A guide to home care

What is home care

A home care agency - also known as a home care aide agency, non-medical senior care, or personal care - provides services that do not require a licensed professional or a physician's prescription. A home care worker can help a person with senior care activities like remembering to take medications; preparing meals; transferring from chair, toilet or bed; bathing; getting dressed; light housekeeping or transportation to and from doctors' appointments. A home care worker can also provide companionship to an older adult or an adult with a disability - engaging in a favorite hobby, watching movies or simply conversing.

What's the cost of home care and is it covered?

Prices for home care services range from $17 to $22 per hour and usually there is a minimum service requirement of three hours. Services can be arranged on a short- or long-term basis for up to 24 hours per day, including weekends and holidays.

Services provided by home care agencies are sometimes referred to as custodial care, assistance with activities of daily living (ADL) tasks, or instrumental activities of daily living (IADL) tasks. Because these services are not medical care, they are not covered by Medicare. If the person requiring care has long-term care insurance, home care services may be covered. Call the insurance provider to find out.

If the person requiring care is an older adult who lives with you, you might qualify for the Family Caregiver Support Program offered by the local Area Agency on Aging. You could use some of these funds to pay for non-medical senior care. To find out if you qualify, call 1.800.677.1116 or go to eldercare.gov to find your local Area Agency on Aging.

How to find a home care agency

You can find agencies listed in the phone book under Home Care. Some are franchises, while others are independently owned. You will also find that some home health care agencies that offer medical services prescribed by a physician include a non-medical senior care division as well.

In many states, companies providing non-medical senior care are not licensed by a state agency because they offer non-medical care. Therefore, it's important that you do your own homework. There are two major voluntary accreditation programs offered to non-medical senior care agencies: the National Association of Home and Hospice Care (NAHC) and Community Health Accreditation Program (CHAP).

You can also check with the Better Business Bureau to see if any complaints have been lodged against the company you're considering. Or ask the local Area Agency on Aging's ombudsman if they know of any complaints (call Eldercare Locator at 1-800-677-1116 to find your local Area Agency on Aging). You should also try to speak with someone who has used the agency’s services.

What to ask

When you interview home care agencies, there are a number of important questions to ask:

May I see a sample service agreement and a listing of your prices?
How do you supervise and oversee the care provided by your caregivers?
Are your services covered by long-term care insurance and will you process the paperwork?
Are the caregivers your employees or are you a referral agency (a registry)?
Who is responsible for paying taxes and Social Security for the caregivers?
What type of training do your employees receive when they’re hired? Do you provide ongoing training? Please describe it.
Do you conduct criminal background checks on your employees and are they bonded?
How long have most of your employees worked for you?
What is the background of your average caregiver (for example, homemaker, certified nurse aide, high school graduate, retiree)?
How do you ensure that the caregiver and the person receiving care will be compatible?
Please describe how workers have been trained to communicate with people who have cognitive (thinking) disabilities such as dementia.
If you provide transportation, have you checked out your caregivers’ driving records?
What kind of weekly (or daily) report will I receive?
Can you put me in touch with someone who has used your services?
Have you received any type of national accreditation?

The bottom line

A home care agency provides non-medical services that ease the burden of caring at home for an older adult or an adult with a disability.
A home care worker can provide everything from companionship to assistance with daily activities such as transferring, bathing, dressing, meal preparation, medication reminders and light housekeeping.
Home care services are not covered by Medicare. They may, however, be covered by long-term care insurance and - depending on your situation - you may be eligible for assistance from the Family Caregiver Support Program offered by your local Area Agency on Aging.
Web resources for further research: To find an accredited home care agency, go to the National Association of Home and Hospice Care at nahc.org. Or go to eldercare.gov for the federal Eldercare Locator program (1.800.677.1116).