Your Complete Guide to Home Care

What is home care?

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

In-home care services are customized to meet a senior’s unique needs. While some older adults may rely on home care providers for help with errands, cooking, and housekeeping, others need more intensive care in their home to manage incontinence, mobility issues, or dementia. 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 are the benefits of home care for seniors?

Home care may offer a source of support for your aging loved one and peace of mind for you and your family. If you’re concerned about your loved one’s safety, emotional well-being, or ability to perform daily tasks independently, consider the following advantages of home care:

• Companionship. A home care aide can provide regular social interaction and develop a close bond with your senior loved one. This can help to combat the adverse health effects associated with loneliness and social isolation.
• Care provided in a familiar environment. If your loved one is hesitant about moving into a senior living community — or maybe they simply prefer 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. Home care aides can drive seniors to doctor’s appointments, the grocery store, community events, or anywhere else they might need to go.
• Respite and reduced caregiver stress. If you’re a family caregiver, it’s crucial to monitor your own well-being while looking after your aging loved one. Hiring a home care aide can help restore balance to schedules and minimize caregiver burnout.
• Flexibility. Home care allows families to determine how and when to use services. There are different types of home care aides who can provide occasional care or visit more frequently. A family may use home care as a way to supplement the care they already provide, or they can opt to have an aide provide all the care their loved one needs.

What services do in-home caregivers provide?

Home care aides administer a wide range of nonmedical services to help seniors preserve or improve their quality of life at home. For older adults who prefer to age in place or those who aren’t ready to transition to senior living, home care can help fill care gaps and simplify their day-to-day routine.

Seniors aging at home can have a range of needs, so nonmedical home care is broken down into three types:

• Companion care focuses on providing aging adults with emotional support, opportunities for socialization, and assistance with instrumental activities of daily living, like shopping, cooking, making appointments, and transportation.
• Homemaker care provides assistance to seniors who live independently but need help with common chores such as laundry, cleaning, or even pet care.
• Personal care services include assistance with ADLs such as bathing, dressing, grooming, and other hygiene needs.

It’s important to note that these types of care don’t need to be provided separately. For example, if a senior needs assistance with ADLs, their care plan may combine both personal care and homemaker services. Or maybe a family caregiver can provide personal care for their loved one but needs assistance with cleaning and laundry. Home care offers the flexibility many families need when caring for their aging loved ones.

What are the differences between in-home care and home health care for seniors?

While they sound similar, there’s a distinct difference between home care and home health care. Home health care is medical care that’s prescribed by a doctor and provided by licensed professionals such as registered nurses and occupational or physical therapists. While this guide focuses on nonmedical in-home care, it’s important to understand how the services differ.

The following table offers a comparison of the two care types:

It’s important to note that home care and home health care services may be provided simultaneously when a patient’s doctor determines these services are necessary for their safety and well-being.

When is it time to consider home care for a loved one?

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 help at home can include:

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

It’s also important to consider your own needs. Common signs of caregiver burnout include:

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

Home care can be a good fit for many seniors who want to age in place. However, it’s important to be realistic about your loved one’s needs and the cost of care. For seniors who require eight or more hours of care per day, home care costs may exceed those of many senior living options. Plus, a community setting may be able to offer a higher level of care and a wider variety of services and amenities.

How does home care compare to senior living options?

Like home care, assisted living communities and memory care communities can provide assistance with ADLs, companionship, meals, light housekeeping, transportation, and much more. And while home care is an excellent option for seniors who prefer to age in place, costs can become prohibitive in the long term — especially as 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 prefers to have planned activities and regular opportunities for socialization, a senior living community may be a better fit.
• Homemaking services. Senior living communities and home care aides both offer light housekeeping, meal preparation, and help with laundry. With home care, however, 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 and accommodate dietary requests.
• Cost. Depending on your loved one’s care needs, home care costs can significantly exceed the typical monthly price of senior living facilities.
• 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 like door alarms and 24/7 supervision. If your family member prefers to age at home, these devices may have to be installed and could require home modifications. If your loved one has wandering issues, they’ll also require someone to supervise them around the clock.
• Amenities. Senior living facilities boast easily accessible amenities like fitness centers, dining rooms, and social activity spaces. While a resident may not have these arrangements in their home, a home care aide can help with exercise routines and transport clients to a senior center, gym, or favorite restaurant.
• 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 your elderly loved one requires the type of care normally offered in a nursing home, home care likely won’t suffice. Home health care services are available, but they must be prescribed by a doctor and may be more expensive than nursing home services over the long term.

Differences between home care and memory care for a 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.

The main difference between memory care and home care for dementia is the space where care occurs. Memory care communities feature increased security and activity areas that are designed to provide stimulation for seniors living with dementia. While some home care aides have dementia-specific training, private homes often need to be modified to offer the same level of safety as a memory care community.

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

Benefits of home care for dementia include:

• Familiar surroundings
• One-on-one care
• Organized dementia care activities at home
• Specific knowledge about your loved one for person-centered care

How much does in-home care cost?

The median cost of hiring a home care aide in the U.S. is $30 per hour, according to A Place for Mom’s proprietary data. Because home care is highly personalized, the cost of home care often depends on the level of assistance your senior loved one needs. Where your loved one lives may also affect this estimate.

How is the cost of senior in-home care calculated?

While it’s typical for home care agencies to charge by the hour, negotiating a monthly or annual contract may allow for discounted prices. To account for costs like transportation and staffing, most home care agencies have a minimum weekly or monthly hour requirement. Caregivers with specialized skills, like dementia-specific training, will often be more expensive to hire.

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

The personalized care arrangements of 24/7 home care come with different costs but in most cases are based on standard hourly home care rates. When evaluating the cost of 24/7 in-home care, families should make sure to define their care expectations. Some families expect 24/7 care to mean that multiple aides work in shifts to provide round-the-clock assistance, while others may decide to employ one live-in caregiver who’s entitled to regular breaks.

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

Cost can play a major role in determining if care at home is a viable solution for your loved one. A primary benefit of home care is its flexibility: It can be an affordable option for seniors who don’t require a high level of care, and for families who have the ability to share some of the care responsibilities. However, living in a senior community may be less expensive if your loved one has advanced care needs or requires many hours of care.

The difference between home care and assisted living is often cost, and a good way to highlight the differences is with a cost comparison. If you estimate your loved one requires eight hours of care per day, the median cost of home care is about $5,300 per month, whereas assisted living costs around $4,800 per month. This data is based on the actual costs families have paid for long-term care at A Place for Mom’s partner communities.

It’s important to consider that the cost of home care doesn’t account for living expenses such as a mortgage payment, rent, utilities, and meals. Assisted living costs include rent, meals, housekeeping, and most care services.

The median monthly cost of other care types are as follows:

• Memory care: $6,195 per month
• Nursing home, semi-private room: $7,908 per month

Paying for home care

Assistance for seniors living at home can be expensive, but there are several payment sources that can help cover home care costs. Most families pay for senior care by using multiple payment methods, including:

• Personal savings. This can include many sources, like retirement funds, pensions, and stocks.
• Reverse mortgage or renting the family home. A reverse mortgage is a loan option to help families pay for long-term are using the value of their home. But if a senior is moving in with a relative, they might instead use their home as a source of income by renting it out.
• Long-term care insurance. If your love one has a long-term care insurance policy, it may help cover the cost of home care. However, it’s important to contact their insurance provider to learn how to make the most of their benefits.
• Medicaid. This federal health insurance program may provide home care assistance for seniors with low incomes. Medicaid programs vary by state, so it’s important for families to contact their state Medicaid agency to determine eligibility.
• Medicare. Medicare can cover certain short-term, doctor-prescribed services meant to help a senior recover from an injury or illness. This may include medical services such as skilled nursing and therapy in addition to assistance with daily activities like grooming, dressing, cooking, and cleaning.
• VA benefits. If your senior loved served in the military, they, along with their surviving spouses, might be eligible for veterans 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, remember that this person will be your loved one’s companion and main source of support. Families can choose to hire through a home care agency or an independent caregiver, and each has its own benefits, but ultimately it’s important to find a caregiver who instills confidence that they will provide your loved one with comfort and a high quality of care.

Differences between a home care agency and an independent caregiver

Hiring a caregiver through a home care agency typically costs more and may require a minimum number of weekly hours, but there are several advantages:

• Home care agencies require employee background checks and screenings.
• Agencies can provide families with more client reviews of caregivers.
• 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 often provide a caregiver with more specialized or advanced training.

Hiring an independent caregiver often means more work for a family. This may include tasks like running a background check, verifying references, and handling payroll. 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 several positive factors including:

• Families and seniors can have more control over the interview and selection process.
• Independent caregivers usually charge lower rates.
• Independent caregivers set their own hours, offering the potential for added flexibility.

Tips for hiring a home care provider

When coordinating care through a home care agency, consider asking questions like what licensing and certifications the company requires and what types of training caregivers must 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 expertise in that area.

If you’re considering hiring an independent caregiver, find the right fit by considering these 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 grab bars?
• If the senior in need of care has Alzheimer’s disease or another form of dementia, does the caregiver have experience providing dementia care in a home?
• Can the caregiver cook and are they able to accommodate your loved one’s dietary restrictions?
• What’s the caregiver’s availability?

How do I find home care providers?

In-home care can provide the assistance your senior loved one needs to live at home safely, but keeping up with their changing care needs and associated costs as they age can be complicated. A Place for Mom’s Senior Living Advisors can help simplify the search for home care by connecting you with local agencies that fit both your loved one’s needs and budget.