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Recently I was ill but needed only 4 hours of service per week. When I inquired about that # of hours, I was told that Home Care agencies will only contract for services if you purchase their minimum # hours which were well over what I needed. That put home care financially out of reach. On the other hand, when I was discharged from a hospital bed, physicians were able to order limited visits (in my case nurse visits 2x a week). This, also, was a time limited order. What happens to those who need ongoing, indefinite home care for a chronic condition but for only a few hours a week?


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Some do and some don't. When I was looking for my brother I found that three days a week for four hours a day was the minimum and it was way over what he wanted or needed at that time.
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It all depends on where you live. We found the same thing. All the agencies wanted over $800 worth of shifts per month on a contract.

Called every agency in the county. Finally found the owner of one who was in a chatty mood. She explained to me that there is a major shortage of health care employees in our area, and that they can pick and choose their shifts. And, the CNAs/Home Health Care personnel choose minimums of 8 hour shifts a few days a week on a routine basis. Nothing we could do about it, really. It's a matter of supply and demand.

Some people are able to find people online via FB and Nextdoor.com , but the ones I found tended to have poor backgrounds (putting it mildly) ... so we didn't go with that approach.

So, I do all the care. Other than the Skilled Nursing/PT that Mom's insurance provides from time to time as needed.

My Mom's bedbound/incontinent, paralyzed. Yup, she needs chronic care - and I provide it all 24/7. It is what it is.

The Area Agency on Aging in my county advised me that Medicaid would be necessary to receive further services.
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The agency we use does not require a minimum number of hours per week, and I don't believe other agencies in our area do either. However, they do have a minimum of a four-hour shift. They used to offer 2 and 3 hour shifts, at a higher cost per hour, but found it was very hard to get workers under those circumstances. If a person only needs one four-hour shift per week, that's fine with them. For short-term home care that is covered by Medicare and ordered by a doctor, e.g. following surgery or an acute illness, agencies do provide shorter shifts, such as for home aides or CNAs who come in to help the person shower. Those are generally two hour shifts a few days a week.
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