What Is In-Home Care?

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In-home care, also known as home care, provides nonmedical support in a senior’s residence. It includes assistance with activities of daily living and everyday tasks to enable older adults to live safely and comfortably at home. Unlike home health care, in-home care doesn’t include nursing or therapeutic services.  

In-home care agencies create personalized plans to ensure services meet individual requirements and preferences. In-home care may provide ongoing senior support. Alternatively, family caregivers sometimes use home care services for respite when they need to travel, work or attend to other personal errands. 

This guide helps you better understand in-home care services and costs. Use it to identify signs that your loved one may benefit from such care and navigate the caregiver hiring process.

Key Takeaways

• Understanding In-Home Care Options: Details of different types of in-home care, including personal care support and companionship.
• In-Home Care vs. Home Health Care: Comparison of nonmedical in-home care and clinical-focused home health care, considering typical services, care team and service provision duration.
• Paying for In-Home Care: Insight into how median home care costs vary nationwide and ways to pay for care, including public assistance programs and insurance plans.
• Signs to Consider In-Home Care: Guidance of what seniors and their loved ones should look out for when deciding if in-home care would benefit them. 
• Frequently Asked Questions

 

Overview of Different In-Home Care Options 

Different types of in-home care accommodate elderly adults with varying needs. The levels of care range from a few weekly hours of companionship and light housekeeping to assistance with multiple activities of daily living.  

Companion Care Services

Some people call aides who deliver companion care services elder companions. This type of in-home care:

• Provides Company: This is crucial for older adults struggling with isolation at home because of frailty or cognitive impairments.
• Includes Practical Support: Companion services may include driving seniors to appointments, safeguarding those unsteady on their feet, reading aloud and preparing light meals and snacks.

Personal Care Assistance

In-home personal care and help with day-to-day activities serve as an alternative to residential assisted living for seniors who don’t require full-time support. This type of in-home care:

• Includes Hands-On Support: Aides assist seniors with diverse activities of daily living, from grocery shopping to nonmedical personal care such as toileting, dressing and bathing.
• Offers Respite: Family caregivers sometimes need a break, and respite services ensure seniors always receive the support they need to live comfortably and safely. 

 

Quick Guide to In-Home Care vs. Home Health Care Services

In-home caregivers visit a senior’s residence to help with activities of daily living. Conversely, home health care involves medical care and therapy delivered by trained professionals. It supports those who benefit from intermittent skilled nursing care, medication administration or rehabilitation therapies but don’t require around-the-clock care and supervision as provided by nursing homes. 

In-Home Care

Home Health Care

Setting

Senior’s home

Senior’s home

Care Providers

Aides and companions

Aides, nurses, rehabilitation therapists and certified nursing assistants

Provider Qualifications

Caregivers don’t need medical training

Care staff have professional training and hold relevant licenses and certificates

Care Plans

Personalized to meet individuals’ nonmedical needs

Personalized to meet individuals’ medical, therapeutic and personal care needs

Service Duration

Long-term, short-term or respite

Generally short-term

Transportation

Medical and nonmedical transportation

Medical transportation only

Medication Services

Medication reminders

Medication administration

Medical Care

No medical care

Skilled nursing services, including catheter and wound care, pain management and management of chronic health conditions

Rehabilitation Therapies

No rehabilitation therapies

Physical, occupational and speech therapy

Personal Care

Assistance with oral and personal hygiene, dressing and toileting

Assistance with oral and personal hygiene, dressing and toileting

Meal Assistance

Help preparing meals, eating and grocery shopping

Feeding tube maintenance, nutritional guidance, eating assistance, home-delivered meals

Domestic Assistance

Housekeeping, light yard work, basic maintenance, laundry

No domestic services

Social Engagement

Companionship and cognitive stimulation

No engagement services

For a more detailed guide, see our full article on home care vs. home health care.

 

How Much Does Home Care Cost? 

According to Genworth’s 2023 Cost of Care Survey, in-home care costs about $32 an hour. That comes out to $2,600 per month for 20 hours of care each week, or $5,200 monthly for 40 hours of care per week. These figures represent the national median rate, so exact costs in your state or city may vary significantly. For example, the statewide median hourly fee runs $36 in California, $33 in New Hampshire, $28 in Ohio and $23 in Texas.   

In comparison, home health care has a median hourly rate of $35 nationwide.   

Financial Assistance for In-Home Care

Although seniors can pay out-of-pocket for in-home care, many people use some form of financial assistance to make costs more manageable. Funding options include:

Payment Option

Overview

Medicaid

Medicaid may cover in-home care through Home and Community-Based Services waivers, though coverage varies by state and seniors must satisfy eligibility criteria.

Medicare

Original Medicare typically does not cover standard in-home care but may cover personal care assistance if received alongside home health care services.

Depending on their terms, some Medicare Advantage and Medicare Supplement plans cover in-home care. 

Veterans Benefits

Pension-receiving veterans may qualify for the supplemental Aid and Attendance benefit to help cover in-home care costs.

Long-Term Care Insurance

Long-term care insurance policies may cover personal care assistance, including in-home care, depending on the policy's details and the beneficiary's needs.

Life Insurance

Seniors can sometimes access life insurance benefits early to finance long-term care, either through accelerated death benefits or selling the policy for cash.

Reverse Mortgages

Reverse mortgages allow homeowners aged 62 and over to convert part of their home's value into cash payments to finance long-term care or other expenses.

 

For a more detailed guide, see our full article on how to pay for in-home care.

 

Signs It May Be Time for In-Home Care

Several signs suggest that you or a loved one may benefit from some extra help at home. You might struggle to complete everyday tasks or notice that a senior relative is finding life more challenging than before.

Although diverse situations can indicate a need for in-home care, common signs include:

• Decreased mobility: Trouble moving around can make it tough to complete routine activities of daily living. Mobility issues also have safety impacts and create barriers to running errands or socializing. Related health concerns include malnutrition, depression and fall-related injuries.  
• Declining hygiene and grooming: Physical or cognitive impairments can affect personal care routines, such as bathing, shaving and brushing the teeth.
• Physical changes: Significant weight loss may indicate that your aging parent is struggling to prepare meals for themselves, get around the kitchen or remember how to cook. Frequent bruising might point to falls, and you may notice that your loved one appears frailer or more infirm.
• Increased forgetfulness: Increasing incidents of forgetfulness, especially concerning vital tasks such as taking medication or paying bills, often suggest a need for support.
• Difficulty maintaining the home: Various aging-related factors create challenges with domestic chores. Look for uncharacteristic dust or grime, unclean clothes, excessive clutter or piles of dirty dishes.
• Less interest in hobbies: Losing interest in previously enjoyable activities may indicate several underlying issues, including depression. In-home aides ensure that your loved one follows treatment plans and has regular social interaction, while also lightening their daily load.    

 

How Do I Find an In-Home Caregiver?

Whether you require regular in-home support or medically focused home health care, our extensive directory lists providers in all parts of the country. Follow these steps to find the most appropriate in-home caregiver for you or your loved one:

• Fill in your zip code, city or state in the Senior Care Directory to find in-home agencies near you.
• Read consumer reviews and compare ratings.
• Contact providers to discuss your requirements.
• Call one of our trained Family Advisors at (800) 973-1540 for customized, one-on-one assistance finding an in-home caregiver.

 

What Expectations Should I Set for the Caregiver? 

Establishing clear expectations is crucial for ensuring that seniors and their families receive the specific care they need from an in-home caregiver. By articulating your needs and requirements from the outset, you lay the foundation for a successful caregiving relationship.

Initiating Clear Expectations

Before hiring an in-home caregiver, it’s essential to clearly define the types of assistance and care required. Many families realize the need for in-home care based on specific tasks and support their loved one needs. Documenting these needs early on not only aids in selecting the right care provider but also ensures a smoother transition when care begins.

Creating a Comprehensive Job Description

Avoid vague job descriptions such as “taking care of Dad or Mom,” as they can lead to misunderstandings. Instead, detail the specific tasks expected of the caregiver, such as cooking, cleaning, laundry, medication pickup and errands. Clarify whether meals will be shared or if the caregiver is expected to bring their own. A written, detailed job description prevents disappointments and sets a clear framework for the care to be provided.

Ensuring a Comfortable Match

The comfort and trust between the caregiver and the family are paramount. The caregiver will be a significant presence in your or your loved one’s home, making it essential to ensure a good fit. During the hiring process or interviews with agency managers, emphasize the importance of a comfortable relationship between the caregiver and your family. If initial arrangements don’t feel right, don’t hesitate to discuss alternatives with the agency.

Table: Key Aspects of Setting Expectations with In-Home Caregivers

Aspect

Summary

Define Care Needs

Document specific care tasks and assistance needed before hiring.

Detailed Job Description

List expected duties such as cooking, cleaning and errands in writing.

Comfort and Trust

Choose a caregiver with whom the family feels comfortable and trust.

Flexibility

Be open to adjustments or changing caregivers if the fit isn't right.

By approaching the caregiver hiring process with detailed preparation and open communication, families can significantly enhance the caregiving experience, ensuring that all parties have a clear understanding of the expectations and responsibilities involved.

Frequently Asked Questions

What Is the Difference Between Home Health and Home Care?

 

The difference between home health and home care concludes that home health involves skilled nursing and therapy services, while standard home care does not. Rather, home care providers offer companionship, housekeeping and personal care assistance such as help with ADLs. Only home health care providers, not personal care assistants, are qualified to provide medical services.

 

 

What Is the Advantage of Home Health Care?

 

The advantage of home health care ensures that clients remain in their homes while actively receiving the care they need. This is especially important for seniors who wish to age in place and are not willing to or interested in moving to a residential care facility. Additionally, home health care services can be tailored to each individual’s specific needs, making care more personalized.

 

 

What Are Home Care Services?

 

Home care services include housekeeping, companionship, transportation and assistance with the activities of daily living such as eating, bathing, and grooming. The services that one receives will depend on their needs, and care is tailored for each individual. Home care services do not include medication administration, nursing care, therapy services or any other type of medical care beyond first-aid and wound care. Those in need of these medical services should seek a home health care aide.

 

 

What Is the Average Cost for In-Home Care?

 

In 2024, the median cost of in-home care in the United States stands at approximately $32 an hour. This comes out to $5,200 a month for 40 hours of care per week. Home health care is slightly more expensive, at a median rate of $35 an hour.

 

 

Does Medicare Pay for In-Home Care?

 

Medicare does not pay for in-home care because it is considered custodial, nonmedical care. However, if the client also receives home health care services from a Medicare-certified provider, their personal care services may also be covered if received from the same provider at the same time as the health care services. Additionally, some Medicare Supplement plans and Medicare Advantage plans may cover standard in-home care.

 

 

How Do You Secure In-Home Care for the Elderly?

 

To secure in-home care for the elderly, start by talking to your loved one’s health care provider. They can offer insight into the individual’s health and medical conditions and guide the type of care that would best suit their needs. They may also provide recommendations for trusted local in-home care providers to contact.

 

 

How Can You Arrange 24-Hour Care for the Elderly at Home?

 

You can arrange 24-hour care for the elderly at home by contacting home care agencies. However, financial assistance programs generally don’t cover around-the-clock nonmedical in-home care, so you’ll likely need to fund such care privately. Alternative care settings might offer more affordable and practical options. If your doctor states that you or your loved one needs medical attention, public funding may cover short-term 24-hour home health care.

 

 

How Do You Choose a Home Care Agency?

 

You choose a home care agency by evaluating your family member’s care needs and identifying providers that offer the necessary services in your area. Interview the available agencies to find the right fit for your loved one. Cost and Medicare coverage factor into this decision for many families. Also, ensure that the home care agency performs background checks on the staff members who will care for your loved one. 

 

 

How Do You Get Home Care for a Dementia Patient?

 

You get home care for a dementia patient by applying for these services through Medicare. Available home health care services for people who have dementia include skilled nursing care and physical, speech and occupational therapies. Medicare members who qualify for home health care also qualify for personal care and housekeeping assistance. While Medicare covers some of these services, other options, such as Medicaid or private insurance, should also be considered.

 

 

Can I Apply for In-Home Care for My Parents?

 

You absolutely can apply for in-home care for your parents. A legal document called a power of attorney allows you to handle medical and financial matters for your loved one when they can’t do so. Establishing power of attorney while your family member has decision-making capacity gives you the information you need to fulfill their wishes about medical care, including home care. 

 

 

Can I Provide Home Care for My Veteran Father?

 

You can provide home care for your veteran father or any family member who has served in the military. The Veterans’ Administration (VA) offers the Program of Comprehensive Assistance for Family Caregivers (PCAFC), which pays a monthly stipend, health care benefits and respite care for eligible family caregivers of veterans.

 

 

How Do You Prepare for Home Care?

 

You prepare for home care by understanding your loved one’s care needs and arranging the necessary services. Many families share caregiving responsibilities with a home care agency, so consider professional support to supplement care provided by loved ones. Research resources in your area as part of your preparation, including programs to assist your family member and benefits for family caregivers. Medicare covers part-time, intermittent home health care services for homebound adults older than 65 who need skilled nursing care or rehabilitation. 

 

 

Why Is Home Care Preferred Over Nursing Homes?

 

Home care is preferred over nursing homes by many older adults because they want to maintain independence and control over their lives. Seniors often feel comfortable in familiar surroundings. Aging in place allows them to maintain strong community connections, especially if they’ve lived in the same area for decades. According to the AARP, 77% of adults aged 50 and older want to live at home as they age. Home care services help these individuals achieve this goal.

 

 

Who Is Eligible for Home Care Services?

 

Elderly individuals and those with disabilities are eligible for home care services in most cases. Individuals recovering from illness or surgery, individuals with chronic conditions and those receiving hospice care also qualify. Specific needs and available resources play roles in determining eligibility. Criteria vary based on location or programs, and services depend upon income levels and insurance coverage.

 

 

Why Should You Choose Home Care?

 

You should choose home care when you need some assistance with your health and daily activities, but you don’t need constant monitoring and treatment. In-home care provides a comfortable and familiar environment, fostering a sense of independence and autonomy. It allows you to maintain control over your life while receiving necessary support. Additionally, home care often costs less than institutional care options.

 

 

Can a Doctor Mandate In-Home Care?

 

Yes, a doctor can mandate in-home care for an individual if they believe it as necessary for the person’s health and well-being. This recommendation typically occurs when a medical condition requires ongoing monitoring or the individual needs assistance with activities of daily living or requires medical treatments delivered safely and effectively in the home environment. The primary focus remains the safety and well-being of the patient.

 

 

Can All Elderly Receive In-Home Care?

 

Not all elderly can receive in-home care, which consists of nonmedical support with daily activities. Accessing these services depends on financial resources, health needs and eligibility for financial assistance programs. For example, Medicaid’s Home and Community-Based Services waivers provide funding for in-home care services based on specific criteria. Those who require extensive medical attention, specialized equipment or around-the-clock monitoring should consider other options.

 

 

Can I Receive In-Home Care If I’m Blind?

 

You can receive in-home care if you’re blind. The federal Rehabilitation Services Administration funds state programs that support independent living services for blind individuals. Through these grants, many states provide benefits such as assistive devices and home care help with:

• Mobility
• Orientation
• Housekeeping
• Meal preparation

In addition, the Braille Institute offers free in-home services designed to help individuals and their families adjust to blindness and live independently with the necessary support. 

 

 

Can the Mentally Disabled Receive Home Care?

 

The mentally disabled can receive home health care through Medicare if they can’t leave the home because of their disability. They must also require skilled nursing care, physical therapy or occupational therapy, such as active treatment from a psychiatric nurse. A doctor must certify the person’s need for home health care, and the family must use a Medicare-approved home health agency. 

 

 

Can You Continue Driving While Receiving In-Home Care Services?

 

Yes, you can continue driving while receiving in-home care services as long as you can drive safely and are appropriately licensed to do so. Some seniors are still able to drive despite needing other assistance with everyday tasks. However, being able to drive may affect public funding eligibility.

 

 

How Do You Decide Between Assisted Living and Home Care?

 

You decide between assisted living and home care by considering your care needs, budget and lifestyle preferences. While these long-term options provide a similar scope of services, key differences may make one solution a more suitable, sustainable option for managing your current and future care needs.

 

 

Do Terminally Ill Patients Prefer Hospital Care or Home Care?

 

Many terminally ill patients prefer home care to hospital care, although preferences vary for each individual. Remaining at home allows a person to live in a familiar and comfortable environment, often close to family, friends and existing support networks. Non Medical in-home care services provide assistance with everyday activities, without which, seniors may require extensive skilled care.

 

 

How Do You Decide Between Assisted Living and Home Care?

 

You decide between assisted living and home care by considering your care needs, budget and lifestyle preferences. While these long-term options provide a similar scope of services, key differences may make one solution a more suitable, sustainable option for managing your current and future care needs.

 

 

Why Might Someone Need 24-Hour Home Care?

 

Someone might need 24-hour home care if they have declining health or dementia or are recovering from an injury or surgery. More than 76% of adults age 50+ wish to remain in their own homes throughout their lives. However, with 20.7% of seniors aged 85+ needing assistance with the activities of daily living, many will require some form of care, either from a family member or an in-home care provider.