Common Concerns About In-Home Care

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For many families, in-home care can be a godsend. However, it is natural to be cautious about hiring outside help to care for someone you love. Achieving a realistic understanding of how home care works will enable you to address concerns head on and make confident decisions for your family.

Below, we identify and respond to common concerns about in-home care.

Concern 1: Professional Caregivers Don't Care About Their Clients

Much like teaching, nursing, social work, and different types of therapy, the caregiving industry tends to attract people who, by nature, care about the welfare of others.

Dr. Michael Fleming, Chief Medical Officer for national home health care company Amedisys, explains that nurses, therapists and aides are hired, first and foremost, to provide in home treatment based on a senior's individual needs. While meeting those care needs, a professional should establish rapport, make the client feel at ease, understand their hesitations and make the experience as comfortable as possible.

Family members are often concerned that home care employees are not invested in caring for their loved ones because they are strangers. However, with time, many families find that a genuinely caring relationship blossoms between the two. The best way to ensure this rapport is to take an active role in hiring a home care company and interviewing individual caregivers. A quality company will help to match a senior’s clinical needs and personality with a caregiver who has the appropriate training and attitude. When interviewing, look for caregivers who are both knowledgeable and demonstrate compassion and warmth.

Read: 5 Qualities to Look for in a Professional Caregiver

Concern 2: Professional Caregivers Abuse and Steal from Seniors

Many of us have heard stories about patients who were mistreated or have been victims of theft. For those reasons, some people avoid using outside services entirely. The threat of elder abuse is real, but doesn’t mean valuable resources like in-home care should be ruled out. There are preventative measures that can be taken to significantly reduce the risk of any wrongdoing.

Dr. Fleming believes the majority of these kinds of crimes are committed by unskilled, independent caregivers or sitters who are not hired thorough a reputable company. The best protective measure is to perform your own due diligence when hiring a home care company. Inquire about potential providers’ methods for hiring and screening employees, and ensure they are licensed, bonded, and insured. Confirm that the company provides regular supervision of its employees and has a thorough process for responding to and investigating client complaints. Knowing that a company thoroughly vets its caregivers and takes steps to insure against any issues will give you added peace of mind.

Read: How to Select a Home Care Company

Concern 3: In-Home Care Is Only for People Who Are Very Sick

It is true that seniors who have chronic conditions or are recovering from an illness or operation may receive skilled services at home. Medically necessary home health care can cover a wide range of medical and therapeutic services, such as wound care, physical therapy, IV therapy and injections.

However, non-medical in-home care is available for seniors who just need some extra help with personal care and household chores. For example, a relatively healthy individual with arthritis could benefit greatly from assistance with getting around the house, cooking and doing laundry. Non-medical care often revolves around assisting with activities of daily living (ADLs), such as eating, dressing and bathing. Depending on the situation, a senior may benefit from a combination of both types of in-home services.

Read: The Difference Between Home Health Care and Non-Medical Home Care Services

Concern 4: I Have No Control Over Who Comes Into the Home

It can be a little unsettling welcoming a professional caregiver into your home, but consumers do have a great deal of control over who will be caring for their loved ones. Hiring a reputable company that allows families to interview individual caregivers before services begin is the best way to ensure a comfortable match.

Finding the right fit requires some up-front work on the company's part as well says Val Halamandaris, president of the National Association for Home Care & Hospice. Staff should analyze the senior’s needs and select a caregiver (or two) who is prepared and suited to meet those needs. If at any point you are unhappy, call the company immediately. They should be willing and able to work with you to find a better fit.

Concern 5: The Quality of Care Provided in the Home is Inferior to Care Provided in Facilities

In-home care is a viable solution for preventing or delaying placement in an assisted living facility or a nursing home. However, it is not intended to replace these residential settings. Both skilled caregivers and unskilled caregivers receive extensive training in their respective fields before they ever enter a person's home. If you’re concerned about the quality of care your loved one will receive, ask the home care company about their training process and continuing education requirements.

Concern 6: If a Senior Only Needs Help with Basic Hygiene, They Don't Qualify for Home Care

One of the best aspects of home care is that there is no level of service that is too basic. In fact, many home care companies offer short, specialized visits simply to provide a senior with bathing assistance. These companies provide care on a spectrum, from basic companionship services and hygiene assistance to skilled nursing and therapy. Be sure to ask prospective providers what level(s) of care they specialize in and inquire about any minimum hourly requirements.

Concern 7: If a Senior Needs Around-the-Clock Care, Home Care Isn’t an Option

Many companies do provide 24/7 care. With around-the-clock care, a company will coordinate a team of caregivers to be awake and able to provide care 24 hours a day, seven days a week.

Concern 8: Home Care Is Not Affordable

Peter Ross, CEO and co-founder of the Senior Helpers franchise, says there are actually many ways for seniors to afford quality care. “With new programs such as reverse mortgages, VA benefits, long-term care insurance, and access to state and local programs such as Medicaid, many more families are able to afford quality care for their loved one,” says Ross.

According to Genworth's 2016 Cost of Care Survey, the national median daily rate for home health care is $127 per day. In contrast, the Genworth study reported that the national median cost of a one-bedroom residence in an assisted living community is $119 per day.

These numbers may seem a little bit backwards, but home care services are offered on an hourly basis (the approximate hourly cost is $20) and easily customizable to fill specific holes in your schedule and care plan. Assisted living, on the other hand, involves a higher level of care that is provided around the clock for the long term. Most people do not use home care as a 24/7 solution for a prolonged period of time. Therefore, home care costs are dependent on a senior’s unique needs. A few hours of in-home services twice per week may be the perfect fit for your family and your budget.

Read: How to Pay for In-Home Care

Concern 9: I Am the Primary Caregiver, So There Is No Need for Additional Help

According to the Harvard Medical School Family Health Guide, no caregiver should ever be on-call 24 hours a day. Even though many family caregivers take it upon themselves to meet all their loved ones’ needs, the physical and mental toll of constantly being “on duty” can be detrimental to the caregiver’s health and that of their loved one. In fact, the level of exhaustion many caregivers reach can lead to what is commonly called “caregiver burnout.” Everyone—nurses, doctors, and family caregivers—needs respite and relief. With home care services, a professional can provide valuable breaks from the rigors of full-time caregiving in the comfort of your own home.

Read: Need a Break from Caregiving? Avoid Burnout, Find Respite Care

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38 Comments

Home health care is expensive. Unless you are destitute, you can't get Medicaid or VA benefits. You might be too old to get long-term care insurance. The only possibility left is a reverse mortgage. That might be an option, but if it isn't, you are left to your own resources.
So sorry ~I stopped reading with
"Concern: Home care workers steal from elderly and/or abuse them."

I can start that as a R.N. who was the one to go into the home & assess the patients for home health care, in my many years of experience in this arena, I have found this statement to be not true. If I was to bring in home care assistance, I would instruct the clients to put valuables in a safe place initially. If possible to move valuables, such as jewelry, to a bank or leave them with other family members who could be trusted or to have a locked box in the home. I have also seen locked boxes missing.
There were things missing with each appointment I had with clients. I so wish this was not my experience.
I have extensive experience with homecare vs assisted living and these are all good points. When mom moved to assisted living,24 hour care and meals and snacks were included . 35 hrs/wk of homecare was 2700 dollars/month plus groceries. Assisted living was 3300/month for day/night care and then minus groceries , easily making assisted living the better deal. The choice is not as black and white as it might look