This FAQ answers some of the most common questions that patients and their families may have about in-home senior care.
What's the difference between home care and home health care?
The terms “home care” and “home health care” are often used interchangeably in discussions involving home senior care, but they are technically different services. Home care can also be thought of as home support as these services include help with activities of daily living such as bathing, getting dressed, using the restroom, personal hygiene, housekeeping, meal preparation, and transportation. Home health care refers to care that is more medical in nature and must be done by a registered nurse or other licensed professional. These services may include changing dressing on wounds, administering medication, monitoring patients for changes in condition, and in-home physical therapy. These services are ideal for seniors who have recently been hospitalized for illness or surgery as well as seniors recently put on new medication.
What do home care services provide?
Generally, home care services for seniors are nonmedical and they consist of services to help seniors with various activities of daily living. It is common for home caregivers to provide assistance with personal hygiene including bathing and dressing, transferring (getting out of bed, etc.), continence care, meal preparation, medication reminders, housekeeping, and transportation to run important errands and get patients to doctor appointments.
What are the common conditions in older adults who receive home care?
Seniors who are dealing with all types of conditions and chronic illnesses may receive in-home care. It is very common for those suffering from dementia or Alzheimer’s disease to have in-home care because it can be dangerous for those affected by these conditions to be alone. Seniors with conditions that limit their mobility such as Parkinson’s disease also receive in-home care to help them with transferring, housekeeping, and other daily living activities that are too difficult for them to handle themselves. Seniors who are recovering from surgery can also benefit from having in-home caregivers to take care of certain activities in the home so they can focus on their recovery. It helps for seniors with any type of condition to have a caregiver nearby to help with medications and respond promptly if there is an emergency.
What are the different types of home care?
While there are a lot of basic similarities among the types of home care, these services can differ depending on the needs and conditions of the seniors. The following are the different types of home care:
- Respite Care: Families who have one of their own members acting as a caregiver for their elderly relatives generally take advantage of respite care services. With a respite care program, a caregiver from a home care agency will come to the home and provide care at scheduled times to give the family caregiver some time off.
- Hospice Care: Hospice care is reserved for those who have a limited life expectancy or have been diagnosed with a terminal illness. The goal of hospice care is to keep the patient as comfortable and pain free as possible so they can live their final days with dignity.
- Live-In/ 24-Hour Care: If a patient needs someone at the home 24 hours a day to provide care, a caregiver can live with them in the home. With regular live-in care services, the caregiver will get their own room to sleep at night. With 24-hour care, two caregivers will alternate 12 hour shifts to ensure that a caregiver is always awake and alert, 24 hours a day.
- Overnight Care: If a patient needs someone nearby at night, a caregiver can arrive in the evening and stay until the morning. Overnight caregivers stay awake all night in case the patient needs help or there is an emergency.
- Post-Operative Care: Seniors returning home from surgery can benefit from post-operative care as caregivers will help give medication and monitor their condition, as well as handle certain housekeeping duties, so the patient can focus on recovery.
- Dementia and Alzheimer’s Care: This type of care is tailored specifically for patients with Alzheimer’s or dementia and typically includes mentally engaging activities to help improve memory.
What is the difference between hospice care and palliative care?
Hospice care is care provided to those with limited life expectancy or a diagnosis of a terminal illness. The purpose of hospice care is to relieve the patient of their symptoms and help them remain comfortable as they live out their final days. Palliative care is care for a serious illness or condition with the hope of finding a cure. Anyone with a serious condition is eligible for palliative care; patients do not have to have a terminal illness to receive palliative care.
Who is eligible for hospice care?
Generally, patients who are not expected to live for more than 6 months are eligible for hospice care. If a patient lives past the six-month period, they can be taken out of a hospice care program. When a doctor believes that they are once again not likely to survive for more than 6 months, they will be entered back into hospice care.
When is it time to call for hospice care?
As soon as a relative is diagnosed with a terminal illness or limited life expectancy, you should talk to a care provider about hospice care. We highly recommend that you discuss hospice care options with your relatives before a diagnosis of a terminal illness or limited life expectancy so that a care plan can be put into place quickly when the time comes.
How long can a person be in hospice care?
A person can be in hospice care for about 6 months before a doctor decides that they no longer need hospice care. A patient can remain in hospice care for longer than 6 months if their doctor verifies that they have a legitimate terminal illness.
How is hospice care paid for?
Medicare or private insurance are the main ways that people pay for hospice care. If a patient cannot pay for hospice care but they meet the qualifications for hospice care from Medicare, the care will be paid for either by the care provider themselves, or through charitable donations. It is against the law for someone who qualifies for hospice care to be denied if they are unable to pay.
Alzheimer’s and Dementia Care
How do I take care of an Alzheimer’s patient at home?
Those suffering from Alzheimer’s disease need constant care or supervision because they are prone to wandering and may forget where they are or how they ended up there. If you are caring for a relative with Alzheimer’s in the home, these simple tips will help:
- Establish a routine: Those with Alzheimer’s get easily confused and irritated. Establishing and following a daily routine will help reduce these instances as it is possible for people with Alzheimer’s to learn routines.
- Be patient: People with Alzheimer’s generally take longer to complete tasks or understand things. It is important to be patient because showing frustration will only make them agitated.
- Involve the individual: Involve the person in activities that they can handle themselves, such as setting the table.
- Give options: Give the individual some options throughout the day and allow them to make their own choices. This could include giving them two options for outfits or asking if they would like to take a walk or play a game. Do not give them too many choices or this could be overwhelming.
- Give simple instructions: People with Alzheimer’s respond best to simple instructions as too much instruction can be confusing.
- Take safety precautions: It is important to create a safe environment in the home to reduce the risk of injury. Keep the home clear of trip hazards; lock away anything that could be potentially dangerous including alcohol, medications, or knives; keep the water temperature low to prevent burns; and always keep fresh batteries in your smoke detectors.
What activities can you do with Alzheimer's patients?
Engaging Alzheimer’s patients in activities is a great way to stimulate their memories and emotions and reduce some of the effects of the disease on cognitive function. Certain activities can also give Alzheimer’s patients a sense of purpose or an outlet for self-expression. There are many types of activities that can be beneficial for an Alzheimer’s patient, the activity should be chosen based on the individual. Choose an activity that the individual enjoyed in the past but make sure it is an activity that is safe and practical for them to do. The following are some suggested activities:
- Singing, playing, or listening to music.
- Simple arts and crafts.
- House cleaning; giving the individual simple cleaning tasks can give them a sense of accomplishment.
- Cooking or baking.
- Puzzles and card games.
- Watching movies.
How much does it cost to care for Alzheimer's patients?
The cost for Alzheimer’s care depends on the type of care chosen. The following are the average costs for different types of care:
- Home care: Home care providers charge by the hour which on average ranges from $15 to $26 per hour. Home health care services are a little more expensive with an average range of $17 to $27 per hour. The average hourly cost for both services is $20 per hour.
- Senior living/ assisted living: The costs for senior living or assisted living residences can range from $2,500 to $5,700 per month depending on the exact living situation. The average for these services is about $3,600 per month.
- Nursing home: A shared room at a nursing home can range from $140 to $770 per day. This averages out to about $6,600 per month. A private room at a nursing home can cost significantly more.
- Adult day care: Adult day cares charge by the day or half day as opposed to the hour. The average cost for a day in an adult day care is $69.
- Medications: The average cost of medication for an Alzheimer’s patient is $150 to $200 per month.
Is Alzheimer's care covered by Medicare?
Medicare can help cover certain costs for Alzheimer’s care, including inpatient hospital care, doctor’s fees, and certain medical items for patients 65 and older. Medicare will only cover nursing home care in limited cases and never for more than 100 days. Long-term care for Alzheimer’s patients is not covered by Medicare.
What are respite care services?
Respite care services are for relieving informal family caregivers who care for their elderly relatives. Family caregivers who take care of their relatives often deal with high levels of stress due to the demands of the job, and they have less personal time to deal with their own matters. With respite care services, a certified caregiver will come to the home at scheduled times so the family caregiver can take some time off.
Is respite care covered by Medicare?
In general, Medicare does not cover respite care. It will cover respite care only if the care qualifies for the hospice benefit.
Overnight Care & Live-in Care
What does a live-in caregiver do?
A live-in caregiver provides all the same basic care services included with regular senior care, such as assistance with personal care and hygiene, housekeeping, transportation, and meal preparation. The difference is that a live-in caregiver will live in the home with the patient so that they are available to provide assistance 24 hours a day. You can expect a live-in caregiver to help seniors with their evening routines and getting them to bed as well as their morning routines when they first wake up. A live-in caregiver should be provided with their own space within the home to stay and they should be allowed at least 5 hours of uninterrupted sleep each night.
How much do you pay a live-in caregiver?
The cost of a live-in caregiver can vary significantly depending on the exact circumstances. On average, live-in care can cost between $4,000 to $8,000 each month. Daily rates for a live-in case can range between $220 and $230. Factors that can affect the cost include whether the caregiver will live in the home and whether room and board will offset the cost of care. The use of a vehicle can also factor into the cost depending on if the caregiver provides their own vehicle or the family provides a vehicle to use. Knowing the average cost of renting a room in your area can help you determine a fair price for room and board for a live-in caregiver.
How much do you pay a caregiver overnight?
The typical hourly wage for an overnight caregiver who spends the entire shift awake is between $18 and $20.