach to medical care, pain management, and emotional and spiritual support for patient and family.
Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit and most private insurers. Medical equipment, supplies and drugs for symptom control and pain relief are covered under the Medicare Hospice benefit. Short term inpatient care for pain and symptom management and respite care is also covered by the Medicare Hospice Benefit. Bereavement support is offered to families for a year after the death of a loved one.
Respite Care Services (421-7833) also offers a program to provide relief to caregivers on a cost sharing basis. If you have any other questions please call me at 788-2400
Question: Does your agency do peritoneal dialysis for a resident in an independent living center?
Submitted by Rose of Coventry
HealthTouch does not do peritoneal dialysis. The Dialysis Center in East Providence has a peritoneal dialysis nurse who will visit a patient in the community to instruct on the procedure. The telephone number is 401-435-5200
Question: My mother has been diagnosed with lung cancer and is now receiving radiation therapy. Right now her good days out number her bad but she is 80 years old. We discussed her future and she wants to remain at home as long as possible. When should I look into home care? I don’t want to wait until she’s doing poorly. So far we are fine with my visits to her but I work and fear that eventually that won’t be enough. Any information you can give me would be greatly appreciated.
Submitted by Darlene of Coventry
Now is a good time to become familiar with the types of services that are available for home care. The VNA of CNE and HealthTouch are both home care agencies that can assist you with keeping your mom at home. The VNA of CNE provides skilled services that are covered by most insurance. HealthTouch provides non skilled care services that are private pay and can be covered by Long Term Care Insurance.
If your mother needs help with meal preparation, transportation, grocery shopping or errands then HealthTouch can help now. We can send in a companion who can assist with these services. If she needs help with her bathing/ showering or getting herself dressed we can assist with a Certified Nursing Assistant. If she needs help with medication management we can send in our registered nurse to prefill her medications into a cassette so she is taking medications correctly.
All of these services are considered non skilled and are not covered by insurance. (With the exception of workman’s compensation or medical assistance.) For skilled services the patient has to be homebound and skilled care (for example that provided by a Registered Nurse and/or Physical Therapist) has to be ordered by a physician. Talk to your physician about the need for skilled services. Please call with any questions at 401-788-2400.
Question: My wife 82 years old gets up every 2-3 hours at night to urinate and she always wets her pj bottom before we get to the toilet. I get up to help her to the toilet since she is very weak has trouble walking and is afraid of falling. It gets worse as time goes on. She is “weak”,” tired” and “sleepy”. It’s going on for 8 years now and getting worse. We have seen about 30 doctors, taken all kinds of pills nothing works. Help! Are there thing she can wear to stop or catch the urine.
Submitted by Jack for Selma of Providence
Yes, there are many products available that your wife could wear to stop her clothing from getting wet. There are diaper like products, panty shields/ inserts, and pull up underwear. You can find them in the drug stores, grocery stores, Sam’s/BJ’s and many are available on line. Incontinent products can be expensive and there are discounts/coupons available on may online websites ( Depend.com, Lynncore.com, homedeliverymedical.com) to name a few.
A bedside commode (portable toilet) may also be helpful so she does not have to walk many steps to get to a toilet. At HealthTouch we have certified Geriatric Care Managers who have received advanced training in the care, treatment and special needs of older adults. They have experience working with patients and their physicians to solve problems. Please call us at 401-788-2400 if we can be of assistance to you.
Question: My father is 92 years old and very independent. In May he suffered a fall and broke a bone in his pelvis (no displacement). He has been in rehab and is ready to come home. How do I handle this? What are my options for home care?
Submitted by Betty of Chepachet
Ask his physician if further skilled therapy( Physical therapy, Occupational Therapy or Nursing) services are needed once he returns home. The rehab facility will also assist you in this process. A physicians order is needed to receive this service. The VNA of Care New England can provide these skilled services which are covered by most insurance. If he is receiving skilled services he may also receive a Certified Nursing Assistant if needed for personal care.
These services are short term. If he continues to need assistance after discharge from skilled services with his personal care, light housekeeping, meal preparation, laundry, grocery shopping or transportation HealthTouch can assist him with these needs. These services are non skilled and are private pay or may be covered by Long Term Care Insurance. If he financially qualifies he may be eligible for DHS/DEA home care service programs at reduced rates. Please call me at HealthTouch with any further questions. 401-788-2400
Question: Could you be more specific about what services you actually provide? My mother has my father, but he is getting too old to take care of her alone. She has mobility issues, and needs help walking to the bathroom, bathing, and such. What services do you actually provide in these areas and what is the cost of such services versus going into an assisted living facility/nursing home? Also, who pays for these services?
Submitted by Carolyn of Johnston
HealthTouch provides Certified Nursing Assistant services to patients in their home to assist with bathing/showering, dressing, ambulation/transferring, meal preparation, light housekeeping, errands, laundry, changing and making the bed, grocery shopping and transportation.
The services of HealthTouch can be purchased in two hour increments. A registered nurse is sent to the home free of charge to do an assessment and with the input of patient and/or family devises a plan of care that meets the patient needs. The hourly fee for a certified nursing assistant starts at $24.00 an hour. Services can be scheduled once a week for 2 hours or 24 hours a day for 7 days a week. It all depends on how much care is needed to keep patient at home safely.
Home Care can be less costly than assisted living or nursing home depending on the number of hours a certified nursing assistant is needed in the home. If your mom has mobility issues you might also want to discuss with her physician the need for skilled physical therapy services in the home. The services of HealthTouch are private pay or can be covered by Long Term Care insurance.
Question: I have an elderly mother who is incontinent of urine and refuses to spend money on adult diapers. Are there any programs available where she can receive these needed personal care items at a reduced rate?
Submitted by Fred in Burriville
Incontinent products can be expensive. There are many websites that offer discounts (for example Depend.com offers one coupon per household per month for their brand products for a reduced cost and also they will deliver for free or homedeliverymedical.com has special offers and Lynncore.com sends out free samples ).
Some of the discount large shopping stores (i.e. Sams club, BJ’s) may also be less expensive. The local senior centers sometimes have these products that are donated to them and will give to local residents. The RI Medicaid program will cover diapers if the patient has a diagnosis of incontinence and it is ordered by a physician.
Question: May my primary physician contact you for an in home rehabilitation, home safety and modification assessment? Chronic Pain, Long Term Care Plan, medical modifications and adaptive equipment.
Submitted by Sandra in Providence
The VNA of Care New England has a Rehabilitation Department that provides in home rehab services. A physicians order is required and he or she can make the determination if the patient requires this level of care. A physical therapist will make a home visit to do an assessment and put together a plan of care that may involve other staff members such as an occupational therapist. They will make recommendations for adaptive equipment and modifications to the home environment to make it safe for patient.
Call The VNA of CNE at 401-737-6050. HealthTouch in conjunction with Lifeline is also available to do a home safety evaluation with a Certified Aging in Place Specialist. This service is free and does not require a physician order. The specialist will do a home review and give you a safety report with recommendations for improvements. Call HealthTouch for this service 401-788-2400
Question: Are services of HealthTouch covered by Medicare?
Submitted by Kathy of Warwick
No, the services from HealthTouch are not covered by Medicare. The services that HealthTouch provide are considered to be non-skilled and Medicare covers skilled services. Skilled services require a physicians order and the care is provided by a registered nurse or a therapist. The VNA of Care New England provides skilled services. These services are usually short term and for acute care. Healthtouch services do not require a physicians order and can be requested by patient or family members. It is for chronic conditions and long term care. The services are private pay or can be covered by Long Term Care Insurance.
Question: Does Medicare cover hospice treatment if end of life issues are close with rapid decline? i.e. my mother has SDAT (Alzheimer) and kidney cancer.
Submitted by Cynthia of Jewett
Medicare does have a hospice benefit. In order to qualify for the hospice benefit the patient has to have a terminal diagnosis and a prognosis of 6 months or less. This has to be certified by a physician. The patient also has to be accepting of the hospice philosophy of treatment which enhances comfort and improves the quality of an individual’s life during the last phase of life.
Question: How do you manage to keep an aging parent home, what type of resources are there for a sick parent who needs extended care and supports?
Submitted by Dawn of Coventry
HealthTouch is a resource that provides all levels of care in the home. We have certified nursing assistants who can assist with personal care, light housekeeping, meal preparation, grocery shopping, errands, laundry, transportation and companionship. They can visit for two hours once a week or for 24 hours seven days a week. It depends on the needs of the patient. We have registered nurses who do medication management.
We have a care management program with a team of RN’s who are certified managers of care who do a complete physical, functional, financial and environmental assessment and put together a plan of care to meet the patients needs and to keep them at home safely. They are experts in community resources. We install Lifelines to give peace of mind to families worried about their loved ones getting the help they need. With Lifeline help is summoned with the push of a button. All of these services are considered non-skilled. If your parent needed skilled services the VNA of Care New England provides that level of care.