In Home Care

In-home care is the solution for patients who require assistance in the home, but it doesn’t necessarily have to be 24-hour nursing care. In-home caregiving agencies can be found in the nursing section of the yellow pages, although some Medicare-accredited home health agencies also provide this type of care.

This type of care is generally considered to be non-medical, although most agencies also provide nursing services as well. The majority of care is provided by homemakers and certified nursing assistants. Most agencies will provide care at an hourly rate, usually with a four-hour minimum. It’s possible that the care can be split – for instance, a worker from the agency can arrive for two hours in the morning to shower and provide other personal care needs as well as to prepare the patient breakfast and place a lunch in the fridge, and another worker will arrive in the evening to help the patient to bed and do a load of laundry.  This option isn’t available in all areas because it depends on how far the workers will have to travel.

With the help of a personal alert button and a medication box that alarms to remind him when to take his medications, in-home caregiving might be a good way to ensure that the patient’s needs are met either long-term or until he is able to get back on his feet.

Agencies that provide in-home care are professionally staffed, and are licensed and bonded. They perform background checks on their workers and usually provide ongoing training for their staff. These agencies provide liability insurance as well as worker’s compensation, which protects against lawsuits should the worker get hurt in the patient’s home.  However, there are no laws that require in-home caregiving to be provided by an agency – some people pay a family member or private party to provide caregiving services.

Paying a private party to stay with a patient can be a huge liability. It’s important to speak with your homeowner’s insurance policy provider to make sure that household help is covered, in case the person is injured while caring for the patient (or steals from the home). There may also be tax implications for hiring household help without paying payroll taxes.

Hiring a private caregiver means that there’s no guarantee the person caring for the patient is trained to provide assistance, or that he’ll be committed to the patient. If the caregiver leaves without notice, the patient is on his own. Family members should check in daily to ensure that the patient is receiving the promised care, and should remain alert to signs of abuse. It’s also best to limit any caregiver’s access to the patient’s finances.

The cost for in-home caregivers varies – it might be as little as $10 per hour in a smaller town to $25 per hour in a larger city. In-home care can be covered by some long-term care insurance policies, but is rarely covered by a regular health insurance policy. Medicaid programs often pay for limited assistance in the home, but only from agencies with which they have a contract.  Some Medicaid programs even pay family members to provide assistance in the home, but in most cases there’s a maximum of 20 hours per week.

It is also possible to pay a person to provide 24-hour care in the patient’s home. This can be provided by an in-home caregiving agency or a private party. An in-home caregiving agency can cost as much as $6,000 per month for a live-in caregiver, with a relief caregiver on the weekends. The cost for this type of care is usually more expensive than placement in the nicest ALF. The benefit is that the patient is able to remain at home. The drawback is that a stranger is living in the patient’s home, and the patient is fairly isolated to the caregiver or to those people who visit the patient’s home. Most agencies are able to provide 24-hour caregivers if given enough notice, but if the worker suddenly leaves or becomes ill the patient might possibly be left alone.

Many people offer free room & board to a college nursing student to stay with a senior – but it’s important to remember that this person will be gone all day (or night) to attend college and will spend time studying when at home. The senior might not receive much attention. You get what you pay for – and the patient deserves the best of care. There are good, honest workers out there – but if these people can’t be located or the care can’t be reasonably provided at home, it’s best to look into an assisted living facility or nursing home.