In-Home Care: Pros and Cons

Many seniors find themselves responsible for the care of aged parents or other family members who are determined to remain in their homes. These senior seniors won’t hear of assisted living and refuse to consider alternative solutions, such as moving closer to one of their children. In such situations, hiring an in-home care giver, though expensive, might seem the best approach.

But finding the right in-home care giver is fraught with difficulties. It’s a problem every senior should give some thought to, because one day any of us could be the one needing in-home care.

Just finding an honest home health aide is something to worry about. We have a friend whose father was bilked out of hundreds of thousands of dollars by a care-giver. This isn’t an isolated problem – AARP recently highlighted the issue. Reports of physical abuse of seniors by health aides are common.

If you’re thinking of hiring a home health aide directly, you should be certain to require references from people you trust. Of course, direct hire means you will be responsible for paying Social Security taxes and unemployment insurance; and you could be left liable in case of an accident.

That’s why it’s more common to use a home health care agency. According to the New York Times, there are 12,000 such agencies serving five million Americans.

Experts advise, naturally, that you inquire whether an agency you are considering conducts background checks on its employees and provides training, but this too can be problematic since industry regulation can be quite loose. AARP points out that

“Only about half of all states require home-care agencies to conduct any sort of training for their employees. Just 15 states require agencies to conduct periodic in-home reviews to make sure workers are doing their jobs. Most states require criminal background checks of home-care workers but do not require agencies to check records in other states.”

Be prepared to pay upwards of $20 per hour for in-home care, and between $250 and $500 per day for round the clock services. An assisted living facility could make more sense from a financial perspective. However, Medicare may pay for some in-home services, and help may be available from Medicaid or the VA.  Some long-term care insurance policies will also cover in-home care.

Despite the problems, in-home care is bringing peace of mind to families and their aged parents across the country. Another of our friends is exasperated with his mother because she has just fired the caregiver the family had found for her. Mom didn’t like having a stranger in her house, tending to her needs, or driving her around. She’s back to depending on her stressed out daughter for care.

There’s a lesson for seniors here. When and if the time comes for us to receive in-home care, let’s try to be good sports about it. Of course, we can’t tolerate abuse or neglect and should speak up if either occurs. But otherwise, let’s give it a shot. Those who love us will be relieved.


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