12 and 24-hour shifts are an option through Private home care services. “Private Services” are usually funded through long-term care insurance or paid out-of-pocket. Many people misunderstand that Medicare will pay for extended care including 12 and 24-hour shifts, but that is not true. Medicare pays for short-term care from a licensed clinician like a nurse or therapist. You must qualify for this service (list qualifiers). Medicare home health care is designed to help you achieve the level of functioning you had before a planned or unplanned illness and/or hospitalization. Some common times you may qualify for and receive Medicare home health care is after a planned surgery like a hip replacement. You may also qualify for Medicare home health care if you have a diagnosis that has caused a decline in your ability to function daily, that has the potential to improve through short-term visits. Now, you can envision the difference between Medicare home health care and Private Services, and begin to understand when each service is applicable.

Medicare-funded services are short term to regain function. On the other hand, 12 and 24-hour shifts, paid for by long-term care insurance or self-pay, provide consistent, planned assistance with general tasks one performs throughout their day. This may begin with rising and dressing, to meal prep, taking medication, moving safely throughout your home and even going out and about in the community for general errands, doctor visits and other appointments.

In some scenarios, an aging loved one may return home after a hospitalization and receive Medicare home health care as well as Private 12 or 24-hour shifts for assistance and supervision. As they become stronger and more independent, they may reduce and then discontinue their Private home care services. In other instances, they may regain some of their functioning but still need ongoing help at home, and may continue receiving Private Services up to 24 hours per day.

24-hour care rarely consists of one caregiver who is working a 24-hour shift. This may also be called, a live-in shift, although your caregiver does not actually live with you. There are qualifiers for this shift including that your aging loved one’s needs must not interfere with their ability to sleep safely and soundly, rarely needing overnight assistance. This is the reason we say one rarely receives this type of care: their needs do not stop simply because it is nighttime. In many cases, your aging loved one’s needs increase overnight for a variety and/or combination of reasons. They may become more confused and disoriented during the evening, for example. If you are certain your aging loved one could be safe using 24-hour shifts, we may suggest that we begin with two, 12-hour shifts. Our documentation and observations by our caregivers will help us work together to agree on the schedule that safely and optimally meets your aging loved one’s needs. If and as they improve, you can change and reduce their home care hours.

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