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In-Home Care Agencies

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 assisted 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

2. 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

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 require help?"

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."

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