SEPTEMBER 2016 ON HEALTH CONSUMER REPORTS 11 ConsumerReports.org/health ILLUSTRATION: 2016 © CHRIS LYONS (LINDGRENSMITH.COM) W hen my patients are injured or need surgery, their first ques- tion is often, “How long will my recovery take?” Those who have a sick spouse or live alone immediately begin to worry about who will help care for them while they heal. If you’re in this situation, here’s what you must know about getting help during at-home recuperation. If the help you require is mostly medi- cal, such as wound care or home intra- venous antibiotic therapy, it calls for skilled nursing care—visits from a regis- tered or licensed practical nurse, often from one of the nonprofit Visiting Nurse Associations of America. (Check with your insurance provider to see what’s covered.) When the needed services are more personal than medical—but impor- tant for helping you heal—a home health aide may step in. WHAT AN AIDE CAN DO FOR YOU Home health aides, who can be certified nursing assistants or personal care aides, usually work for Medicare-­ certified agencies, which meet certain health and safety requirements. They are trained to assist with tasks such as bathing and dressing, and to pro- vide basic health-related services such as checking vital signs and keeping track of your symptoms. Aides can also help plan doctors’ appointments and arrange for trans- portation. And they can aid with food shopping, prepare healthy meals, and follow a dietitian’s recommendations, as well as assist with laundry and light household chores. From a doctor’s point of view, an aide can be an important partner in care. When home health aides accompany pa- tients to my office, they’re often reliable sources of information about how their clients are progressing and setbacks they’re experiencing. The Proactive Patient FINDING THE RIGHT HELP The quality of agencies can vary, but these steps can help you choose wisely: àPlan ahead if possible. If you’re hos- pitalized, a hospital staffer should meet with you or your family a day or two be- fore discharge to discuss your needs for help at home. Otherwise, ask your doctor for a referral to a social worker, who can tell you about local agencies. àGet the lowdown on area agencies. Go to medicare.gov/homehealthcompare and search by ZIP code for local agencies, a list of services they provide, ratings of their care, comparisons with other lo- cal agencies and national averages, and results of patient satisfaction surveys. (Some of the information is reported by the agencies themselves.) If you live in Arizona, Florida, Iowa, Maryland, Mas- sachusetts, Nebraska, North Carolina, Tennessee, or Washington, your state is part of a pilot program that is scrutinizing and evaluating agencies more closely for their quality of care. àAsk questions. Go to eldercare.gov for a list of suggested questions to ask a prospective agency about the quality of its caregivers, screen- ing procedures, fees, and more. (Click on the Resources tab, then on “Factsheets” and “Home Health Care.”) COVERING THE COSTS When prescribed by a doctor or recom- mended by a visiting nurse, part-time help from certified home health aides may be covered by private health insur- ance and Medicare. Be sure you know how many hours of care are covered and over what period of time. If the agency doesn’t specify, ask your insurer. You’ll also have to meet certain speci- fications. For example, traditional Medi- care covers a home health aide when you’re under a doctor’s care; your plan of care is reviewed regularly by a doc- tor; and you’re getting skilled care such as nursing care or physical therapy, oc- cupational therapy, or speech-language pathology services from the home health agency. A doctor must also certify that you’re homebound, meaning that leaving the home is a major effort. If all you need are homemaker ser- vices such as food shopping, cleaning, and laundry­­ , or personal care such as help bathing, dressing, and using the bathroom—or those services aren’t re- lated to your plan of care—your Medicare coverage will be denied. In those cases, or if you simply need more help than insurance will cover, you and your fam- ily will have to decide whether to pay out of pocket. Orly Avitzur, M.D., M.B.A., is Consumer Reports’ medical director. Board certified in neurology, she is a fellow of the Ameri- can Academy of Neurology, a clinical instructor at the Yale University School of Medicine, and a medical consultant to the New York Rangers hockey team. When You Need Help at Home How to find, hire, and cover the costs of a home health aide while recovering from an injury or surgery Orly Avitzur M.D., M.B.A. If the services you need are more personal than medical, a home health aide may step in.