Your Complete Guide to In-Home Care

What is home care?

Home care is a service that provides senior care within an individual’s residence. Care at home best serves seniors who want to age in place, but who may desire companionship or require support with daily chores and activities of daily living (ADLs), such as dressing and bathing.

The services that an at-home caregiver provides will depend on a senior’s individualized needs. While some seniors may rely on home care providers for help with errands, cooking, and housekeeping, others need intensive care in their home to manage incontinence, mobility issues, or dementia. In-home care may increase peace of mind for family members, enhance senior safety, and result in a deeper, one-on-one bond between a senior and their caregiver.

What services do in-home caregivers provide?

Home care aides administer a wide range of services at home to help preserve the quality of life and safety of seniors, as well as their social and emotional well-being. For seniors who prefer to age at home or who aren’t yet ready to transition to senior living, home care can fill in the gaps and simplify their day-to-day routine.

• Home care services

• Housekeeping
• Medication management
• Complimentary transportation
• Mobility assistance
• Cooking and meal preparation
• Companionship
• Incontinence care and toileting

Is it time for senior home care?

It may be time for senior home care if your family member regularly needs assistance with daily chores and activities, or if you’re worried about their safety. Signs a senior needs home care can include:

• Increased difficulty with everyday tasks, like cooking meals or doing laundry
• Persistent forgetfulness
• Issues with mobility or transportation
• Loneliness and decreased interest in their hobbies
• Difficulty maintaining good hygiene
• Frequent falls or accidents

In determining whether it’s time for home care, it’s important to consider not only your family member’s needs, but also your own. Common signs of caregiver burnout can include:

• Depression and anxiety
• Insomnia
• Difficulty saying “no”
• Lack of self-care
• Poor performance at work
• Difficulty maintaining other relationships

What are the benefits of home care for seniors?

If you’re concerned about your loved one’s safety, emotional well-being, or ability to perform daily tasks independently, home care may offer peace of mind for you and a source of continued independence for your family member.

Consider the following advantages of home care:

• Companionship. Loneliness and social isolation can have adverse physical and mental health effects for seniors. A home caregiver can provide regular social interaction and develop a close bond with your senior loved one.
• Care provided in a familiar environment. Seniors can form emotional attachments to their homes, seeing them as sites associated with comfort and good memories. If your senior loved one is wary about moving into a community — or simply prefers to age in place — home care can help meet their care needs in a reassuring, comfortable setting.
• Safe, reliable transportation. For most seniors, the time arrives when they can no longer drive safely. Whether you’ve taken the keys from your senior loved one or they become overwhelmed by daily outings and errands, a home caregiver can fulfill this important role. Home caregivers are available to drive seniors to doctor’s appointments, the grocery store, community events, or anywhere else they might need to go.
• Respite and reduced caregiver stress. As you look after your senior loved one’s well-being, it’s also crucial to monitor your own. Family caregiver stress can result in problems at work, less time to spend with friends and other family members, and even physical health problems. Hiring an at-home caregiver can restore balance to family members’ schedules and minimize burnout. This reduced family caregiver strain can also enhance the relationships between seniors and their family members.

Is home care the right fit for my family member?

Home care is one of many senior care options. Like home care, senior living communities that offer assisted living or memory care also provide assistance with activities of daily living (ADLs), companionship, meals, light housekeeping, transportation, and more.

And while home care is an excellent option for seniors who prefer to age in place, home care costs can become prohibitive in the long term, especially if care needs change over time. For seniors who require help on a daily basis, senior living is typically a more affordable option.

As you explore which type of care is the right fit for your loved one, think about these important considerations:

• Social interaction. Home care aides offer one-on-one companionship, while senior living communities provide a wide variety of group activities. Since home care often offers transportation, older adults can visit senior centers and spend time with friends for similar social experiences. However, if your family member would prefer to have planned activities and regular opportunities for socialization, a senior living community may be a better fit.
• Homemaking services. Both senior living communities and home care aides offer light housekeeping, meal preparation, and help with laundry. With home care, seniors may have more opportunity to supervise these services and ensure their home is cared for in a way they’re used to. For example, while assisted living communities offer restaurant-style dining, a home care aide could prepare favorite recipes.
• Cost. Home care costs significantly exceed the typical monthly price of senior living facilities, as home caregivers provide one-on-one companionship, treatment, and supervision.
• Safety. Assisted living communities offer safety features like grab bars, fall protection, and wheelchair-accessible common areas. Memory care communities often have increased security measures as well, like door alarms to prevent wandering. If your family member prefers to age at home, these devices may have to be installed in-home, and some parts of the house — like upper stories or rooms with narrow doorways — may be inaccessible without modifications.
• Amenities. Senior living facilities boast easily-accessible amenities like fitness centers, dining rooms, and activity spaces. While a senior may not have these arrangements in their home, a home care aide can help with exercise routines and transport clients to favorite restaurants.
• Licensed medical care. Senior living communities generally have nurses and other health care professionals on staff. But in most states, in-home care aides aren’t required to have any level of medical training. If a senior is in relatively good health, home care may be able to cover their medical needs. However, if an elderly loved one requires the type of care normally offered in a hospital or nursing home, home care likely won’t suffice. More intensive home health care services are available, but they must be prescribed by a doctor and are often much more expensive than nursing home services.

How do I choose between home care and memory care for my loved one with dementia?

Memory care is generally offered in stand-alone facilities or in senior living communities with multiple levels of care. Like other senior living options, memory care communities provide meals, scheduled activities, and assistance with ADLs, as well as private rooms and staff supervision. They also offer unique assistance for seniors experiencing memory loss due to Alzheimer’s disease or other types of dementia.

Some home care aides are also specially trained to assist older adults with dementia. The main difference between memory care and home care for dementia is the space where care occurs — memory care communities often feature increased security, unique architecture to prevent wandering, and activity areas designed to stimulate seniors with dementia, while homes may have to be modified to offer the same level of safety.

With the assistance of home care aides, elderly people who have early- to mid-stage cognitive decline may be capable of aging in their own homes. It’s important to select a home care provider who’s familiar with dementia. Caregivers with dementia-specific training will be able to arrange activities that help slow cognitive decline, promote positive reminiscence, and comfort seniors experiencing memory loss.

Benefits of home care for dementia include:

• Familiar surroundings with memory-evoking objects
• Increased one-on-one stimulation
• Organized dementia care activities at home
• Specific knowledge about your loved one’s lifestyle, interests, and accomplishments to offer person-centered care

What are the differences between home care and home health?

“Home care” and “home health care” may sound the same, but the services they provide differ.  Home health care — sometimes called “home health” — offers professional medical assistance, while home care provides companionship and help with activities of daily living, housekeeping, and transportation. Both types of care can help your loved one age safely in the comfort of their own home.

Home health care may be unnecessary for seniors aging in place without significant medical concerns. However, if your loved one is prone to falls, requires assistance with a recent injury, or lives with a chronic condition like diabetes or heart disease, their doctor may prescribe home health care as an alternative to a nursing home or assisted living community. Home health professionals — typically nurses — complete significant training in geriatric care needs and can help your loved one with everything from daily medication management to wound care and insulin injections. In other words, they can perform any basic medical services that a skilled nursing facility offers.

Families may find that a combination of home care and home health care benefits their aging relative. While home care aides assist with everyday activities and offer companionship, health professionals can provide medical services as needed, ensuring that seniors’ social, emotional, and medical needs are all met. Some registered nurses or nursing assistants may also offer a combination of home care and home health services, including both homemaking and basic medical assistance, like medication administration, injections, and pain management. Before selecting home care, home health care, or a combination of the two, consider the services each care type provides.

How do I talk to a family member about receiving care at home?

Getting accustomed to the daily presence of an in-home caregiver can be an adjustment for many seniors. Prepare them for the change with these conversation tips.

• Tips for talking to your family member about home care
• Be intentional about timing and setting. Make sure to bring up the topic of home care at a place and time that feels comfortable for your loved one. Will they feel most secure voicing their opinions and concerns at home? Are they most alert in the morning? Taking questions like these into consideration can help in taking a thoughtful approach. Additionally, it’s important to be transparent: Don’t catch your parent off guard or bring up home care unexpectedly during a family event.
• Decide who should be a part of the conversation. Just as you should give your senior loved one some notice before discussing home care, do the same with any other family members you want to include in the discussion. While it’s smart to make room for voices your parent values and trusts, involving too many people could be overwhelming or make your loved one react defensively.
• Be an active listener. Listening to your loved one’s thoughts is just as necessary as expressing your own. Signal your commitment to understanding their perspective by maintaining eye contact, asking follow-up questions, and validating their opinions.
• Use “I” statements and share your concerns. Let your parent know that your plan to hire a home caregiver is based in concern for their safety and a genuine desire to help. Statements like “I feel worried when you go to appointments by yourself” or “I think some help at home might be good for you” can help convey this intent.
• Research and involve your loved one in the process. Browse top-rated home care agencies in your area or reach out to your loved one’s physician for a potential recommendation. Enhance your loved one’s feeling of independence by asking them what qualities they value in a caregiver or by inviting them to participate in the interview stage.
• Be open to continued dialogue. Making decisions around senior care typically involves repeated, open conversation — don’t assume this first discussion will be the last. Let your loved one know that you will value their input throughout the entire process.

How much does in-home care cost?

Since home care is highly personalized, costs can vary widely depending on the level of assistance your senior loved one needs. A senior’s median home care costs added up to $4,481 per month in 2020 across the U.S., according to Genworth’s Cost of Care Survey. Where your loved one lives and the level of training their home care aide has received may also affect this figure. For seniors needing home health care, which consists of more intensive medical treatment from a certified aide, this cost reached a median figure of $4,576 per month.

How is the cost of senior home care calculated?

Agencies and individuals configure the cost of daily home care using many different models. While it’s typical for home care companies to charge by the hour — with the average hourly rate ringing in at about $23 — monthly or annual contracts may allow for discounted prices. To account for costs like transportation and staffing, most home care agencies have a minimum hour requirement. Caregivers with highly specialized training will often be more expensive to hire.

How much does 24/7 in-home care cost?

When evaluating the cost of in-home caregivers for elderly loved ones, it’s important for each family to define home care expectations. While some families expect 24/7 care to mean that an aide is always awake to provide round-the-clock assistance, others employ live-in caregivers or allow aides to sleep during night shifts. These personalized care arrangements come with vastly different cost expectations for families, according to figures from Genworth:

• The median cost of non-sleeping visits, meaning a caregiver is awake and consistently supervising a senior, is $17,280 per month. This includes 720 hours of continuous care provided by multiple aides.
• Sleeping visits, which involve a caregiver waking to a bell or alarm in case of emergency, typically range from $120-$200 per 12-hour shift, or a total of $12,780 per month.
• Live-in caregivers usually enter into a caregiver contract with a senior’s family to outline daily duties and expectations. Though live-in caregivers receive room and board, families will still pay a negotiated hourly rate. The average hourly rate for in-home caregivers is $24.

What’s the cost of home care compared to other care types?

Cost can play a major role in determining if care at home is the solution for your loved one. Compared to the home care costs detailed above, living in a senior community may be more affordable if your loved one has advanced care needs or requires many hours of care. The Genworth figures below represent median costs for each care type.

How do I pay for home care?

Assistance for seniors living at home can be expensive. Luckily, several payment sources can help cover home care costs. Most families finance senior care through multiple payment methods, such as:

• Personal savings, including retirement funds, pensions, and stocks.
• Selling or renting the family home. Selling a house is one of the most common ways to pay for senior care. Using your home as an investment — such as through a property management company — is also growing in popularity. If a senior is moving in with a relative, they may consider this option.
• Long-term care insurance, also called senior care insurance, may help cover the cost of home care. If your love one has a long-term care insurance policy, it’s important to contact their insurance provider to learn how to make the most of their benefits.
• Medicaid. Low-income seniors often receive home care cost assistance through Medicaid in the form of monthly reimbursements. Regulations vary by state, so families can contact state Medicaid agencies or a local eldercare attorney to assess whether or not they’re eligible.
• Medicare. Medicare doesn’t pay for home care, but it can cover certain doctor-prescribed services offered by home health providers, such as in-home physical therapy or assistance with diabetes management.
• VA benefits. If your senior loved served in the military, they might be eligible for veteran benefits, such as VA Aid & Attendance or housebound benefits, that can help offset the cost of care.

How do I choose a home care provider?

When hiring an in-home caregiver for a family member, it’s important to remember that this person will be a daily companion and your loved one’s main source of support. Find the right fit with some essential questions:

• Will you require the caregiver you hire to be certified?
• If your loved one needs help with transportation, does the caregiver have a good driving record? Do they have a car, or will you provide a vehicle?
• If your family member needs mobility assistance, is the caregiver able to lift them? Are they familiar with devices like stair lifts, wheelchairs, and bar grabs?
• If the senior in need of care has Alzheimer’s disease or another form of dementia, does the caregiver have experience providing person-centered care for individuals experiencing memory loss?
• Can the caregiver cook? Will they accommodate any dietary restrictions your loved one may have?
• What is the caregiver’s availability?

When coordinating care through a home care agency, consider asking questions like what licensing and certifications the company requires and what training caregivers undergo. If your loved one has a specific need — like help with transfers — let the agency know so that your loved one receives care from someone with specialized expertise.

Home care options: Private caregiver vs. agency

Whether you choose to find an at-home caregiver independently or contract through a home care agency, each approach has its own benefits. In general, sourcing care through a home care agency comes with higher costs, as well as a minimum number of weekly hours. However, hiring a caregiver through a home care agency can have several advantages:

• Home care agencies require background checks and screenings for added peace of mind.
• Agencies can provide families with more client reviews.
• If your loved one’s regular caregiver is sick, finding a replacement through the same agency is usually quick and hassle-free.
• If your senior loved one’s care needs change, home care agencies can suggest a caregiver with more specialized or advanced training.

Managing an independent caregiver often means more work for a family. When it comes to running a background check or verifying references, this responsibility will fall on you. Similarly, if an independent caregiver gets sick, a family member will have to find a replacement or stay home with the senior themselves. Despite these drawbacks, many families still choose to hire personal caregivers due to positive factors:

• Families and seniors can have more input in the interview and selection process, allowing them to hire a caregiver whose interests and personality mesh well with the person who needs care.
• Independent caregivers usually charge lower rates.
• Independent caregivers set their own hours, offering the potential for added flexibility.

How do I find home care near me?

Are you wondering how to find home care? A Place for Mom’s local, expert advisors can connect you with home care agencies in your area. They can also help you consider your loved one’s needs, your expectations, and your financial resources to find the right in-home care option for your loved one.