Home Health When Memory Is Changing

Caring for someone with memory loss is a full-time act of love, and it gets harder when a medical problem is added on top: a wound, a new medicine, a fall. Home health brings the medical care home, in a way that respects who your parent is.

If the doctor orders it and your parent qualifies, Original Medicare covers home health at no cost to you.

What dementia support can look like at home

Your mom still knows her way around her kitchen, but the pill bottles on the counter have become a puzzle. Some mornings she takes them twice, some mornings not at all. Last week she got up at two in the morning, dressed for church, and was halfway down the hall before you heard her.

Then something new lands on top: a fall on the front steps, a skin tear that is not healing, a new medicine she cannot keep straight. Home health brings the medical care into the rooms she knows and teaches you, so you can keep the routine going when nobody is visiting.

How home health helps

Here is what each person on our team does under your doctor's plan of care.

Skilled nursing

Your nurse treats the problem that brought us in, whether a wound, an infection, or a new health problem. Your nurse also goes through every bottle with you and helps you set up your weekly pill organizer. A locking one from the pharmacy can help if she takes doses twice. Sudden confusion can point to something else, like a bladder infection or too little to drink, so your nurse watches for that and tells the doctor.

Occupational therapy

The occupational therapist finds the version of bathing, dressing, and meals your mom can still do: clothes laid out in order, a picture of a toilet on the bathroom door, a bath at the hour she is calmest. Then a walk through the house with you: night lights in the hallway, the stove knobs, the rug at the top of the stairs.

Physical therapy

The physical therapist practices standing up from the sofa, walking with a walker if she needs one, and stepping over thresholds, and shows your family how to guide her without pulling on her arms.

Speech therapy

A speech therapist helps with communication: simple questions, one step at a time, cues that can lower frustration. If she coughs at meals or holds food in her cheek, the therapist checks her swallowing and shows you which foods and drinks are safer.

Medical social work

The social worker is for you as much as for your mom: adult day programs, respite options, caregiver support groups, and help with paperwork. The social worker can also point you to the Alzheimer's Association.

Home health aide

An aide can help with bathing and personal care, following the therapists' routine, but only as part of skilled care.

What the first visit looks like

The first visit usually happens within 24 hours after the doctor or hospital sends the order. A nurse or therapist meets your mom where she is comfortable and takes it slow: health history, every medicine in the house, blood pressure, and a walk through the rooms she uses most. If new people make her anxious, tell us when you call: (818) 579-4012.

You get one named coordinator to call with any question. We send the same nurse or therapist whenever possible, because familiar faces matter with memory loss, and we call before every visit. If someone else must come, we call first. Our team speaks English, Spanish, Armenian, Russian, and Tagalog. Speak another language? Call and ask whether we have staff who speak it. If we do not have staff who speak your language, we arrange a free interpreter.

When to call

Call your doctor or nurse if you notice:

• Confusion suddenly much worse than usual, or unusual sleepiness
• A fall, even if she seems fine afterward
• Fever, pain when she urinates, or a new cough
• Refusing food or fluids for more than a day, or coughing with meals
• New agitation, hitting, or fear that is not like her

Call 911 for chest pain, trouble breathing, a fall with a head injury, or signs of stroke such as a drooping face, a weak arm, or slurred speech. Call 911 too if she wanders off and you cannot find her quickly.

What family can do

• Keep the days the same. Same wake-up time, same meals, same chair.
• Make the house simple. Clear the hallway to the bathroom, add night lights, lock up the medicines.
• Answer the feeling, not the fact. If she asks for her mother, who died years ago, you do not have to correct her. Ask what she misses.
• Take care of yourself. Ask the social worker about respite, and read our guide on caring for a parent or spouse.

Cost and who qualifies: with Original Medicare, covered home health is $0 if you qualify, and your doctor decides. See what Medicare covers, who qualifies, and what is not covered.

If she qualifies, Original Medicare pays for home health at $0 to you. Equipment such as a walker has a 20% coinsurance of the Medicare-approved amount after the Part B deductible. Medicare Advantage plans cover home health too but may use their own agency networks and rules. We also accept private insurance. Medicare does not pay for 24-hour care, meal delivery, or homemaker or personal care when that is the only care needed; supervision and companionship on their own are home care, not home health. See what Medicare covers and home health vs. home care.

Medicare does not cover 24-hour care at home, meal delivery, or housekeeping and personal care when that is the only help you need. That kind of help is called home care, and our guide on home health versus home care explains where to look.

Medicare requires a face-to-face visit with a doctor or nurse practitioner, within 90 days before or 30 days after home health starts. Some doctors make house calls. Ask us, and we will help you find one. That doctor is independent of Comfort Care, and the choice is yours.