7 Answers to the Most Frequently Asked Questions About Home Care

Are you recovering from surgery and require rehabilitation or other supportive care at home? Does your loved one have a chronic illness and require long-term care? Home care services are an attractive option for many because it means getting the supportive and/or specialized care they need while staying in their own home.

Home care services come in different forms and encompass practically nearly all aspects of senior care, and to a more individualized and private degree. If you’re thinking about getting home care for you or your loved one, there are some important considerations you should keep in mind to ensure the best care possible.

1 What is Home Care?

Home care is supportive care and/or health care given to an individual who has special needs associated with aging, a chronic illness, recovery from surgery, or disability. For seniors, in particular, home care allows aging in place while they receive the care they need. Home care may be provided by a caregiver, nurse, or rehabilitation therapist (such as a physical therapist or speech therapist).

Home care services may be round-the-clock, only some hours of the day, or only a few days a week; and they may be short-term or long-term. Services include:

• Personal and hygiene care, such as help with bathing, getting dressed, going to the toilet, and moving around the house.
• Basic home upkeep, including cleaning, cooking, doing the laundry, and yard work.
• Bills management
• Medication management
• Specialized health care, such as help monitoring blood sugar levels, dressing and treating surgical wounds, or administering injections.
• Companionship and emotional support, particularly for those who suffer from severe cognitive decline or who are in the final stages of an incurable condition.

2 Is home care the right option for your loved one?

If any of the following is true, then you should seriously consider getting home care for your loved one.

• Everyday tasks have become difficult and, perhaps, even dangerous due to a chronic condition such as arthritis, or a progressive one such loss of eyesight.
• They are at risk for falls and other serious accidents due to stability, mobility, or memory problems.
• Their forgetfulness has worsened, causing them to forget to take their medications, check their blood pressure or blood sugar regularly, or even pay their bills. They might be exhibiting symptoms of early-stage dementia.
• They constantly suffer from loneliness and isolation and have been indifferent about their personal care, health, and/or home maintenance.
• They are depressed.
• They have a condition that requires constant monitoring; specialized care, such as for advanced Alzehimer’s; and/or specialized treatment, such as injections.
• They are recovering from surgery and need help with basic tasks and moving around.
• They need rehabilitation therapy but don’t want to leave their home.
• They need round-the-clock care, or daytime or nighttime care when you or other family members are not around.

3 Does home care have limitations and disadvantages?

Home care is often not recommended for medical conditions that require frequent diagnostic testing; breathing treatments; strictly monitored intravenous medications; and/or complicated medical equipment.

Some medical conditions may also necessitate certain home modifications and the use of basic medical equipment. If the modifications are not possible or there’s not enough space for equipment, home care may not be the most suitable option for your loved one.

While many agencies do a good job of ensuring the professionalism and ethical behavior of their caregivers, leaving your loved one alone with a complete stranger may carry the risk of exposing them to neglect or abuse. If you’re going with an independent caregiver, it’s always best to find one who comes highly recommended by former patients; if you’re getting a caregiver from an agency, make sure the agency is reputable and trustworthy.

Home care costs may also not be covered by Medicare or insurance, unless specific conditions are met. And depending on the services needed and how long they are needed, home care can be costly.

4 How much does home care cost?

Home care costs vary based on the following factors:

• The number of hours of service provided, when agencies or private caregivers charge by the hour. For long-term home care, some home care providers offer discounted monthly rates.
• The level of care provided and if supplies and equipment are necessary. Caregivers that only provide basic supportive care cost less than private nurses or rehabilitation therapists.
• Geographic location; home care is typically more expensive in places with a high cost of living.
• State regulations and licensing requirements and their associated fees

According to Genworth Financial’s 2019 survey of nearly 4,000 home care agencies in the United States, more than 90% of home care agencies charge on a per-hour basis. Private caregivers often cost less than agency caregivers.

5 How do you find a suitable caregiver?

If your loved one needs 24/7 in-home care, you will have to employ either two caregivers working 12-hour shifts or three caregivers working 8-hour shifts. Round-the-clock care requires what is called non-sleeping visits, wherein caregivers have to be awake for the entire duration of their shift to constantly monitor their patient, assist and clean them up when necessary, or to regularly turn them on the bed to prevent bedsores.

If your loved one requires 24/7 care but sleeps through the night, the overnight caregiver provides what is called sleeping visits, wherein they can sleep when their patient sleeps, but an alarm or a bell wakes them up if their patient needs to go to the bathroom or if there’s an emergency.

Live-in caregivers typically provide non-medical and even some basic medical support (such as medication management and monitoring of blood sugar levels) during the day, and emergency support at night. Live-in caregivers typically do not work on rotation alongside other live-in caregivers; although you may request for a substitute during your regular caregiver’s day/s off if no family member is available to take over.

The level of care your loved one requires will also determine the kind of home care provider they need. If your loved one only needs help with personal care and with house chores, for example, a non-medical caregiver would be adequate; but if your loved one needs injections and close monitoring of their vitals, then a registered private nurse would be the most qualified to do the job.

6 Which is better: private or agency home care?

When it comes to costs, private caregivers often have lower hourly rates because they determine their own rates; keep in mind, however, that you will have to pay taxes for independent caregiver services. There might also be additional costs if you want to conduct a background check; if you need a lawyer to review the contract; or if you want to purchase liability insurance coverage or have to pay out-of-pocket for any accidents on the job and the caregiver has no worker’s comp insurance.

In comparison, hiring an agency caregiver is slightly more expensive, but you also have less to worry about as contracts, taxes, and insurance are usually already included in the home care costs.

With independent caregivers, you have the freedom to directly communicate with potential candidates to determine who would be the most suited to take care of your loved one. State regulations regarding caregiver tasks typically don’t apply to independent caregivers, so there’s more room for maneuverability when you’re finalizing the duties to be included in your caregiver’s service contract.

Home care agencies, on the other hand, generally only employ certified care aides, nursing assistants, or private duty nurses; and most reputable agencies provide continued training for their caregivers, as required by state regulations. This means you’ll have a better guarantee of the caregiver’s background and experience. However, state regulations also impose certain restrictions on the kinds of tasks agency caregivers can perform, and the agency often determines caregiver assignments based on availability and patient requirements.

There’s less safety and legal risks involved when hiring a caregiver through an agency. And you can always be assured that all shifts will be covered; if your usual caregiver gets sick, for example, the agency will send a replacement, so you can be sure that your loved one will receive uninterrupted care.

Weigh all the pros and cons of hiring an independent caregiver versus an agency caregiver — as they apply to your loved one’s needs.

7 Why is home care better than other care options, such as assisted living or a nursing home?

The biggest advantage of home care is that the patient can remain within their comfortable, private, and familiar home environment. Many seniors, for example, are hesitant about or completely averse to moving out of their home and into a care facility simply because they don’t want a change in environment.

Home care also provides the benefit of one-on-one companionship. Many long-term caregivers develop a friendly relationship with their patients, and this connection may actually contribute to the patient’s quality of life and well-being.

Home care also offers individualized care. As the caregiver is solely focused on a single patient, they can develop a better understanding of the patient’s unique needs and preferences and modify their approach as needed. You can also let them know which tasks to prioritize and customize your loved one’s care regimen based on what you know works best for them.

Final Thoughts

For some individuals who require regular supportive and/or medical care, the comfort and familiarity of home are often important factors in improving their overall wellness and quality of life. Fortunately, many of the services provided by different kinds of care facilities are also available through home care.