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In-Home Care Options & Costs

Issues to Consider

Decide who’s in charge.

The family needs to decide who is going to be managing the process; there must be one main go-to person so that the professional caregiver gets a clear message on your expectations and their performance. Then, decide what you want the caregiver to do. Is it to help with “activities of daily living” such as personal care, bathing, feeding, and mobility? To make meals, do laundry or light housekeeping, grocery shop, remind Dad to take his medication, drive him to appointments or be a companion? Or, does he need more medical help such as wound care or other nursing-type tasks?

What kind of caregiver do you want?

Home care options are typically either personal aides, also known as homemakers, or home health aides. A personal aide may not need to be licensed or certified; it varies from state to state. The big distinction is that home health aides are usually certified nursing assistants (CNAs) who provide medical-like tasks, whether it’s dispensing medication, changing dressings, or helping with medical equipment. They may also do some of the personal grooming or other tasks performed by an in-home aide.

A doctor might prescribe a home health aide after surgery, for at-home rehabilitation or if a patient is unable to take care of himself. Medicare, Medicaid or a private health insurance policy may cover the cost for a limited time.

Understanding costs.

Rates vary depending on how you hire (look on your own vs. an agency), the tasks required and your state and area. That said, the national median rate for both personal care assistants and home health aides is $20/hr. That translates to around $45,000/yr. Compare this to assisted living which has a median annual rate of $43,200 and $80,300-$91,250 at a nursing home.

Exploring Medicaid or Medicare options.

Does your family member qualify for Medicaid? (They must have less than $2,000 in assets and there are more requirements.) Will Medicare help defray drug or other costs? If they have a long-term care insurance policy, see if it covers home help.