As an increasing number of seniors choose to remain in their home rather than move into an assisted living community, the demand for home care continues to rise. Also called “companion care,” home care consists of non-medical services that allow an individual to receive assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). In contrast, home health care consists of skilled nursing services that are provided in the home by licensed professionals such as nurses, physicians and therapists.
Seniors who require home care services often require assistance with ADLs or IADLs to remain independent.
ADLs generally include the following:
- hygiene (brushing hair, brushing teeth, denture care, etc.)
- toileting (including hygiene, use of incontinence products)
- transferring (moving from bed to chair, walker to toilet, etc.)
IADLs generally include the following:
- light housecleaning and upkeep
- meal preparation
- medication management
- shopping for groceries or clothes
- using the telephone to schedule appointments, etc.
- managing money (balancing a checkbook, paying bills)
The frequency of home care services provided varies depending on several factors. The primary factor is the level of independence that a senior is able to maintain while ensuring their basic care needs are met. For example, a senior who doesn't require assistance with ADLs may only need assistance with IADLs, such as house-cleaning, laundry and transportation to shopping once a week. In other situations, seniors may need daily supervision of particular activities in order to ensure their physical safety and well-being. For couples in which one spouse acts as the primary caregiver, home care services often serve as an intermittent, yet much needed break in day-to-day responsibilities.
Home care also offers flexibility as services can be arranged on a short-term or long-term basis. For example, services are often arranged for seniors after a medical crisis has occurred, such as a stroke or injurious fall. In such cases, temporary assistance may be needed while regaining strength and/or mobility. Services may also be provided on a long-term basis in order to allow a senior to receive care while their adult child is working during the day.
A prospective home care client's needs are determined by a licensed medical professional through an initial assessment. This process typically takes place at the home of the client but the location of the assessment varies as well. An assessment determines the frequency of care needed and thus the estimated expense based on an hourly rate. Most home care agencies have a four-hour minimum per day.
According to the MetLife Mature Market Institute® the average hourly rate for home care services provided nationwide was $18 in 2008. If a client requires around-the-clock or overnight care, a daily or nightly rate is assessed and may cost approximately $150 to $375 depending on the geographic area.
While Medicare does not cover home care, those eligible for Medicaid may receive financial assistance for services provided in the home. However, most home care agencies do not accept Medicaid and thus private pay is required. For veterans or spouses of veterans, Veteran's Aid and Attendance benefits may also be available. Visit http://www.veteranaid.org for general information about these benefits and the eligibility requirements.
It is highly advised to arrange for home care services through a reputable agency that is licensed, bonded and insured. Caregivers that advertise independently through newspapers or other means may not have the qualifications required of employees at home care agencies. By going through an agency, you're ensured that the caregiver has gone through a state and/or nationwide background check and has completed formal training requirements.
Written by gerontologist Sara Shelton and Andrea Watts.