Home Care

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Home Care: An Overview

Just like there’s no place like home, there’s no care like home care. The comfort of a familiar environment can’t be overestimated, especially during illness or old age. As you look into healthcare for your loved one, home care is a unique option that balances essential care without disrupting the solace of home. 

Let’s give an overview of what home care is, how it improves quality of life and how you can pay for it. 

What is home care?

Home care (also known as domiciliary care or in-home care) is a wide-ranging set of services provided to a patient in order to age in place. Granted in an individual’s home, this care can vary between nursing support, custodial care, and other personal care services.

Unlike other health options, such as nursing homes, care is provided on an individual basis rather than in a group setting. Nurses, aides or therapists attend patients in their own homes a few hours a day, or on a more long-term basis. 

In-home patients often enjoy their relative independence as they manage or recover from health issues, whether illness, disability or aging. This type of care ensures a level of safety and comfort. It may also prevent future hospitalization and emergency care. For these reasons, in-home care is typically a lower-cost option with high patient satisfaction. 

What types of home care are available?

This care falls into four distinct categories. 

1. Nursing care

Provided by a certified nurse, this long-term care is aimed at managing an illness, injury, or disability. Only a health professional can take care of these tasks, which may include:

  • Monitor vital signs
  • Perform laboratory tests 
  • Manage medication
  • Document health status and tasks
  • Liaison between patient, family and doctor
  • Pain care
  • Ventilator care
  • Catheter care
  • Feeding tube care
  • Tracheostomy care
  • Ostomy/gastrostomy care
  • Other care related to chronic injuries and conditions

2. Home health care

Provided by a therapist, this short-term care is aimed at recovering from an illness, injury or hospital stay. Often these patients need to relearn skills or speech and require temporary therapy such as:

  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Temporary nursing services
  • Medical social services (i.e. counseling and community resources)
  • Other health aide services

3. Personal home care 

Provided by a health aide, personal care services are focused on the patient’s quality of life and daily convenience. Aides assist with daily tasks that can be challenging for the elderly, such as:

  • Custodial care (bathing, dressing, toileting, etc.)
  • Medication reminders
  • Mobility assistance (getting in and out of bed, using the stairs, etc.)
  • Housekeeping tasks
    • Meal preparation 
    • Laundry
    • Errands and appointments
    • Shopping
    • Yard work
    • Bill paying
  • Transportation
  • Companionship activities

4. Specialized home care

Home care can also be specialized according to the patient’s needs. For example, patients with Alzheimer’s or dementia, or those who are transitioning from a hospital stay. Some care may even be related to palliative or end-of-life care. In these cases, these services will be customized according to the patient’s medical treatment plan. 

What are the benefits of home care?

Home care may be right for loved ones who enjoy their independence at home and aren’t interested in moving to a care facility. Every senior has a right to age in place, and this care ensures they can with dignity. Familiar routines and scenes can be maintained while receiving care. This care is highly personalized to their needs and may prevent emotional distress, including elderly depression

Another key benefit of in-home care is the financial cost. It’s typically a more affordable option than live-in care such as nursing homes or assisted living facilities.

How does home care compare to assisted living?

Home care and assisted living have two different focal points. While home care takes place in an individual’s home, assisted living is a live-in option within seniors-only housing.

Another potential difference is the type of care. Assisted living typically involves custodial care, such as dressing and toileting. Home care can entail custodial care tasks, as listed above, but it can also expand to include nursing and therapeutic care as well.

Finally, the living experience of assisted living is perhaps more social than home care. Those who live in a group setting are more likely to connect with their peers.

What is the experience of home care like?

For many seniors, independence and privacy is essential. Moving to senior-specific housing or facilities doesn’t interest them because they’re already content with their routine. This makes home care an ideal experience. Care is provided on the terms of your loved one, fitting into their schedules and preferences.

Should I be worried about COVID and home care?

Home care has a lower risk of COVID infection because it occurs in the home. This means only a nurse, therapist or aide will be in contact with your loved one. At the same time, it’s important to understand the COVID protocols for providing care at home. Basic protocols such as wearing a facemask might be mandatory to minimize risk.

How much does home care cost?

Home care costs will vary by state, but the national average is $4,290 a month (via Genworth Financial’s Cost of Care Survey). This is significantly more affordable than the average cost of a nursing home, which runs at $7,513 a month for a shared room.

Of course, these costs will fluctuate depending on the degree of care. For example, the hourly rate of in-home care is $24. If your loved one only needs a few hours of care a day, it will cost less than $4,000. To give an example, if you require 20 hours of care a week at $24/hour, you’ll be charged $1,950 every month.

However, if you require more frequent care, the costs begin to escalate. According to Genworth, at 42 hours a week, the cost of home care reaches $4,095 a month, which is on par with assisted living costs at $4,051 a month.

At the end of the day, if your loved one needs more than 42 hours of home care a week, it’s probably more financially smart to select an assisted living or nursing home.

How can I pay for home care?

There are several ways to pay for this type of care, depending on your care requirements.

Medicare

Medicare will cover at-home care under a few conditions. First of all, it must be health-related care. If you only need personal care, it won’t be covered. Services like meals, housekeeping or errands are almost never covered.

However, both Medicare A and B will cover home health services that fall under nursing, therapy and specialized care. Sometimes it will cover custodial services (such as dressing and toileting), after a hospital stay or if considered medically necessary.

If you want to cover home care with Medicare, the eligibility requirements include a doctor certification that you’re receiving regular care and require nursing or therapeutic care at home. You must also show proof of being homebound. The definition of homebound varies, but patients who attend adult day care are still eligible for in-home services.

Medicaid

For seniors who qualify (fulfilling both the financial and medical components), Medicaid covers all medical costs. However, personal care services may or may not be covered depending on the state. You’ll have to check eligibility according to your region. If personal care isn’t covered, some states also have other programs available to cover these types of services.

Private insurance

Private insurance is another way to cover home care services. Your coverage will vary depending on your provider and plan. Typically, personal care services aren’t covered, but you should contact your insurance provider to get full details.

How else can I pay for home care?

Home care can also be paid through other means. Here are a few options to consider:

Long-term care insurance 

If you have long-term care insurance, you may be able to get in-home care services, including personal care services. Check with your provider to find out your coverage details. 

Life insurance

Another possibility is life insurance. Some life insurance can be paid out early to pay for elderly care. It’s a good alternative to long-term care insurance. 

Veterans

Veterans are eligible for the “Aid and Attendance” program that pays for home care services. Veterans have to apply for the benefit, which is an additional payment to the regular veteran’s pension. If you’re a veteran, check with a benefits specialist (or a veteran’s non-profit) to get more information about the Aid and Attendance program.

Home and Community-Based Waiver program (HCBS waivers)

Depending on your state, you may also be eligible for HCBS waivers. Those who require nursing care can elect to receive in-home care, covered by Medicaid. Basically, the recipient can choose their preferred method of care, instead of simply a nursing home. Contact your Medicaid state program to understand if HCBS is available. 

Program of All-Inclusive Care for the Elderly (PACE)

PACE is a new program that aims to better serve elderly needs. The idea is to provide home and community care for those who require nursing care. Once again, this program is only available in some states and typically for seniors who are already eligible for Medicare and Medicaid. Contact the PACE program to learn more.

Why should I choose home care?

Home care is an excellent choice for seniors who want to remain in the comfort of their homes, while receiving needed health or personal care. It’s especially apt for seniors who aren’t thrilled by the idea of moving to a nursing home or assisted living facility. For those who already have an established routine and social group, it’s a good way to maintain independence without interruptions. 

How can I find the right home care agency?

You can start your search for a home care agency with My Caring Plan. Here you’ll find options for care in your area, as well as other resources for senior living. You can even get home care ratings for different options.

As you research care options, make sure to talk with home care agencies about their caregiver profiles and the possibility of a customized plan. You should also meet with the agency to talk through the specific needs of your loved one. 

Home Care by State