Senior home care service options
What you need to know about in-home health care help
by Jami Barnett, Ph.D.
ConsumerAffairs Research Team
Aging or illness doesn’t mean you or your loved one must move into an assisted living facility or nursing home. With the medical assistance available through home care, most people have several options for getting a little extra help and building a supportive community in their own home.
This article outlines the types of in-home care available to people who can’t take care of themselves the way they used to.
Types of home care service providers
There many types of home health care providers, and understanding the differences between them might seem complicated at first, especially because their services often overlap. If you’re confused about what kind of provider you’re working with, ask them. These distinctions may be important when it comes to getting Medicare or your insurance to pay for a service.
Home health aides
Home health aides are professionals who can help with self care, housework, cooking and more. They might also perform some basic medical tasks. Home health aides sometimes have medical training, so they might be certified nursing assistants (CNAs) or licensed practical nurses (LPNs). However, there aren’t any specific standards requiring a home health aide to have particular training or certification. If you’re looking for someone to help with any medical-related tasks, ask about certifications when choosing your provider. Medicare or Medicaid might pay for help from a home health aide.
Home care nurses often handle basic medical needs of those aging in place, like tracking their vitals, giving them IV medications and changing bandages. These professionals could either be licensed practical nurses (LPNs) or registered nurses (RNs). The higher level of care a person needs, the more likely their nurse will be an RN. Sometimes, a nurse will visit a patient less frequently but will manage a team of home health aides that visits the person every day. Medicare or Medicaid might pay for help from a home care nurse.
Geriatric care managers
Geriatric care managers are professionals that help caregivers figure out how much care their loved one needs and what living situation might be best for them. They also help caregivers and families navigate the medical system and figure out how to pay for care and hire appropriate home care professionals. Geriatric care managers often have backgrounds in gerontology, social work, nursing, psychology or another related field. You’ll often have to pay out-of-pocket to hire a care manager, but it could be worth the investment if they help you save money in other ways.
Companion services vary a lot from one to the next. Companions might just be someone who keeps your loved one company, or they might also offer transportation and housekeeping services. Companions don’t handle any medical tasks, and they don’t usually help with bathing, grooming or other activities of daily living (ADLs). Because these individuals don’t provide medical care, Medicaid and Medicare won’t pay for them. You may be able to find a community service organization, like Volunteers of America, that provides these services for free.
Meals on Wheels
Meals on Wheels is a national organization that operates in most communities in the United States. It works with local businesses and volunteers to serve meals to people over 60. The organization delivers meals to people in their homes, and the volunteers who drop meals off provide some companionship to seniors. The group also serves meals in local community centers, so people who can drive can get out of the house to socialize. These services are free or low-cost, depending on where you live.
Villages are non-profit organizations designed to help people age in place. Villages coordinate volunteers and paid workers to organize social and educational activities. Villages typically offer transportation services and limited in-home assistance as well as discounted services from health professionals. Each village is independently operated, so the services offered in your area will vary. To find out about a village near you and learn more about these organizations, visit the Village to Village Network’s website.
PACE, which stands for Programs of All-Inclusive Care for the Elderly, is a part of Medicare and Medicaid. The programs provide as much care as feasibly possible to people in their own homes. For example, someone in a state with PACE might be eligible for in-home care, social work counseling and many other services. Programs in different parts of the country have slightly different offerings, but the overall goal is to keep people in their own homes as long as possible. These programs currently exist in just over 30 states, but they don’t necessarily cover the entire state. To find out about PACE programs in your area, visit the PACE page on the Medicare website.
Choosing a service provider
When it’s time to select an in-home health care provider, you need to do a little research. After all, this person will be spending a lot of time with you or someone you love. Use this checklist to help you screen providers and find the right one.
1. Write down all the care services needed
Start by making a complete list of all the tasks you or your loved need help with. Once you have this list, you can decide whether you need one provider or a few with different specialties.
2. Screen over the phone first
Next, call the companies that advertise the services you need and confirm that their employees can do everything needed. Then, use this list of questions from Eldercare.gov to ensure your loved one will receive quality care.
3. Interview in the resident’s home
If a provider meets your standards after talking to them on the phone, have an in-home interview with the people who will work with your loved one. Make sure you and the care recipient feel comfortable and confident.
4. Call the provider’s references
Anyone who will be working in your loved one’s home should be willing to give you a list of references, including current clients. Call these people to learn more about the provider and ensure they’re someone you want to hire.
5. Run a background check
Run a background check on each individual who will be helping your loved one in their home. Read our guide on background check services to learn more about this step.
Paying for in-home care
Paying for in-home care may seem overwhelming, but you probably have more resources than you think. These tools will help you learn about payment options.
Use this site to search for benefits you’re entitled to. Search by state, agency or category. You can also use the site’s online quiz to find benefits automatically.
This website’s tool helps you find benefits you may qualify for. Answer a few questions about the person who needs assistance and the type of services they need (health care, nutrition, etc.), and it will show you all the programs in your area that can help. It includes non-governmental programs.
Medicare is the single-payer health care program for people over 65. Visit the Medicare website to see if you or your loved one qualifies and to learn about the services Medicare covers.
Medicaid is a health care program offered by the federal and state governments. It is for people of all ages with limited income or resources.
Medicare Supplemental Insurance
Medicare Supplemental Insurance, often called Medigap, pays for services that aren’t covered by Medicare. You can read our guide to learn more about this type of coverage and to find a provider.
If your loved one doesn’t want to move to an assisted living facility, they have lots of other housing options. If you and your loved one decide they should stay in their own home or move in with you or another caregiver, there are many services to provide them the care they need. These services mean you and your loved one have plenty of choices. Being a caregiver and needing one are both stressful and sometimes upsetting experiences. Take advantage of these in-home care options to make life a little easier for everyone involved.
- 9/8/17 Last Updated