How to choose a home care agency - Seniors Matter

Aging in place is by far the most popular choice for seniors approaching their twilight years, with almost 90% of Americans over the age of 50 expressing their preference for this care option. But while aging in place certainly has its benefits, seniors can't do it alone. Home care agencies provide assistance to those who want to remain in their residences long-term. Without this type of assistance, aging in place may not be possible for your senior. Home care agencies provide a wide range of services, and they can lessen the burden for seniors and family caregivers. 

In this article, you can explore the ins and outs of home care agencies, including their benefits, their services, and how to find one near you. If you're ready to start searching for a nearby home care provider right away, check out our Resource Hub. This free online resource provides detailed referrals for home care agencies in your neighborhood, allowing you to quickly connect with reputable, qualified service providers. With help from home care agencies, your senior can age in place with unparalleled stability and comfort. 

Home care agencies: lending a helping hand to seniors who value their independence

What is a home care agency?

As the name suggests, a home care agency specializes in providing in-home care. Instead of providing services at a facility or a hospital, these agencies deliver services straight to your senior's home. These services cater to seniors who value their independence, and they can be tailored to meet your loved one's specific care needs. 

Examples of home care services include:

• Skilled nursing care
• Therapy
• Delivery of medical equipment
• Personal care
• Housekeeping and laundry
• Meal preparation
• Companionship
• Transportation
• Money management

As you can see, these services encompass both medical care and non-medical needs. 

Why not just use an independent caregiver?

Independent caregivers may be used in place of home care agencies. These are "freelance" home health aides who are employed directly by the family to provide care for seniors—often around the clock. Some may be skilled nurses, while others may focus more on a lower level of care that includes companionship, homemaking and other non-skilled tasks. 

So, why not use an independent caregiver instead of a home care agency? While this option is certainly viable, there are a few downsides to consider. First of all, hiring an independent home health aide forces your family to become an employer. This means you're responsible for running background checks, managing payroll and deducting Social Security from paychecks. For families trying to minimize extra work, this can create needless stress. 

A home care agency also offers a wider range of services because it employs a variety of staff members—each with their own unique skill sets. For example, a home health care agency might have skilled nurses, physical therapists and homemakers on their roster. In contrast, an independent caregiver may not be able to take on all these roles. 

Why not let a family caregiver handle in-home care?

If your senior has chosen to age in place, you may wish to take on the role of caregiver yourself. Although this is certainly admirable, you need to be realistic with yourself and assess whether this is the best option. Most family caregivers are not skilled nurses or therapists, and they may have limited time due to other family commitments and work. This can affect the quality of care a senior receives.

You also have to consider the possibility of burnout. According to studies, as many as 40% of family caregivers report high levels of emotional stress, while 20% report high levels of physical strain. Another 20% reported financial issues as they attempted to juggle their caregiving duties with their full-time jobs. Another study suggests that up to 38% of caregivers suffer from depression as a result of their duties. 

Accredited home care agencies provide you with much-needed relief and peace of mind, saving you from burnout and a range of other mental health issues. 

Why would my senior need a home care agency?

Seniors may need home care agencies for a variety of reasons. Some may need help with basic personal care tasks like dressing, eating and preparing meals. Others may need more specialized medical care from nurses and other practitioners. Your senior may also need companionship from time to time—especially if you live in a different state. 

What are some signs I should seek out home care agencies?

If your senior has expressed a desire to age in place, you can start looking for home care agencies right away. Even if they're still able to care for themselves without any assistance, their situation may suddenly deteriorate at a surprisingly rapid pace—especially after a bad fall or an Alzheimer's disease diagnosis. By researching referrals for home care agencies ahead of time, you can immediately turn to the right home care agency when the time comes. 

That said, here are some clear signs your senior might need help:

• Your senior has trouble getting dressed.
• Your senior's personal hygiene has declined.
• Your senior can no longer prepare nutritious meals.
• Your senior forgets to take their medication.
• Your senior has suffered falls while trying to carry out daily tasks.
• The residence has become messy and cluttered.
• Your senior is becoming increasingly confused.
• Items constantly go missing.
• Your senior is dealing with depression, anxiety and other mental health issues.

Questions to ask yourself as you consider home care agencies

• Do I have time to act as a full-time caregiver for my senior?
• Does my senior value their independence and ability to age in place?
• How often can I visit my senior? Do they live close by?
• How does the cost of a home health care agency compare to the cost of a nursing home?
• What type of care does my senior need as they age in place?

What services does a home care agency provide?

Services offered by home care agencies can be divided into a number of categories:

• Activities of daily living: Also known simply as "ADLs," these are tasks like walking, dressing, eating, personal hygiene and taking medication. 
• Instrumental activities of daily life: Often referred to as "IADLs," these are tasks like driving, preparing meals, managing medication and keeping the house in order. 
• Home health care: Home health care is distinct from "home care" because it involves the delivery of skilled medical treatment to the senior's residence. This treatment may be conducted by registered nurses, physical therapists and a range of other professionals. 
• Companionship: This type of home care focuses primarily on improving a senior's mental health with plenty of social interaction. Examples of companionship home care may include guided hobbies, games, shopping outings and other activities. 

Here are some specific examples of the type of care services provided by home care agencies:

Home care agencies provide therapy

Seniors aging in place can benefit from a range of therapy care options via home care agencies, including:

Physical therapy: Seniors aging in place are in danger of becoming too sedentary and immobile. Over time, this can weaken their bodies and make them increasingly vulnerable to falls and other injuries. Physical therapists can help your senior regain strength, allowing them to become more independent while doing the things they love. 

Respiratory therapy: Respiratory therapy can help seniors with a range of issues, including sleep apnea, COPD and much more. Home care agencies utilize skilled medical professionals to oversee oxygen therapy, CPAP machines and more, following a physician's orders and using respiratory equipment in a safe manner. 

Occupational therapy: Occupational therapy can help seniors become more independent in their own homes. This type of therapy is especially helpful for seniors who are struggling to complete everyday tasks due to rheumatoid arthritis and other issues. 

Speech/language therapy: Speech and language therapy is often necessary for stroke survivors, and home care agencies can provide qualified professionals who can help your senior build language and speaking faculties. 

Home care agencies provide meal services

Preparing a nutritious meal might seem like a relatively basic task, but it becomes increasingly difficult for seniors, as physical and even mental limitations set in. Adequate nutrition is important for overall health and well-being, and enlisting the assistance of a home care agency helps your senior consume the best diet possible. 

Home care agencies provide skilled nurses

Seniors aging in place often need help from skilled nurses. These nurses can provide a wide range of services and medical care, including:

• Monitoring vital signs
• Administrating/organizing medications
• Gastronomy care
• Feeding tube care
• Catheter care
• First aid
• Wound care
• Managing chronic conditions
• Blood withdrawals
• Vision assistance

Each senior has unique medical needs, and the best home health care agencies will provide skilled nursing professionals who cater specifically to your loved one's condition. 

Home care agencies provide personal care services

A decline in personal hygiene and tidiness is one of the first signs your senior might need help while aging in place. Home care agencies can provide a range of personal care services, including:

• Grooming
• Bathing
• Dressing
• Using the toilet
• Ambulation (walking)
• Transfer (moving from bed to wheelchair, etc.)
• Housekeeping
• Laundry
• Errands
• Transport
• Companionship
• Grocery shopping

Questions about home care agencies

Are home care agencies reliable?

Home care agencies are often more reliable than independent caregivers. This is because when you hire an independent caregiver, you have to vet and interview them yourself—and you may miss certain red flags due to your own inexperience with the home care industry. On the other hand, the best home care agencies carefully assess all their staff members and only select the most qualified, experienced candidates. 

Home care agencies are typically insured and accredited, and it's easy to determine their track record and reputation. Plus, if there's turnover in a caregiver, a home care agency is more likely to provide a quick and capable replacement. Overall, the backing of an agency may give seniors and family caregivers more peace of mind about the quality of care an older loved one receives.

Is home care available for Alzheimer's disease and other forms of dementia?

Home care can easily be catered to the needs of seniors with Alzheimer's disease or dementia. According to a study by Johns Hopkins, seniors with access to home care resources were able to stay in their homes for an average of 9.5 months longer than those who didn't. 

Here are some dementia-specific services a home care agency can provide:

• Supervision: Seniors with dementia and Alzheimer's tend to wander, and this can lead to serious safety concerns. Adequate supervision can ensure seniors don't go missing. 
• Home health care: There are specific health care concerns associated with dementia that can be addressed by specialized medical professionals. For example, dementia often comes with serious mental health problems such as depression and anxiety. A home health care agency can organize treatment for these issues as your senior ages in place. 
• Diet plans: New evidence suggests that certain diets can slow down cognitive decline or even prevent dementia in some cases. For example, the "MIND diet" is becoming increasingly popular, and specialists can help your senior follow this diet as they age in place. 
• Exercises and therapy: Certain exercises and therapeutic activities can help address symptoms of dementia. For example, music therapy has shown tremendous promise in this area, and memory exercises can improve outcomes considerably. 

What questions should I ask home care agencies?

• Can you provide personalized assistance based on the unique care needs of my elder loved one?
• Can you provide our family with regular updates regarding our senior's well-being?
• Can you provide a full list of your services?
• Is your pricing clear and transparent, or are there hidden fees?
• Do you provide any guidance as I try to locate funding assistance for home care?
• Are you available 24/7?
• How do you make sure your staff members are properly qualified and experienced?
• Do you take the time to search for a caregiver that matches my senior's personality?
• Are your caregivers insured? Is your business accredited?
• Do you conduct background checks on your caregivers?
• Can your caregivers handle "difficult" seniors?
• Do you have caregivers who can address my senior's language barriers?

Talking about home care agencies

Working with a home care provider is a major decision—one that should involve the entire family. Ideally, you should try to talk about the possibility of a home care agency with everyone present, including your senior loved one. 

How to talk to family members about home care agencies

Many family members may be concerned about the cost of home care agencies. While it's true these services can be costly, you might want to point out the alternatives. Nursing homes will almost always be more expensive. In addition, family members may have to sacrifice their jobs to become full-time caregivers. Because of these factors, home care agencies are actually quite cost-effective when you take everything into account. 

How to approach the topic of home care agencies with your senior

Seniors who wish to age in place value their independence, and this might make them reluctant to accept outside help. You can point out that a home care provider will allow them to continue living comfortably in their residence. Let them know that without these services, a nursing home might be the only option. 

Remember, some home care services involve sensitive and potentially embarrassing subjects. For example, a senior might be in denial that their personal hygiene has deteriorated, or that their home is now a mess. Always approach these subjects with a degree of care and consideration. 

Questions to help a senior consider a home care agency

• You've worked so hard your entire life. Isn't it time you had some help around the house?
• Wouldn't you like a bit of company throughout the day?
• It must be so difficult to remember all of your medication. Wouldn't it be easier if you had some help?
• What if I had someone come over to clean your place every once in a while?
• Wouldn't it be nice if someone came over to help you maintain your hair and skin?

Paying for home care agencies

How much does a home care agency cost?

The cost of a home care agency depends entirely on your senior's unique needs and priorities. If your senior simply needs a little help around the house once a week, they can expect to pay less for a home health aide than a senior who needs assistance around the clock. 

That being said, home care agencies are generally more expensive than independent caregivers because you're paying about 20% more for the "middle-man" fee of hiring caregivers and nurses through an agency. 

Can I get help paying for home care agencies?

You can get help paying for home care agencies in a number of different ways:

• Medicare: As long as home care is related to your senior's medical needs, there's a good chance it will be covered by Medicare. This means that while Medicare can cover things like therapy and professional nursing, it won't cover things like housekeeping, meal preparation or companionship. On the other hand, Medicare Advantage plans may cover the cost of non-medical home care under very specific circumstances. 
• Long-term-care insurance: While standard health insurance will not cover at-home personal care assistance, you may have more luck with long-term-care insurance. Also known as "LTC" insurance, this type of coverage is specifically designed to cover various aspects of senior care. 
• Life Insurance: While it's true life insurance benefits only come into play after your senior's death, you may be able to use some of the funds to finance long-term home care. This can be handled in a number of different ways, including selling the policy to a third party. Another option is something called an "accelerated death benefit."
• Veterans Benefits: If your senior is a veteran, they can access Aid and Attendance benefits under Veterans Benefits. Also known as "A&A," this benefit provides monthly payments you can use for home care. 
• Reverse mortgages: If no other sources of funding are available, you can always consider a reverse mortgage. The most reliable option is the Home Equity Conversion Mortgage (HECM), which is available to adults over the age of 62. Keep in mind you will need to repay the loan once the house is sold. 

How can I find home care agencies?

If you're ready to start searching for the right home care agency in your area, a variety of options are right at your fingertips. Check out our Resource Hub for detailed referrals of reputable, established home care agencies nearby. From there, you can begin to develop a customized, effective care plan for your senior. When you take advantage of the right resources, your senior can age in place for longer.