In Texas, home care, home health care, in-home care and custodial care are terms that are often used interchangeably to mean any form of care provided to a senior or other individual in their own domicile. For example, the terms above are frequently used interchangeably regardless of whether the individual needs skilled care or non-skilled care. It’s important in practice however, to distinguish between home health care (meaning skilled care) and home care (a more general category of services that include both non medical home care and home health care).
A caregiver in a client home can assist with a multitude of needs. As a general guideline, there are two different classes of needs or activities served by home care attendants and home health care aides: Activities of daily living – called ADL’s for short – are comprised of six activities which include bathing, dressing, transferring, toileting, eating, and ambulating (walking). These needs are often served by home health aides (HHA) and certified nurse aides (CNA).
The second class of needs or activities are called instrumental activities of daily living (IADL’s) and consist of eight tasks: light housekeeping, laundry, food preparation, medication reminders, using a telephone, grocery/clothes shopping, assistance using money and escorting/transportation to appointments. These activities are most often filled by a non medical home care attendant or custodial caregiver.
Texas Caregiver and Aide Qualifications
The Texas Department of Aging and Disability Services is responsible for licensing home care agencies. Caregivers under agency employment have previous experience in home care and or institutional care facilities like nursing homes, hospitals and assisted living units. Caregivers can also take an examination to become a Certified Nursing Assistant (CNA).
Licensed Non Medical Home Care in Texas
Texas is a licensure state for both non medical and home health care services, meaning an agency must be licensed to operate legally. This provides consumer protections, minimum conventions and standards which must be implemented and general oversight by the state.
Full service Texas home care and home health agencies do caregiver background checks (criminal), department of motor vehicle checks (DMV) as well as perform employment reference checks. Full service agencies also educate, train, coach and supervise their caregivers.
Paying for Care in Texas
Home care fees paid for non-medical agencies are done so “out of pocket” and are not reimbursed by government or private healthcare insurance carriers. For example, medicare and medicaid will not reimburse your out of pocket costs. But, long-term care insurance will help pay the cost of non-medical home care based on the terms dictated in the policy. In some cases (e.g. after a patient leaves the hospital) medicare may cover short term care costs for several hours of home health care per week.