What Is In-Home Care?
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 may cover in-home care through Home and Community-Based Services waivers, though coverage varies by state and seniors must satisfy eligibility criteria.
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.
Pension-receiving veterans may qualify for the supplemental Aid and Attendance benefit to help cover in-home care costs.
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.
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 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.
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.
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Top Cities for Home Care
- Akron, OH
- Albuquerque, NM
- Alexandria, VA
- Alpharetta, GA
- Ann Arbor, MI
- Arlington, VA
- Arvada, CO
- Ashburn, VA
- Atlanta, GA
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- Cary, NC
- Chandler, AZ
- Charlotte, NC
- Chicago, IL
- Cincinnati, OH
- Cleveland, OH
- Colorado Springs, CO
- Columbia, SC
- Columbus, OH
- Dallas, TX
- Dayton, OH
- Denver, CO
- Downers Grove, IL
- Duluth, GA
- Durham, NC
- Englewood, CO
- Englewood, NJ
- Fairfax, VA
- Fairfield, CT
- Falls Church, VA
- Floral Park, NY
- Fort Lauderdale, FL
- Fort Wayne, IN
- Fort Worth, TX
- Franklin, TN
- Glendale, AZ
- Grand Rapids, MI
- Greensboro, NC
- Greenville, SC
- Greenwich, CT
- Henderson, NV
- Honolulu, HI
- Houston, TX
- Indianapolis, IN
- Jamesburg, NJ
- Jericho, NY
- Kansas City, MO
- Knoxville, TN
- Lake Worth, FL
- Las Vegas, NV
- Lawrenceville, GA
- Lexington, KY
- Lincoln, NE
- Little Rock, AR
- Littleton, CO
- Los Angeles, CA
- Louisville, KY
- Marietta, GA
- Memphis, TN
- Meridian, ID
- Mesa, AZ
- Milwaukee, WI
- Minneapolis, MN
- Mobile, AL
- Montgomery, AL
- Myrtle Beach, SC
- Nampa, ID
- Naperville, IL
- Nashville, TN
- New Canaan, CT
- New York, NY
- Norwalk, CT
- Oak Brook, IL
- Oklahoma City, OK
- Olympia, WA
- Omaha, NE
- Overland Park, KS
- Palm Beach Gardens, FL
- Peoria, AZ
- Philadelphia, PA
- Phoenix, AZ
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- Raleigh, NC
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- Washington, DC
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- Alabama
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- Colorado
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- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
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- Illinois
- Indiana
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- New Jersey
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