Last Updated: April 4, 2013
When mom (or dad) gets sick or can't take care of her basic
everyday needs anymore, she can often turn to family for help. But
as time goes by, family caregivers might begin to consider moving
their loved one to a nursing home or an
living residence. An increasingly popular alternative is to
hire an in-home care agency, which can supplement or replace care
provided by family members and allow seniors to maintain their
independence and stay in familiar surroundings.
For reasons ranging from acute illness to long-term health
conditions, more than 7.6 million Americans receive in-home care,
according to the U.S. Census Bureau. But that number is far greater
if you include care given by family members. Informal care is given
to an adult family member in 1 in 5 American households, according
to the 2004 survey Caregiving in the U.S. The typical caregiver is
a 46-year-old woman, who spends about 20 hours a week taking care
of her mother, according to the survey, which was paid for by the
National Alliance for Caregiving and AARP.
"A lot of people just want to stay in their home," says Dennis
Autrey, a Senior Living Advisor with A Place For Mom, who, with
his wife, operated two offices of TLC, an in-home care agency, in
Washington state for three years.
"It can be extremely hard for seniors to make that kind of
change," he says. "Some seniors want to downsize and want the
freedom of going to assisted living, not having so much stuff, and
having people cook their meals. But a lot of people just want to
stay in their home."
Personal Care Home Care Agencies
Personal care is typically provided by a certified nurse's
assistant (CNA), who can assist with everyday basic tasks, such as
cleaning, cooking, and helping mom dress, bathe, and use the
bathroom. A CNA can also remind the senior to take her prescription
medications. These kinds of homemaker services agencies may or may
not be licensed depending on the state.
Medical Home-Care Agencies
Home health and medical care might be necessary if the senior
requires someone who can administer medications, take his blood
pressure, or provide in-home physical therapy, among other medical
needs. State and federal laws regulate these agencies, and they are
often Medicare and Medicaid certified, which means federal
financial assistance through those programs might be available.
Paying for Home Care
1. Out of pocket
Medicare or Medicaid and/or other public programs. An agency
must meet certain federal standards and provide skilled nursing
services to be eligible for Medicare or Medicaid.
3. Insurance such as Medigap, long-term care, or other
commercial policies. These programs do not pay for personal care or
homemaker services alone, and your loved one must be under a
doctor's care and unable to leave his or her home without
assistance in order to qualify for coverage.
The National Council on Aging offers a free online service that
can help to figure out which benefits someone qualifies for, see http://www.benefitscheckup.org.
Most in-home care agencies will come to a client's home to
conduct a free needs assessment, Autrey says. "When you do an
assessment, you meet with a family member in the parent's home. You
want to see how the home is laid out, and you want to be where
they'll require their care," he says. "You determine what's
required: how many hours a day, how many days a week will mom
For instance, he says, the senior might just need somebody to
spend the night to help her get to the bathroom in the middle of
the night or help her if she falls out of bed. In-home care, Autrey
says, "totally gives piece of mind-not only for the people being
cared for but also for family members who have been trying to care
for their parents and want some respite care or need a break."