If the person you care for needs therapy or other medical services but has trouble getting out, house calls are a great solution. Historically, Medicare has had strict rules for home-based services and how “homebound” a patient must be for the services to be covered. It also limits the number of visits per week or the number of weeks allowed for care at home. In addition, the rules typically require a certain level of improvement in the patient for services to continue. Some of these rules are loosening. It’s worth checking. If you find Medicare won’t cover a service, you may have the option to pay privately.
Physicians. If your relative is frail and you don’t want the drive or the wait in the doctor’s office, consider finding a primary doctor who has arranged with Medicare to make house calls. Check out the American Academy of Home Care Medicine.
Rehabilitation therapists. Hiring privately allows for more visits per week or for a longer time period if your loved one’s progress is slow. This can mean the difference between a full versus a partial recovery. Or even better quality of life, with your relative retaining as much functioning as possible even if they aren’t “improving.”
- Physical therapists help with exercises to improve movement and relieve pain.
- Occupational therapists identify exercises and “adaptive technology” to make it easier to perform daily tasks of living.
- Speech pathologists suggest exercises and techniques for swallowing and speech problems. They also teach strategies to offset logical thinking problems due to dementia.
Psychotherapists. Is your loved one reticent to seek counseling? Home visits can feel more like a friendly chat. Your relative may feel safer and more in control on their home turf. Plus, house calls also allow for more privacy if they have concerns about stigma—no one will see them walking into a counselor’s office. Ask the therapist whether Medicare will cover home visits.
Check for quality. There are fewer guardrails on quality for home-based providers. Ask for references and always ask if they are licensed or board certified. Get their license number and look it up to see if there have been complaints or suits against them. If they can’t give you a license number, you might want to think twice.
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