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In-home care isn’t solely for adults 65 and older, despite common perception. In fact, home care for adults with disabilities is a great option for anyone 18 or older in need of support.
“Home care for disabled adults provides personalized assistance to individuals who cannot live independently,” says Yelena Sokolsky, a registered nurse and founder and CEO of Galaxy Homecare in New York City. “This may be due to physical, mental or social needs.” The care, she explains, can vary, from help with daily tasks to medical help, surgical recovery or support managing chronic conditions or disabilities.
Here, Sokolsky and other experts explain the ins and outs of in-home care for disabled adults.
Key takeaways
- In-home care isn’t solely for folks 65 and older.
- In-home care breaks down into three fundamental categories: nurses, aides and caregivers.
- To find the right in-home caregiver, it’s important to know the exact tasks you’d like done, along with the hours and level of care you need.
What is home care for disabled adults?
Home help for disabled adults isn’t all that different from home care in general, notes Dr. Gerda Maissel, a board-certified physical medicine and rehabilitation physician and founder of My MD Advisor. She explains that in-home care — any kind — breaks down into three fundamental categories:
Nurses. These are either registered nurses (RNs) or licensed nurse practitioners (LPNs). In-home nurses provide medical care to folks in their own homes. They can do things like set up I.V.s, give injections, tracheotomy suctioning, etc.,” Maissel says.
Aides. “These can be home health aides,” she explains. “Aides can help with activities of daily living (ADLs), such as toileting, showering and other intimate personal care tasks.”
“Additionally,” notes Dr. Macie Smith, a gerontologist at Synergy Home Care, “caregivers can ensure the home is safe and accessible by identifying potential hazards and adjusting the home environment to meet the person’s needs.”
“The companion aspect of home care helps reduce social isolation and loneliness by offering caregivers who act as both helpers and friends.”
— Dr. Macie Smith, gerontologist
Caregivers. From meal prep to driving to housekeeping, caregivers can take on a number of forms. “They’re essentially a responsible person in the house who can help out and provide companionship,” Maissel explains.
“The companion aspect of home care helps reduce social isolation and loneliness by offering caregivers who act as both helpers and friends,” notes Smith. “Caregivers can engage in conversations with the client, join in favorite activities, and provide them with a comfortable social outlet.”
“The lines in these roles are all drawn by the state,” she adds. “For instance, in some states, an aide may be able to give an injection, but in others not. Similarly, in some states, if you’re not an aide, you shouldn’t be helping with bathing, toileting and other personal tasks.”
In addition to rules being state-specific, they’re also arrangement-specific, she says. For instance, if there’s a situation where both a caregiver and an adult are OK with personal care support (and particularly if the caregiver is privately-hired, as opposed to being from an agency), it shouldn’t be an issue.
Who is in-home care for disabled adults right for?
In-home care is particularly beneficial for adults with the following:
- Mobility challenges.
- Intellectual, developmental or sensory disabilities.
- Chronic conditions that make daily activities difficult.
“In-home care also serves individuals recovering from surgery or injury who need temporary assistance while they heal,” says Suzanne Hickel, a care expert at Preferred Care at Home in Anchorage, Alaska. “And in many cases, home care is a great resource for family caregivers who need respite support, allowing them to take a break while making sure their loved one continues to receive compassionate care.”
“It’s also great for people who experience social isolation and could benefit from companionship and emotional support,” Smith adds.
From a personal preference standpoint, Sokolsky notes that in-home care is a good choice for those who prefer to receive care in the comfort of their own home rather than in a nursing facility. (And, no, you needn’t be 65 or older to be in a nursing facility.)
“This type of care helps individuals maintain a sense of stability and control over their lives while receiving the necessary support,” Sokolsky says. “While it may seem counterintuitive at first, home care empowers individuals to live more independently and enjoy a higher quality of life.”
“This type of care helps individuals maintain a sense of stability and control over their lives while receiving the necessary support.”
— Suzanne Hickel, care expert, Preferred Care at Home
Is home care for disabled adults covered by insurance?
Medicaid has services for folks with disabilities who are under 65 in every state, notes Maissel; again, though, rules vary by location. Additionally, individuals will typically need to undergo an assessment, which will determine the amount they’ll receive.
Folks can also look into nursing home diversion programs, which use Medicaid funds to provide support and services to folks who are nursing home or hospital eligible, but who would rather stay at home.
Maissel also notes that it’s worth looking into consumer-directed personal care assistance programs (CDPAP), which allow individuals to use funds from Medicaid towards the caregiver of their choosing (such as a family member).
Additionally, veterans may be able to use VA benefits for in-home care; this varies by state, though. And for folks using private insurance, keep in mind, if the issue is more or less acute, care is generally covered while you’re sick or injured, but “you’re on your own once you start leveling off,” notes Maissel.
The cost of home care for disabled adults
Everyone’s situation is different, based on where they live and the amount of care they need, but it’s generally more expensive than a nursing facility or assisted living community, Maissel says.
To get an idea of what in-home caregivers are asking for on Care.com, check out our list of recently posted rates in top cities or plug your area into our Cost of Care Calculator.
Latest posted in-home care rates for top U.S. cities
| City, State | Hourly In-Home Care Rate* |
| Atlanta, Georgia | $19.69/hr |
| Brooklyn, New York | $22.74/hr |
| Charlotte, North Carolina | $20.08/hr |
| Chicago, Illinois | $22.03/hr |
| Denver, Colorado | $24.29/hr |
| Las Vegas, Nevada | $20.20/hr |
| Los Angeles, California | $24.12/hr |
| Minneapolis, Minnesota | $24.41/hr |
| Philadelphia, Pennsylvania | $20.51/hr |
| Phoenix, Arizona | $22.82/hr |
| Portland, Oregon | $24.80/hr |
| San Antonio, Texas | $18.53/hr |
| Tampa, Florida | $19.20/hr |
Also, Maissel reminds, some folks need live-in care, and since caregivers can’t work 24-hours straight, another person needs to be hired for the night shift or period when the live-in is off the clock.
How to find the right home help for disabled adults
The key to finding the best in-home care, according to Maissel: “Know thyself,” she says. “Know exactly what you’re looking for — the tasks you need done and the amount of time.”
“It sounds obvious,” she continues, “but a lot of time families feel overwhelmed, and say ‘we just need someone here.’” Ultimately, that’s not going to cut it. Think more along the lines of: We need someone here in the morning to help brush teeth, make breakfast and ensure medications are taken. Or: We want someone who’s warm and loving, likes to play cards and speaks Spanish.
“During the interview, see how caregivers and clients mesh. Notice the chemistry. This is someone, after all, who will be like a part of the family.”
— Dr. Gerda Maissel, physician and founder, My MD Advisor
“The more specific you can get upfront, the less likely you’re going to waste your time and others,” she says. “It’s also a good idea to overestimate the amount of time you think you need someone. People will say: ‘I need someone for an hour a day.’ Be realistic — and make it worth someone’s while.”
Other things to consider: Personality and connection. “During the interview, see how caregivers and clients mesh,” notes Maissel. “Notice the chemistry. This is someone, after all, who will be like a part of the family.”
Why choose in-home care for disabled adults?
In-home care for adults with disabilities can be crucial, and finding the right fit for your particular needs is key. “Think of someone who’s paraplegic,” says Maissel. “They may work from home, but need help in the morning with their routine.”
And regardless of the support needed, Smith adds, “home care for disabled adults is there to provide emotional support and a sense of companionship and empowerment.”
