When you or your loved one shows signs of needing more help at home, you may not know where to start. That’s common and understandable. There are so many in-home senior care options, and it can be overwhelming trying to decide which is best. Additionally, you may have questions and concerns about the specifics of each option.
“Seniors and their loved ones often have a range of questions regarding the potential for in-home care, including the overall cost, the qualifications to look for in caregivers, whether or not their caregiver is a compatible match, patient safety and a host of other variables,” says Dr. Monica Mahajan, geriatrician and medical director at the Center for Better Aging.
If that sounds familiar, we’ve got you covered. Here, you’ll find a detailed breakdown of in-home senior care options, including who each option is best for, what the care includes, how much it costs and other important considerations to keep in mind.
Medical vs. non-medical in-home senior care
In a nutshell, there are five different types of in-home care options for elderly individuals:
- Home health aides.
- Companion care.
- Respite care.
- Skilled nursing care.
- Hospice care.
These can be further broken down into medically-centered care and non-medically centered care. Of these options, skilled nursing care and hospital care provide more medicalized care, whereas home health aides, companion care and respite care are intended for people who need non-medical support in their homes.
So, how do you know which care is best for yourself or a loved one? “The kind of care someone needs depends on their health, mobility and how well they can handle daily activities,” explains Jung Baccam, board-certified family nurse practitioner at Atlas Ketamine.
Likewise, the type of care you need may change over time. For example, a home health aide may be sufficient for someone who needs help with the activities of daily living, but skilled nursing care might be more appropriate if that person is recovering from surgery or develops a chronic health condition.
Without further ado, let’s dive into each of these options, so you determine which is best for you.
“The kind of care someone needs depends on their health, mobility and how well they can handle daily activities.”
— Jung Baccam, board-certified family nurse practitioner
The different in-home senior care options, explained
1. Home health aides
Home health aides (HHAs) help with some of the daily tasks of living, such as dressing, feeding, bathing and light housekeeping. They may also help with medication reminders and mobility around your home.
Who it’s best for
“These are best for seniors who need help with activities of daily living (ADLs) but do not yet require skilled nursing care, which is a medical need,” says Mahajan.
Cost
The cost of a home health aide can vary, depending on where you live. Cost is typically between $20-$35 per hour or $4,000-$7,000 per month, for full-time care, Baccam says. Enter your city and state in our Cost of Care calculator to see posted rates for home health aides near you.
Some types of insurance, such as Medicaid, may help cover some of the cost. Often, long-term care plans will cover home health aides if you previously purchased a long-term care plan. Medicare doesn’t cover home health aides for help with daily tasks.
Other considerations
If you need regular medical care, a home health aide may not be the best choice. “HHAs aren’t nurses, so they can’t do medical procedures like wound care or administer medications,” Baccam says. “If [you or] your loved one needs medical attention, a nurse may be a better fit.”
2. Companion care
As opposed to care from a home health aide, companion care is more about emotional support than hands-on assistance, Baccam explains. “These caregivers provide conversation, go on walks, help with errands and do light housekeeping.”
Who it’s best for
Companion care is “a great option for seniors who are mostly independent but could use some company and a little extra help around the house,” Baccam says.
“Companion caregivers don’t provide medical or personal care. This is best for seniors who don’t need physical assistance but would benefit from social interaction.”
— Jung Baccam
Cost
The cost of companion care in the U.S. averages between $20.62 and $28.75 an hour, according to recent rates posted on Care.com. Rates can vary significantly depending on where you live and who you hire. For example, companion care in certain areas can be as low as $18 per hour and as high as $30 per hour, Baccam notes. Health insurance typically doesn’t cover companion care.
Other considerations
Companion care is much less formal than care from a home health aide. It can be provided by a friend, a college student or a more seasoned helper. “Companion caregivers don’t provide medical or personal care,” Baccam underlines. “This is best for seniors who don’t need physical assistance but would benefit from social interaction.”
3. Skilled nursing care
Skilled nursing care is specifically for people who have medical needs. “This level of care is provided to those who need medical care at home, including recovery from a surgery or illness as well as those with chronic health conditions,” Mahajan explains. Usually the care is given by a registered nurse (RN) or licensed practical nurse (LPN).
Who it’s best for
According to Baccam, some of the conditions that can be managed with skilled nursing care include:
- Wound care.
- Medication management, including IVs.
- Therapy, including physical therapy and occupational therapy.
- Post-surgical care.
- Chronic disease management (e.g., diabetes, heart issues).
Cost
Without insurance, the cost of skilled nursing care can be expensive, averaging about $100-$150 per visit or $5,000-$10,000 per month for ongoing care, says Baccam. Thankfully, Medicare and most other insurances will cover this type of in-home care, as long as your healthcare provider deems it medically necessary.
Other considerations
Skilled nursing care should be only provided by a licensed health professional. “Since this involves medical care, you’ll want to work with a licensed nurse or a reputable agency,” Jaccam recommends.
4. Respite care
Being the caregiver for a senior can be emotionally and physically taxing. Respite care is short-term, temporary care to relieve caregivers.
Who it’s best for
This type of care is usually used by family members who care for their senior loved ones. It’s an opportunity for a caregiver to get a much-needed break and may last anywhere for a few days to a few weeks.
Cost
Rates for respite care providers in the U.S. average $20 to $35 per hour. Sometimes a friend or relative will provide the care for free or at a low cost. Additionally, many local eldercare groups have volunteers who will provide respite care. Most insurance companies do not cover respite care, unfortunately.
Other considerations
Respite care can be provided in your home, typically by friends, family members, volunteers or temporary home health aides. But if you live with your loved one, placing them in a care setting, like an adult day care or assisted living facility, may be a good option for you. ARCH National Respite Locator Service is a source you can use to find local respite care.
5. Home hospice care
In-home hospice care “allows people to spend their final days at home, surrounded by loved ones, rather than in a hospital,” says Baccam.
Who it’s best for
Hospice care is for seniors who are living with a terminal illness. Usually hospice care is started when the senior has six months or fewer left to live. According to Baccam, some of the tasks that hospice care workers can do include:
- Pain and symptom management.
- Emotional and spiritual support.
- Help for family members, including grief counseling.
- 24/7 support, when needed.
Cost
In the U.S., hospice care rates average between $21.64 to $29.42 per hour, according to recent Care.com data. In most cases, Medicare, Medicaid or private insurance will cover hospice care 100%, Baccam says.
Other considerations
When it comes to in-home hospice care, the focus is on comfort, not curing the illness, Baccam notes. “Hospice isn’t about prolonging life; it’s about making sure the person is comfortable and at peace,” she says. “It can be an emotional journey for families, so having support in place is important.”
The final word on in-home senior care
Wading through in-home senior care options can feel overwhelming. If you need further assistance and support, talking to a nurse practitioner, a senior care specialist or a geriatric doctor, can be enormously helpful.
Most of all, don’t be afraid to reach out for support when you need it. “You’re not alone in this — there are great resources available to guide you through the process,” Baccam concludes.
