Is It Time for Home Care?

Most “is it time for home care” checklists ask vague questions and give a vague answer. This one does two things those cannot. It scores your loved one against the same clinical framework that nurses and the state actually use, and it shows what that score means for whether Medicaid or other programs may help pay for care. By the end you will know two things: how much help your loved one really needs, and whether that level of need may qualify them for funded care.

Care professionals do not measure “struggling.” They measure two specific things:

• Activities of Daily Living (ADLs): the core physical tasks of caring for yourself.
• Instrumental Activities of Daily Living (IADLs): the tasks of running an independent household.

The pattern of which ones are slipping, and how far, tells you the level of care needed, and it is the same language a Medicaid assessor uses.

Score each from 0 to 2: 0 = fully independent, 1 = needs reminding or standby help, 2 = needs hands-on help or cannot do it.

1. Bathing. Getting in and out of a tub or shower safely. The most common first ADL to slip, and a leading site of serious falls.
2. Dressing. Choosing suitable clothing and putting it on, including buttons, zippers, and shoes.
3. Toileting. Getting to and using the toilet and managing hygiene.
4. Transferring. Moving safely between a bed, a chair, and standing without falling.
5. Continence. Controlling the bladder and bowels.
6. Eating. Getting food from plate to mouth (not cooking, which is below).

Score each the same way, 0 to 2.

1. Managing medications. The right dose at the right time. Missed or doubled doses are a top cause of avoidable hospital visits.
2. Preparing meals. Planning and safely cooking. An empty fridge or a scorched pot is a signal.
3. Managing money. Paying bills, avoiding scams, keeping accounts straight.
4. Transportation. Driving safely or arranging rides to appointments.
5. Housekeeping and laundry. Keeping the home clean and safe.
6. Using the phone and staying connected. Calling for help and keeping in touch.

The ADL total (out of 12) matters most.

• 0 to 2: mostly independent. Watch the IADLs, which usually slip first, and revisit in a few months.
• 3 to 5: meaningful help is needed at home. The window to set up support before a fall or hospital stay forces a rushed decision.
• 6 or more: substantial daily help is needed. Continuing without it puts safety at real risk.

A diagnosis alone does not decide care needs, but these conditions frequently progress to needing ADL help: Alzheimer’s and other dementias, Parkinson’s disease, recovery after a stroke, advanced COPD, and congestive heart failure. If one of these is in the picture and ADLs are slipping, do not wait for a crisis to plan.

Match this to your Part 3 result.

• Private pay: the simplest to start, and common while other options are arranged.
• Long-term care insurance: if a policy exists, it often covers in-home care; check the elimination period and the daily benefit.
• Pennsylvania Medicaid (Community HealthChoices): if your loved one meets the level-of-care standard from Part 3 and the financial limits, CHC can fund in-home care. A-Team helps families check eligibility and apply.
• Veterans benefits: some wartime veterans and surviving spouses qualify for help with the cost of care at home.

You do not have to read the assessment alone or guess at eligibility. A-Team Home Care is an ACHC-accredited, RN-supervised agency providing companion care and personal care across Philadelphia, Bucks County, and the surrounding Pennsylvania counties, caring for local families since 2016. The team can review your score, talk through which funding path fits, and help with a Medicaid eligibility check at no charge. A-Team has been recognized in the community, including the Philadelphia Inquirer Philly Favorite (2025), the Philadelphia100, and the Bucks Happening List.

Call A-Team Home Care at (215) 490-9994, or visit ateampa.com. No pressure, just a clear conversation about what your loved one needs and how to pay for it.

This self-assessment is educational and does not replace a clinical evaluation or an official Medicaid determination. Eligibility is decided by the Commonwealth of Pennsylvania based on its own assessment.

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• Questions to Ask a Home Care Agency Before Signing a Contract
• Home Care in Philadelphia
• Home Care in Bucks County