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All too often, older patients get released from the hospital and are fully eligible for help at home but refuse it.  The reasons for this vary, but often it gets down to privacy or pride.  Seniors see their homes as sanctums.  They don’t want strangers invading their privacy. They think they’ve been getting along just fine and have unrealistic expectations of what recovering from a hospitalization will entail.

Occasionally, there are situations at home where the home is in disrepair or maybe a hoarding habit that the older adult does not want anyone to know about.  Sometimes the patient’s cognition is compromised, and he doesn’t understand his needs or limitations. Or cost might be a concern.

According to a report from the United Hospital Fund, as many as 28 percent of patients offered home health care after a hospital stay decline the offer of help.  There are a lot of misperceptions about what home health care is.

Many seniors and caregivers confuse home health care with “home care” delivered by aides who help people shower or get dressed or who cook, clean and serve as a companion. The two types of services are not the same: Home health care is delivered by medical professionals; home care is not. Nor is home care covered by Medicare, for the most part.

Typically, these services last four to six weeks after a hospitalization, with a nurse visiting several times a week. Some patients receive them for much longer.  Home health care services are available under Medicare to older adults who are homebound and need intermittent skilled care from a nurse, a physical therapist or a speech therapist, among other medical providers.

Refusing home health care after a hospitalization puts patients at risk of a difficult, incomplete or slower-than-anticipated recovery. Without these services, older adults’ odds of being readmitted to the hospital within 30- or 60-days double, according to The American Journal of Managed Care.