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Personal Care Services
Personal Care Services are defined as assistance, either hands-on (actually performing a personal care task for a person) or cueing so that the person performs the task by him/herself, in the performance of Instrumental Activities of Daily Living (IADLs) and/or Activities of Daily Living (ADLs). ADLs include eating, bathing, dressing, toileting, transferring, personal hygiene, and maintaining continence. IADLs capture more complex life activities and include light housework, laundry, meal preparation, transportation, grocery shopping, using the telephone, medication management, to include informing a client that it is time to take medication as prescribed by his/her physician or handing a client a medication container, and money management to consist of delivery of payment to a designated recipient on behalf of the client. Personal Care services can be provided on a continuing basis or on episodic occasions. Skilled services that may be performed only by a health professional are not considered personal care services.
Personal care services have two different levels. The higher level will are considered personal care services II and will be used, based on assessed need,when the majority of care is related to activities of daily living (e.g. hands-on care to include bathing, dressing, toileting, etc.). This home care service may also include monitoring temperature, checking pulse rate, observing respiratory rate, and checking blood pressure. The lower
level, personal care services I, will be authorized when, based on assessed need,all of the care is for instrumental activities of daily living (e.g. hands off tasks such as laundry, meal preparation, shopping,etc.). PC I services do not include hands-on care. Both personal care services allow the home care provider to accompany the individual on visits in the community when the visits are related to the needs of the individual, specific in the plan of care, and related to needs for food, personal hygiene, household supplies, pharmacy or durable medical equipment.
Gail Schwartz wants to keep her 85-year-old husband out of a nursing home as long as she can, but it isn’t easy.
Because David Schwartz, a retired lawyer, has vascular dementia and can no longer stay alone in their home in Chevy Chase, Md., she tends to his needs from 1 p.m. to 11 p.m. every Monday through Saturday and all of Sunday.
When she dashes out for errands, exercise and volunteer work in the morning, she checks in by phone with the home care aides she has hired. “I’m always on alert,” she said. “At the grocery store, I’m thinking, ‘Is David O.K.?’ ”
A home care aide now stays overnight, too, because Mr. Schwartz awakened so frequently, disoriented and upset, that his wife began to suffer the ill effects of constantly disrupted sleep. She has moved into the bedroom across the hall.
“I need my rest,” she said. “I’m no spring chicken myself.”
Indeed, Gail Schwartz is 78. While she thinks her husband does better at home — “he’s getting 24-hour attention, and you don’t get that in a nursing home,” she said — friends point out that the arrangement is much harder on her. She worries, too, about costs climbing as Mr. Schwartz’s health declines and his needs increase.
For now, though, she manages, part of an apparently growing phenomenon: the old taking care of the old.
Every few years, the National Alliance for Caregiving and the AARP Public Policy Institute survey the state of American caregiving; their latest report, published last month, focused in part on caregivers over 75. They constitute 7 percent of those who provide unpaid care to a relative or friend, the survey found — more than three million seniors helping with the so-called activities of daily living (bathing, dressing, using a toilet), instrumental activities of daily living (shopping, transportation, dealing with the health care system) and a rising tide of medical and nursing tasks……….
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