In-home care is a term that covers a broad range of services, but what they all have in common is that they occur in a person’s home. Instead of going to a medical office, therapist’s location, or to assisted living or a nursing home, the patient stays home and the caregivers come there to provide assistance and medical care.
This type of care may be chosen to help an older adult remain in the home as he or she begins to struggle to stay independent. It may be a good choice for a disabled adult who would otherwise not be able to live independently. In-home care is also an option for anyone who is recovering from an illness or injury and needs short-term medical care or support services as they recover.
Who Needs In-Home Care?
In-home care is largely a personal decision driven by factors such as a desire to stay in the home and to remain independent as long as possible, the abilities and limitations of informal caregivers and family, and expenses and insurance. Most in-home care is provided for older adults who want to remain home as long as possible. Care for seniors can range from occasional support for household chores or transportation to full skilled nursing care.
Disabled adults represent another category of people who can benefit from all types of in-home care. A disabled adult who needs some support to live independently can use unskilled home workers for chores or home health aides for minor medical care and supervision. People who have been injured or have been sick can also benefit from all levels of in-home care to provide support until they get better and can function independently again.
For disabled or older adults who are mostly independent but just need some help with chores and other household tasks, support services can help. This type of in-home care is not medical or skilled and makes use of in-home aides or assistants, who can do things like clean, do yard work, cook, do the shopping, provide transportation, or provide in home supervision during the day while the primary caregiver is at work. This kind of care can also serve as companionship for home bound patients.
Similar to support services, personal care is provided typically by non-skilled workers, although they may be trained in basic first aid or CPR. These home health aides provide services for the elderly or disabled who are not independent but either want to stay home or do not yet need to go to assisted living or a nursing home. These aides provide personal services, such as assistance with bathing and dressing, help getting around the home, transportation, supervising and reminders for medication, and other personal tasks. They may also provide some support services, such as cleaning and cooking.
In-Home Medical Care and Skilled Nursing
When someone needs actual medical care, such as the administration of an IV, changing catheters, the use of a respirator, tube feeding, wound care, and others, more skilled workers are required, typically nurses. This is the most costly type of in-home care, especially if a person needs someone in the home every day. In-home nursing care may be a good choice, and one that is cost effective, if the patient needs only occasional or short-term skilled care. It is not cost effective as a regular, long-term solution. If the person receiving care is not going to get better with time, it may make more sense to move to a nursing home.
Therapy in the Home
Another type of in-home care that anyone may need is therapy. This may include physical therapy, occupational therapy, speech and language therapy, or alternative therapies for behavioral or mental health conditions. As with nursing care, this is considered skilled care. You may choose to have therapists come to the home if the patient cannot move easily or struggles to leave the house because of a disability or mental illness.
Informal Home Care
Many people use informal in-home care, which is care that is provided for free by a family member or friend. This may include a neighbor cooking or doing yard work for an older adult or an adult child providing daily personal care for a parent, and many other examples of care that loved ones provide. Some people choose to provide this type of care because they want to and they enjoy caring for a loved one. Others feel a sense of obligation or guilt over the idea of sending family to assisted living or a nursing home.
Costs can also be a reason to choose informal home care. Some families struggle to pay for professional in-home services. Others may save money by using a combination of informal and paid care for family. Informal caregivers are at a greater risk of burnout than professionals, and should rely on others for their own support. Sharing the work involved in caring for a loved one helps, as does relying on professionals for occasional respite care.
Government Programs for In-Home Care
For older and disabled adults who need in-home care but also need help paying for it, there are several government programs that can help. You can search benefits.gov and eldercare.gov to find community programs that assist the elderly and disabled as well as government programs that you or your loved one might qualify for.
Medicare covers some costs of in-home care for older people who qualify but generally not for support services, only medical care. Medicaid covers many of the costs of home care for people with lower incomes. A joint Medicare and Medicaid program called Programs of All-Inclusive Care for the Elderly, or PACE, aims to keep seniors at home instead of nursing homes by providing in-home services. There are qualifications to enroll and restrictions once you do.
Veterans may qualify for a number of programs through the Veterans Administration for home care. These include the Skilled Home Health Care, Homemaker/Home Health Aide, and Home Telehealth programs. These offer qualified veterans skilled, in-home nursing care, home support services, and remote medical care and monitoring.
In-home health care is an important type of care because it allows many people to stay in their own homes where they are most comfortable. When you are choosing in-home care services or professionals, make sure you find a reputable company, get good references, ask a lot of questions, and monitor care to make sure your loved one is getting quality care.