Case Studies

Joan is an 82 year old female diagnosed with COPD (Chronic Obstructive Pulmonary Disease) and living alone in Westbury, NY. Joan also suffers from periodic urinary track infections (UTI), balance issues resulting in frequent falls and the onset of dementia. Joan is currently on Medicaid. After a recent visit to her physician with her cousin Iris, Iris called HOME Agency. HOME immediately responded to the inquiry and dispatched a registered nurse to Joan’s home performing an onsite evaluation. As a result of the evaluation and coordinating with Joan’s physician, HOME set up a schedule of two, twelve hour shifts with billing to NHTD (Nursing home transition and diversion program). Today, Joan is making significant positive progress. Joan has four well trained personal care aides coming to her home; her COPD is stabilized and her frequent falls no longer an issue. Her aides prepare meals for her, assist her with grooming and hygiene and always remind her to take her meds. Joan enjoys playing board games with her aides and relishes the time when her aides read to her.

George is a 92-year-old male, living in Sands Point, NY. He was recently discharged from a rehab facility. George has significant ambulation problems resulting in accidents attempting to go to the bathroom. In the evening, George often soils himself requiring almost daily bedding changes. George lives with his 87-year-old wife, however since both have dementia issues, George frequently forgets to take his medication. Additionally, George suffers from hypertension, arthritis and recently recovered from a mild stroke. George’s daughter, Allison, called the rebab facility that just discharged George to ask for assistance on receiving help at home. The rehab facility recommended several home care agencies, including HOME, an agency that specializes in the care of the elderly. Allison spoke with HOME’s intake coordinator and shortly thereafter, a registered nurse from HOME came to George’s home to conduct an evaluation. Based on the nurses’ evaluation and the input from George’s physician, a customized Plan of Care was developed and service began with live-in services. George no longer soils his bed; the HOME aide assists him either to the bathroom, or on occasion, to his commode. George is reminded to take  his prescribed meds and is gaining a few pounds since his aides are preparing delicious, nutritious meals. Feeling better, his hospital visits are very infrequent, and George often goes out for a short walk or just enjoys the spring sunshine from his porch.

Isabelle, is a 64-year-old female from Smithtown, NY, is currently at a rehab facility waiting to go home. Isabelle suffers from stage 3 lung cancer, hearing loss, and depression, Going home makes Isabelle nervous because she has no help, nor does she have the finances to pay for home care. She asked the social worker at the rehab facility for assistance, and she recommended HOME Agency. After speaking with the HOME team, Isabelle filed for community Medicaid. She had three appointments guiding her through the Medicaid process and assigning her to a Medicaid Long Term Care Plan (MLTC). The MLTC approved six hours a day service, 7 days per week. Based on the registered nurse assessment from HOME, the plan of care was developed. HOME health aides caring for Isabelle provided personal care, meal preparation, bathing, medication reminder and light housekeeping. The aides also escorted Isabelle to her frequent physician appointments. HOME billed the MLTC directly; Isabelle was not responsible for any charges relating to service.  Isabelle is progressing well and is stable. Hospitals visits have dramatically decreased and now she can enjoy visits from her friends and family. Isabelle often tells HOME Agency, “thank you…there is truly no place like home.”

Ben has little funds to pay for private home care services. He lives on a small pension and his social security benefits. He needs help. He recently was hospitalized with pneumonia but also has cognitive decline. He is confused and doesn’t know what to do. Ben called HOME Agency to learn how he might be enrolled in the Medicaid program. Ben spoke with a Medicaid specialist from HOME and was advised how to apply for Medicaid coverage. Ben could either come to the HOME office  or a Medicaid specialist could come to Ben’s home to assist with the Medicaid application process. Ben completed the paperwork, and 60 days later commenced home care services with a MLTC (Medicaid Long Term Care Plan). Life is far less stressful for Ben, and he sees brighter tomorrows.