The pandemic has made home care more appealing for many older clients. That’s why, especially for the chronically ill, medically directed home care is a becoming an important option. Here’s a quick look at the essential points to cover when talking about home care with a chronically ill client.

The desire to age in place

The AARP reports what many Elder Law attorneys already know: Americans want to stay in their homes as they age. Yet fewer than 50% anticipate being able to stay in their current home, due to finances, difficulty in managing the space, or the progression of their own infirmities.

The truth is that, especially for elderly people with chronic and medically complex conditions, staying at home is not always an easily accessible option. For Elder Law attorneys with chronically ill clients, here are 3 important things to consider when weighing home care as an option

“While 76% of Americans age 50 and older say they prefer to remain in their current residence…just 59% anticipate they will be able to stay in their community, either in their current home (46%) or a different home still within their community (13%).

AARP 2019

3 things to remember

1. Care changes

Health is a moving target for any client, but even more so for those with degenerative conditions and diseases. Further, chronological age is not a determinant or a predictor of overall health. So there has to be flexibility in home care planning.

“Ideally, you should have access to medical and non-medical care and care coordination as issues arise,” said Bryan Adler, a Certified Elder Law attorney and Managing Attorney at Rothkoff Law Group. “The best-case scenario is to be able to toggle back and forth between the two, so the client gets medically directed care when necessary, but also receives home care that improves quality of life for the client and the caregivers.”

“Care changes. That’s important to understand. Everything is a snapshot in time. You have to see care as a dynamic variable."

Bryan Adler, Certified Elder Law Attorney and
Managing Attorney at Rothkoff Law in New Jersey.

2. Prepare caregivers for the task of care coordination

Attorney Adler, who has worked in association with SeniorBridge for several years, had this insight: “Unfortunately, our health care delivery system tends to focus on the “conveyor belt” of patients and clients rather than how things need to work together.”

For this reason, coordination of care from level to level is a challenge often left to the client’s caregiver, for whom the complexity and urgency of this work can be stressful. Offering resources for care coordination and transitions is valuable information for family caregivers of clients.

3. Evaluate home care services based on multiple criteria

  • Is the company licensed according to state regulations? Home care organizations are subject to both state and federal laws. Licensing requirements vary by state and it’s a good idea to be familiar with your home state’s specific requirements – and affirm that any candidate meets basic licensing criteria.
  • Are the providers happy employees? Research has shown that satisfied employees are more productive and effective. They’re also more likely to deliver “discretionary effort”, so examine social media platforms for employee anecdotes about work-related issues and culture at competing home care agencies.
  • What are the standards of practice at work? While it’s difficult to audit home care services, it’s good to ask about key practices: Do nurses and home health aides educate the client about their condition? How does the home care agency ensure a good “fit” between providers and clients? How are problems and issues resolved?


Medically directed home care is positioned to deliver solutions for chronically ill clients who want to remain at home. Elder Law attorneys advising such clients should look at both sides of the equation:

  1. The qualifications of the home care service and
  2. The projected needs of the client and the family caregiver.

The integrated care management model by SeniorBridge

Home care services vary widely in the services they provide.

SeniorBridge offers an integrated care management practice model that involves two components:

  1. Clinical care (under the direction of an RNCM/Registered Nurse Care Manager) supported by a Social Worker and a team of caregivers, based on patient’s needs and
  2. A portfolio of home care services and geriatric care management in such areas as nutrition, caregiver education, benefit coordination, transportation, and coordination with discharge planners, physicians, pharmacy, home health agencies, and care managers.

NOTE: We have full COVID-19 safety protocols in place to keep clients, families and associates safe.

For more information on medically directed home care, contact SeniorBridge.

Sources consulted:
AARP 2019
National Library of Medicine/NIH (2020)
LinkedIn (2020)

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