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How to Find In-Home Care

Updated on June 5, 2012

When Should You Ask For Help?

I got a call from a friend of mine just the other day, he was struggling with the decisions he faced regarding his parents care. He had just returned from a visit with his parents and was concerned with their ability to remain in their large home safely. He not visited them for some time and was shocked by their declining health status, while visible to him, his parents seemed unaware of their own decline. During his visit he and his parents discussed several options including moving to a smaller home or apartment or a retirement community. As you might expect he met with some resistance. Mom was adiment, wanting to remain in the family home at all costs. While dad was open to the idea of moving to a smaller home, but the retirement community was out of the question. The discussion created a great deal of tension among the family and he left with his concerns unresolved.

Now Is The Time To Ask For Help

When Do I Need In Home Care Services

Sooner is better than later. When you notice your loved ones begin to struggle you should consider providing supports for them. Signs of functional decline appear as changes in daily activities, home clutter and reduced activity. A person who normally keeps an immaculate home will begin to put off household chores because they become tired or overwhelmed with housekeeping chores.

Additional Signs:

  • Depression and feelings of loneliness
  • Weight loss and missing meals
  • Medication errors
  • Unkempt appearance or reduced personal care
  • frequent calls "just to talk"
  • Missing appointments
  • Noticeable balance issues


Planning In Home Care Services

Bringing an outside caregiver into the home is difficult even under the best of circumstances. Many elders refuse to acknowledge that they need help and often rely on a spouse or family member to help them meet their needs. Although it is difficult recognizing an need and addressing it early will produce the best results over the long term. All too often the need for help is only recognized after a catastrophic event such as a fall or injury.

What Services Do I Need?

In-Home care services are driven by an assessment and a care plan. When you contact an agency regarding you need for services, the first step is an interview and assessment. In-home care agencies provide an assessment as a service to you to help you determine the level of care that is needed. A good asseseement will take some time to complete and typically will include questions for the client, questions for family members, an assessment of the home enviornment and observations of the clients activities and abilities.

Following an assessmnet the agency will discuss their findings and provide a care plan that will describe the services they reccomend. The care plan outlines the services to be provided, the day and time services are delivered and who will deliver the services.

In Home Care Costs

In-Home care costs vary widely from State to State and even within each State with different rates for Home Health Aid and Homemaker services:

Type of Service
Home Health Aid

Most agencies have minimum charges for a visit measured in minimum time alocated and charged for a visit ranging from as low as 30 minutes to a high of 8 hours, averaging roughly 3 hours. Some agencies will have a daily rate that is lower than the hourly rate for 24 hour care. It is important to know how each agency charges based on the services needed. In Home services can add up quickly and become very expensive, it is important to monitor tasks performed and length of visits. For example 30 minutes per day for 30 days at $20.00/hr will cost you $300.00 per month.

Tips For Hiring An In-Home Care Provider

  • Each family is unique, know the level of care you need
  • Set high expectations and expect them to be delivered
  • Be sure all caregivers have passed an appropriate background check
  • Ask questions until you have all the information you need
  • Check on the reliability of each agency. Regulations vary from state to state, start at your state's Department of Human Services.
  • Ask for references from each agency
  • Educate yourself on your states regulatory laws
  • In-home care is personal, if a caregiver is not working well for you, ask for a different one.
  • Remember your agency and caregiver work for you.

Who Pays For In-Home Care?

  • Self Pay when a patient does not meet the criteria for public programs or does not have insurance coverage, the pay "out of pocket" for In-Home care.
  • Medicare will pay for In-Home care under limited circumstances and on a part-time basis. If a patient suffers from an acute illness that requires skilled nursing or in-home care under a doctors orders, Medicare will pay for In-Home care.
  • Medicaid pays for In-Home care for low income patients, typically those below the poverty level. There are restrictions and patients must meet specific guidelines to qualify.
  • Older Americans Act (OAA) through the local Area Agency on Ageing there are funds available to help elders remain in their home including providing home care assistance.
  • Veterans Administration pays for In-Home care for veterans who are 50% or more disabled as a result of a service related condition. There are specific guidelines for receiving services.
  • Medigap pays for acute services related to short term injury or illness, but is not intended to cover long-term care needs.
  • Long-term Care Insurance was developed to primarily pay for skilled nursing services, but in recent years insurance companies have recognized the need to cover In-Home care costs. Check Your policy as coverage varies.
  • Managed Care Organizations cover pre-approved Hospice services inclucing In-Home care under a contract with Medicare in specific geographic areas.
  • CHAMPUS covers In-Home care costs for active military members and their dependent as well as retirees.


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    • Lady_E profile image

      Elena 5 years ago from London, UK

      Thanks for posting. Many will find this useful. It was sad to read that his parents didn't even realise what was happening to them. Maybe because they had each other. I'm so glad he is taking some action in getting proper care.

      Best wishes.