What Is In-Home Care?

Home. It’s not a place – it’s a feeling. And that feeling grows stronger as we age. Three out of four adults over 50 say they want to live in their own homes as the years go on. But when daily life becomes more difficult, many find they need additional support to age in place successfully.

So the question arises: how do we make "home" work for our changing needs? Balancing independence with the need for support can be a challenge, leaving many families feeling overwhelmed and unsure where to turn. Fortunately, there's a solution that allows your loved one to age in the comfort of their home while receiving the care and assistance they deserve. In-home care services and hired caregivers can lend support in a variety of ways, from offering simple companionship to helping with basic tasks and even providing specialized medical care.

Learn more about these options, how to find in-home care services and how to decide which one is right for your loved one. Before starting the conversation, keep in mind that aging in place requires a home that’s easy to maintain, safety features that promote mobility and prevent falls and readily available senior support network of caregivers and health care professionals.

What is In-Home Care?

Home care professionals can provide occasional, daily or round-the-clock assistance. Depending on your loved one’s needs, you can hire a personal care assistant and/or a home health care professional.

Personal Care Assistants

Personal care assistants can make your loved one’s life safer and easier. These caregivers can help with everyday tasks like:

• Bathing
• Dressing
• Toileting
• Mobility
• Cooking and eating
• Household chores
• Transportation

Their presence in the house and friendly conversation help to alleviate the symptoms of  social isolation. But one thing these caregivers cannot provide is medical assistance. That’s where home health care comes in.

What Can a Personal Care Assistant do?

Help with the everyday things people do (activities of daily living):

• Bathing and showering
• Getting dressed
• Using the toilet
• Moving in and out of bed
• Getting out of a chair
• Walking safely across a room

Meal preparation:

• Help with eating
• Cooking
• Going to the grocery store
• Preparing meals and cleanup

Light housekeeping:

• Dusting
• Vacuuming
• Laundry
• Making sure the house is organized and safe

Transportation:

• Running errands with or without the older adult
• Door-to-door service to the doctor and other appointments

Money management:

• Tracking and paying bills
• Filling out health insurance and other forms

Pet care:

• Feeding and watering
• Dog walking

Home Health Care

If your loved one requires frequent medical assistance due to chronic conditions or is recovering from surgery, an accident, illness, stroke or heart attack, their doctor will recommend in-home health care. Because these caregivers are specially trained and certified health care professionals, they can administer treatments available in skilled nursing facilities.

When Should I Consider In-Home Care for My Loved One?

It's a natural concern, and there's no one-size-fits-all answer. However, some signs that your loved one might benefit from additional support include:

• Noticeable weight loss may mean they aren’t eating right.
• Decreased mobility and frequent falls are causes for alarm.
• Forgetfulness, while sometimes a normal part of aging, can be the source of missed medications, inattention to bill paying, wandering and safety issues.
• A messy appearance and lack of personal hygiene can come from depression or the inability to maneuver in the bath or shower.
• Unsafe driving caused by vision problems, slowed reaction times, diabetes or dementia are big red flags.
• Certain health conditions require frequent monitoring and treatment.

What Can an In-Home Health Care Professional Do?

• Monitor general health
• Take vitals such as temperature, heart rate, blood pressure and respiration
• Pain control
• Wound dressing and care
• Intravenous therapy and IV insertion
• Occupational therapy
• Physical therapy
• Speech therapy
• Ostomy care

What Are The Advantages of In-Home Care?

Emotional Benefits

A dedicated caregiver is so much more than the help they provide. They provide peace of mind to family members who know their loved one is getting personalized attention and support. Family caregivers need respite from their responsibilities. Hiring in-home help takes the worry and guilt off your shoulders.

Social isolation affects older adults both emotionally and physically. Seeing an in-home caregiver come through the door can bring a sigh of relief. That person is a welcome companion to an older adult who looks forward to conversation and a friendly smile.

Older adults as well as their caregivers enjoy a higher degree of safety, security and independence when receiving in-home care.

Physical Benefits

Receiving frequent personalized medical attention promotes better health outcomes than waiting for care between doctor appointments. Patients heal more quickly if resting in the comfort of their familiar homes. Consistent nutrition boosts overall health.

Cost Benefits

Throughout the U.S., the average cost of personal assistance care is $4,957 per month. In-home health care is higher, averaging $5,148 every month. The cost of care will vary, depending on where you live. As expensive as these services seem, you will be paying less than if your loved one was living in an assisted living community or a skilled nursing facility.

If a doctor prescribes home health care and a senior has Medicare Part A (hospital insurance) and/or Part B (medical insurance), Medicare will cover eligible costs. Veterans can finance in-home care from their Aid and Attendance benefit.

What Are The Downsides of Aging in Place?

Even with the best in-home care services, aging in place has its disadvantages. Here are four drawbacks that people report most often.

1. Home Maintenance

Keeping up a home is costly. Appliances, roofs, furnaces and air conditioners wear out and take time and effort to replace. Whether these repairs are planned or unexpected, the bills add up. Property taxes tend to increase every year, too.

2. Home Modifications

Installing safety features improves accessibility but can drain finances. Start by correcting any problems like loose railings or steps, uneven floors and cluttered pathways. The National Association of Home Builders certifies contractors who can install:

• Wider doors and hallways for wheelchairs and scooters
• Nonslip flooring
• Grab bars and grips
• Walk-in tubs and showers
• Ramps

While these changes make it easier for your loved one to age in place, they may make the house harder to sell and affect its value.

3. Social Isolation

The time between in-home caregiver visits leaves plenty of hours of being home alone. The Centers for Disease Control (CDC) warns that social isolation carries health risks for older adults. Studies indicate that an older adult has a higher chance of depression, heart disease, stroke or dementia if they are persistently lonely. Many people look into senior living as a healthier alternative.

4. Caregiver Reliability

Finding the right personality fit between a care recipient and their caregiver can take a while. Getting in-home health care workers up to speed on your loved one’s medical conditions takes time too.

Job websites report average salaries for in-home care workers start at about $17 an hour. Unfortunately, this leads to a high turnover in staffing. Because of that, home visits may be delayed and rescheduled. Frequent changes in caregivers can threaten your loved one’s sense of security, and strangers may frighten people diagnosed with dementia.

How Can I Find the Best In-Home Care Services?

Talk to people you trust.

• Word of Mouth. Extended family, friends and neighbors are dealing with these challenges more often than you may think. One of them may be willing to take on the tasks of being a personal care assistant or can point you to reliable people or agencies.
• Health Care Teams and Hospital Staff. Doctors, nurses and hospital social workers are excellent sources for informed referrals.
• A Geriatric Care Manager.
• Home Care Agencies.
• Places of Worship and Charities.
• Your local area agency on aging and Eldercare.
• Community resource lists from the Alzheimer’s Association and AARP.

No matter which route you go in hiring in-home care services, proceed with caution.

• Look for consistent answers during the interview process.
• Ask for referrals and speak to previous clients. Don't rely solely on online reviews.
• Ask about their hiring process and background checks.
• Get financial policies and lists of liabilities in writing.

Alternatives to In-Home Care

You’re probably seeing more adult day services in your neighborhood. These programs offer companionship, personal care, social activities, meals and exercise, allowing family caregivers to go to work and catch up on other responsibilities.

Many senior living communities welcome older adults on a short-term basis. In addition to the respite care they provide, it’s a good opportunity to test out how well your loved one could adapt to this living situation.

Assess Needs

Consult this checklist to determine what kind of help you need and how many hours are required. Share your concerns honestly with the in-home caregiver.

Activities of Daily Living

Can your loved one:

• Dress and undress?
• Prepare nutritious meals and clean up afterward?
• Shop for groceries and other necessities?
• Get in and out of bed or a chair on their own?
• Bathe, shower and generally maintain personal hygiene, including oral care?
• Walk and use the stairs safely?
• Drive or use public transportation?
• Manage medications?
• Keep the house clean and organized?

Mental Health

Are they:

• Forgetful to the point that safety is a concern?
• Depressed?
• Showing decreased interest in life, family, friends or hobbies?
• Wandering?
• Able to pay bills, manage insurance and legal forms?
• Experiencing mood swings?

Physical Health

Do they have:

• Special dietary needs?
• Chronic conditions?
• Short-term illnesses or recovery issues?
• Balance problems?
• Sleep disturbances?
• Vision or hearing problems?
• Moderate to severe pain?

An in-home personal care assistant or home health caregiver can bring tremendous relief, but it isn’t the right solution for everyone. Once you understand what in-home care can offer and how their services match up to your loved one’s needs, you’ll be ready to start your search for a reliable, compassionate caregiver.