What types of services are available to help with care at home?

By Amy Goyer

If you’re planning to provide care at home, there are home- and community-based services that can help. Some may be free or low-cost, depending on your loved ones’ location and eligibility. Others are covered by insurance or require you to pay out of pocket.

Assessment

An assessment will help you identify which services are needed for your loved ones.

  • Your local area agency on aging may offer an in-home assessment service in which a professional (usually a social worker or a nurse) comes to the home, evaluates your loved ones’ needs, and recommends helpful services. The area agency on aging generally knows about most of the services offered in your area.
  • A geriatric care manager or aging life care expert can do an assessment and help you locate appropriate services.
  • If your loved ones are enrolled in Medicaid and your state has a waiver to provide in-home Medicaid (as opposed to in nursing homes), they should have a case manager who can help you set up in-home services.
  • If your loved ones are veterans and enrolled in VA Health Care, there may be home-based primary care available in your area.

If your loved ones are living with cancer, you may be able to call on their care team’s psychosocial oncologist or oncology social worker for help with a needs assessment. Read more about working with these professionals in our Real World Health Care blog article, Caring for a Loved One with Cancer Can Be Tough: These Two Care Team Providers Can Make it Easier.

Home- and Community-Based Services

Be aware that service availability varies across the nation. However, never assume the services don’t exist; these services change all the time due to funding, staffing, and other fluctuations, so keep asking. Some services are offered through the area agency on aging or the city/county council on aging; others may be offered through Veterans Affairs for veterans and their families. Medicaid may also provide some of these services. Private agencies also provide services. These options may be available to you as you make and adjust your caregiving plan:

  • Adult daycare programs
  • Care management
  • Caregiver support
  • Housekeeping/homemaker, chore services, home repair, home modification
  • Information and referral/assistance
  • Medical alert or personal emergency response systems
  • Nutrition counseling and congregate or home-delivered meals
  • Transportation services

Home Health Aides and Paid Caregivers

If your loved ones need day-to-day supervision or hands-on help, you may be able to arrange for a home health aide or professional caregiver to assist.

  • Contact the area agency on aging and ask if they have any programs that would provide ongoing personal care, companion care, or the services of a home health aide at no or low cost.
  • If your loved ones are enrolled in Medicaid, ask their caseworker if they can arrange for day-to-day care (in some states a family member may be paid to provide care.)
  • If your loved ones have long-term care insurance that covers care at home, find out how the policy handles paid care. Some policies require you to work with an agency; others don’t have that stipulation.
  • If your loved ones are veterans, VA Health Care may provide home health aides to assist. VA also has Aid and Attendance benefits for certain eligible veterans, which helps pay for care not provided by the VA.
  • To hire caregivers, you can either work with an agency, which will screen, train, and provide the workers; or you can hire directly by using a matching website, asking friends and family for recommendations, or hiring a family member. Be sure to do background checks and get references. Some families hire live-in caregivers, providing room and board and therefore paying them less.

Learn more about care options in our article, How can I find the best housing and care for my loved ones?

Respite care

Respite care is care provided for your loved ones to give you a break from caregiving so you can rest, socialize, go to medical appointments, and take care of yourself. Some areas have respite care programs that provide respite services for free or at a low cost. The level of care may vary, with some programs stipulating that they only provide “companion care” (and no hands-on personal care). Other programs will provide whatever your loved ones need. Some programs will even do housekeeping, run errands, organize, and make meals. Your area agency on aging will either provide respite care or refer you to local programs that do so. Veterans Affairs offers respite care to eligible veterans. Other organizations provide respite care as a community service. Friends and family can provide respite care for you. Or you can pay a professional caregiver to provide care while you take a break.

Learn more about the advantages of respite care for family caregivers of loved ones with dementia in our Real World Health Care blog article, Nine Steps to Respite Care for Family Caregivers of Persons with Dementia, including Alzheimer’s Disease.

Medical Care at Home

If your loved ones have difficulty leaving the home, certain providers will offer health care services at home. Availability varies across the nation, but in-home care and house calls are a growing trend, so be sure to check frequently. Medicare may pay for in-home healthcare if your loved ones are considered to be homebound. Many families use a blend of virtual, in-home, and in-office healthcare.

  • Mobile primary care – There are healthcare providers who focus on house calls, and some who do both in-person and in-home appointments. Do an online search for such providers or ask friends, family, and healthcare providers if they are aware of such services. Veterans’ Health has a Home-Based Primary Care program that provides health care at home.
  • Mobile testing and laboratories – Increasingly, companies provide services at home, including x-rays, ultrasounds, EKGs, blood draws, urine sample collection, and more. My parents even had swallow tests at home in a van parked in our driveway, which was so much easier than taking them to the hospital.
  • Physical, occupational, and speech therapy – Your loved ones’ doctor can create orders for these therapies to be provided on an outpatient basis or in the home.
  • Telehealth – Many healthcare providers offer virtual appointments in which you and your loved ones see the doctor via the telephone or video chat on a smartphone, tablet, or computer.

Learn more about creating a caregiving plan for your loved ones in our article, How can I create a caregiving plan? 10 steps every caregiver needs to take.

Resources

Amy Goyer is a nationally known caregiving expert and author of Juggling Life, Work, and Caregiving. A passionate champion for caregivers, she has also been one her entire adult life, caring for her grandparents, parents, sister, and others. Connect with Amy on Facebook, Twitter, and LinkedIn.</em