What Qualifies as Long-Term Care at Home? Financial Assistance Options and How to Pay

Aside from the amount of time a person receives care, the main difference between short-term and long-term home care is that person’s condition. Typically, situations dictate whether home care is brief or prolonged.

If your loved one is recovering from surgery, illness, or injury, they may benefit from short-term home care while they heal. In this case, your loved one’s doctor may have prescribed a care plan, and they’re expecting that your loved one will eventually no longer need help at home. Short-term care could last for a few days or a few months, depending on your loved one’s care plan.

A senior who needs long-term care may have a progressive or chronic illness, or they may simply need extra support due to aging. In this case, you and your loved one would be planning for ongoing care. The type of assistance your loved one needs and the amount of time a caregiver spends with them may increase over time.

The services a senior can receive for short-term home care are similar to what they might need with long-term care. Basic home care services may include assistance with personal care tasks such as bathing or toileting, and they can also include help around the home. However, if a senior’s condition requires medical care, those services fall under home health care and typically involve licensed professionals such as a registered nurse.

Can you afford home care?

The goal of long-term home care is to provide seniors with the assistance to stay at home, safely, for as long as possible. You’ll find there’s a range of services available, from companionship to home health.

Companionship and homemaker services

This light level of support is ideal for a senior who can handle personal care tasks, such as bathing independently, but could use some help around the house. With homemaker services, your parent can receive help with errands, laundry, and household chores. You can find these services through home care agencies as well as independent caregivers.

Personal care

Many independent caregivers and home care agencies offer this service for seniors who need help with activities of daily living such as bathing, toileting, and transferring. You can use home care services for a few hours a week, or even around the clock, depending on what your loved one needs.

Home health care

Home care is different from home health care, which typically requires a physician’s prescription and is more substantial than the personal care assistance offered by a caregiver. You’ll want to work with a home health care agency to find a qualified caregiver for your loved one.

Home health includes the following services:

• Physical therapy
• Occupational therapy
• Wound care
• Medication administration

Home care can be an expensive commitment, so before you decide that long-term home care is the right choice for your loved one, you’ll want to explore your payment options.

Private pay

In most home care scenarios, your loved one will pay out of pocket for homemaker or personal care services. You can use savings or other assets to fund long-term home care. These include the following:

• Annuities. Once their annuity is funded, your loved one can receive monthly payments from it, and those payments can be used for home care.
• Life insurance. You can convert some or all of the death benefit and use the funds to pay for the cost of care.
• Long-term care insurance. Your loved one may be able to use their insurance policy to help pay for home care. However, this will be different for each policy.
• Reverse mortgage. Your loved one can use the equity in their home to help pay for care. Be sure to work with a reputable institution, though.

It’s best to discuss these options with your loved one to find out which private pay options they might be able to put towards the cost of home care. Many people use a combination of sources and strategies to pay for home care, including supplemental care from friends and family members at no cost.

Medicaid

If your loved one qualifies for Medicaid, they can apply for home and community based services (HCBS) waivers, designed to help people receive care in their homes instead of moving to a nursing home. Available waivers vary by state, and many have waiting lists.^[01]

Veterans benefits

If your loved one is a veteran who is eligible for community care, they may also be eligible for the Homemaker Home Health Aide Care program ^[02] and Veteran Directed Care.^[03] In addition, if a veteran (or the surviving spouse of a veteran) has substantial home care expenses and demonstrates a need for assistance with activities of daily living, then they may qualify for the special monthly pension benefit with a rating for Aid and Attendance.^[04]

Expert advice for affordable home care

Before you commit to long-term home care, consider your loved one’s current care needs as well as what they may need in the future. In most cases, a senior will need more assistance as they age, so you’ll need to find a caregiver or home care agency that can support any upcoming changes.

Consider the following questions to help you make your decision:

• How many hours of care does my loved one need? Would this mean hiring a full-time caregiver or working with multiple caregivers to provide round-the-clock care?
• Does their home need any safety modifications, such as support bars in the bathroom or a chair lift?
• Do we have family members in town who can check in regularly to see if care needs are changing?
• Has their doctor prescribed any skilled nursing care that needs to be taken into consideration before we choose an agency or caregiver?

Many people want to age in place for as long as possible, and it’s commendable to help a loved one with this goal. But it’s a big commitment, so once you make this decision, it’s important to choose a caregiver or home care agency you trust.

Expect a home care agency to conduct an assessment of your loved one’s needs to help ensure that they can provide the right amount of care. You should also have an opportunity to interview potential caregivers before they’re assigned.

For help finding a reputable caregiver or home care agency, consider working with the Senior Living Advisors at A Place for Mom. At no cost to you, they’ll provide you with guidance to find a home care agency that fits your needs and budget.