What is Home Care?

Home Care (sometimes also known as in-home care or private duty care) is personal, non-medical senior care provided right in a senior's own home. While Home Care was once provided only on a short-term basis to those recovering from surgery or other hospitalizations, now it's available to let seniors age in place at home while remaining safe and comfortable. Professionally trained caregivers work to keep seniors as independent as possible while providing the assistance they need to be able to stay in their homes.

In-home caregivers typically help aging citizens with daily tasks such as bathing and dressing, preparing meals, and managing medication. Depending on their needs, Home Care may consist of a caregiver who comes in one day a week or someone who lives in the home to provide 24/7 assistance.

Many seniors would rather stay in their own homes rather than move into a retirement community, an assisted living community, or even a nursing home. Home Care is a viable alternative that makes that possible. It also helps families experience peace of mind because they know their loved one is safe and cared for on a daily basis, and it provides extra companionship for lonely seniors.

Why Choose Home Care?

Home Care is the optimal choice for many seniors because it allows them to stay in their favorite place: their own home, which provides a sense of comfort that few other environments can match. Home Care can also make it possible for younger generations to bring their parents into their homes in a multi-generational setting without the children being overwhelmed by the physical demands of caring for an aging senior.

Home Care also helps seniors stay independent as long as possible. It provides freedom that even the best residential facility can't match, and it reduces stress. Studies show that care at home even promotes a longer life, and it certainly improves quality of life. On the financial side, in-home care is also often less expensive than the other forms of senior care available.

In addition, Home Care enhances socialization, removing the isolation that too many seniors living on their own experience. Health limitations often restrict seniors' ability to participate in social involvement the way they used to. Seniors who become isolated can feel intensely lonely and unhappy, and they even run a greater risk of developing dementia. Having an in-home caregiver provides instant companionship while also opening the doors to facilitate other social interaction.

Back to top

What Services Are Provided by Home Care?

Most Home Care focuses on non-medical services. Caregivers help seniors with the activities of daily living, including assistance with bathing, dressing, and grooming. They also handle meal preparation with a personal touch that takes into considerations each senior's food preferences and dietary restrictions.

Since many seniors are no longer able to drive, in-home caregivers provide transportation, either by driving their clients to appointments and errands or by accompanying them on public transportation. When seniors have limited mobility, caregivers help them with moving and transferring to beds, chairs, or showers. Caregivers also often perform light housekeeping duties, such as making beds, laundry, and washing dishes. In addition, they make sure their clients receive all their medications in a timely fashion.

Seniors with significant medical needs are often able to augment their basic non-medical home care with services provided by licensed medical professionals. Nurses, nurse practitioners, and other medical professionals can come to the home to handle injections, wound care, therapy, and testing.

In some cases, seniors require care around the clock. This may occur during recovery from surgery, or it may be necessary if your loved one experiences the frequent waking and nighttime wandering that sometimes accompany dementia. If your loved one requires 24/7 care, you have a couple of options. You can seek out live-in care, or you can bring in multiple caregivers who work opposite shifts.

If you hire a live-in caregiver, you need to provide them with a place to sleep and allow them eight hours a day to do just that. You should also arrange for other downtime, including substitute caregivers on the weekends. If you don't want to go this route, check out the possibility of hiring two caregivers, each working a 12-hour shift. While this choice is typically more costly, it can be a good choice if your loved one requires significant medical care around the clock.

Back to top

What Costs Are Associated With Home Care?

Costs associated with Home Care can vary widely depending on the type of care your loved one needs as well as on where you live. Home Care is often more expensive in cities than in rural areas. If you're bringing in someone for a few hours a week, you should expect to spend anywhere from $14 per hour to as high as $40 per hour. The average costs for a full-time in-home caregiver is about $46,000 per year, though this varies by location.

Medicare doesn't cover the costs of non-medical home care. While it does cover medical home health care, usually coverage is limited to a few hours per week for the duration of a specific, demonstrable medical need. In addition, to receive this coverage from Medicare, a senior usually has to be homebound. Private health insurance usually follows the same rules as Medicare and doesn't cover Home Care.

Long-term care policies are available to cover home health care. These policies vary widely in terms of what they cover and for how long, and many of them have financial caps. In addition, military veterans and their spouses may be eligible for pension benefits that include non-medical home care services.

One way to mitigate the costs of Home Care is to take advantage of the adult day care programs offered in your neighborhood. Adult day care is typically set up to provide both social interaction and some basic medical care within a safe, controlled environment. This makes it an ideal choice for seniors who are experiencing early levels of dementia. Costs are low — generally about $60 per day. Use adult day care as a chance to give caregivers a break, or schedule it into your loved one's routine as a regular occurrence. Seniorly CEO Arthur Bretschneider wrote about this "hack" in his article, "A Secret Solution to Paying for Assisted Living."

Back to top

How to Decide If Home Care Is the Right Choice

Two factors are involved in the decision to bring in Home Care to help your loved one. One is the issue of whether your loved one needs some assistance around the house, and the other is whether your loved one needs more assistance than Home Care can provide.

Take a look at your senior loved one's home to see if a little help is needed. Has your loved one started being lax about cleaning up, with dishes left in the sink, laundry left undone, and trash piling up? Look as well at your loved one's personal hygiene to see if they need some help and reminders with grooming and bathing.

If your loved one is no longer able to drive, care at home can provide the bridge that's needed to keep them connected to the outside world. Most seniors are extremely reluctant to abandon the freedom that driving brings, so keep an eye open for traffic tickets or scratches on the car that indicate it's time to take away the car keys.

Seniors who lose interest in meal preparation or who become unable to care for themselves often lose weight dramatically. They may also gain weight because they start making poor nutrition choices and just eat the easiest thing available. In both cases, it's a sign that Home Care may be needed. Seniors who are becoming isolated and withdrawing from others may also need the companionship that home care provides.

Take a look at this chart to understand some of the options available to you if you choose Home Care.

Type of Home Care Pros Cons
Care Provided by Family Member
  • Senior loved one feels more comfortable because of familiarity
  • No additional costs
  • Added pressure on family members
  • High burnout rates and increased stress for entire family
  • Lack of formal training means seniors may not receive expert care
Personal Hire (referred by friends, etc.)
  • Costs are often lower
  • Family must handle taxes, unemployment insurance, etc.
  • Privately hired caregivers often lack training, licensing and insurance
  • No backup plan if caregiver cannot come in or quits suddenly
Hired Through Home Care Agency
  • Agency usually handles taxes and insurance
  • Caregivers are trained and licensed
  • Agencies handle scheduling in the event of emergencies or days off
  • More costly than other options
Back to top

Home Care vs. Assisted Living

While many people consider assisted living communities to be the primary choice for aging adults who need some assistance, Home Care is increasingly a viable alternative. Assisted living communities provide meals, personal care, and housekeeping services to seniors within a residential setting. However, they can be more costly than care at home, and each resident in assisted living shares their caregivers with many other seniors.

With Home Care, seniors gain the emotional comfort of remaining in familiar surroundings. Even when dealing with chronic medical problems or memory loss, they can still enjoy a sense of independence. In addition, because they have the undivided attention of their caregivers, seniors in Home Care enjoy personalized care plans that take into consideration their own preferences, physical status and lifestyle choices.

Back to top

Specialized Home Care Options

With 90 percent of seniors wanting to remaining in their own homes as long as possible, it's not surprising that Home Care is a popular option. Some seniors, however, require a little more than personal care and meal preparation. Fortunately, options are available to help in these circumstances.

In-Home Care for Chronic and Acute Medical Conditions

Health care aides, physical therapists, registered nurses, physicians' assistants, and other medical care professionals can be part of your loved one's Home Care team when needed. For example, what if your loved one requires a hip or knee replacement? In many circumstances, they would be sent to a nursing home for recovery. It's possible, however, to bring physical therapists and other aides to the home to assist in recovery.

If your loved one requires diabetes care or other regular health care for a chronic condition, you can typically make arrangements for health care professionals to come to your home to provide treatment or therapy. Combining these periodic visits with an in-home caregiver can make the difference that lets your senior loved one age in place at home.

In-Home Care for Seniors With Alzheimer's Disease or Dementia

In the early stages of Alzheimer's disease or dementia, Home Care can be an excellent option to provide the safety that seniors need while keeping them connected to others socially.

Memory loss is the most well-known symptom of Alzheimer's and dementia, but it is far from the only one that requires round-the-clock monitoring. Seniors with dementia may have difficulty with their sense of balance or visual perception. They may experience problems trying to focus or to communicate clearly. In later stages of Alzheimer's disease, seniors may become aggressive or agitated easily.

Because of the complex symptoms involved with Alzheimer's disease and dementia, in-home caregivers should be specially trained and licensed. That gives you the peace of mind that your loved one's caregiver is able to provide the calming environment needed, to adjust daily routines based on the ebb and flow of symptoms, and to minimize any outbursts. A trained caregiver can also maximize the social interactions and stimulation that helps delay the onset of further symptoms while keeping you notified about the progression of your loved one's condition.

Back to top

A thought while you wait ...

We are young at heart. Slightly older in other places!