Home care can be a good option for older parents with low needs, but when a senior becomes frailer and needs grow, the limitations of relying on one individual to provide visiting care can become starkly obvious.
Path of Least Resistance
When seniors who live alone first begin to need a little assistance around the house, it’s natural for their loved ones to address the needs by hiring a home care aide to visit periodically.
It’s the path of least resistance. Very often, the senior simply doesn’t want to move to an “old folk’s home”, and hiring a visiting attendant solves this problem.
And it can initially seem to be a more affordable option than assisted living or other kinds of residential care. It’s cheaper (so we think). Mom can stay at home and receive care for less money than moving to an assisted living community. Problem solved, right?
For many families, it’s alright at first. Home care is often sufficient for seniors with lower needs – those who could use someone to check-in on them and do some housekeeping. But for seniors who need assistance with day to day personal activities like going to the bathroom, it can be inadequate or prohibitively expensive.
Is Home Care Actually Less Expensive?
As seniors age, their needs usually increase. A home care regimen that initially started as four hours per day, three days a week progresses to, say, four hours per day, seven days per week. Then eight hours per day, everyday of the week. And eventually a live-in aide becomes required. But somewhere along the line between just a little home care and around the clock care, a line is crossed when assisted living is the more affordable solution.
For example, the cost for average assisted nationwide is approximately $3400 per month, while home care typically costs about $25 per hour. A home care aide who visited five hours per day, everyday, costs more than the average cost assisted living community. And unlike assisted living, where help is available 24/7, a senior with five hours of home care per day would still be completely on his or her own for the remaining 19 hours of each day.
The Challenge of Finding and Keeping the Right Caregiver
Families that were initially satisfied with home care often begin to find it problematic for reasons beyond cost. Matching the senior with an appropriate, trustworthy caregiver can be extremely challenging. Sometimes families will try many caregivers until they find one who seems right, but when that caregiver leaves for another job, the whole process of finding the right match begins anew.
Gaps in Care
And even families who find a long serving aide whose personality meshes with the senior, that caregiver, like any other employee, will sometimes have to miss work when sick or having other issues. But unlike at assisted living, where there is a whole team of staff and layers of redundancy, when a home care aide has to call-in and miss a visit, the senior is usually out of luck for that day. (Most home care agencies don’t have a team of reserves standing by in case a coworker can’t make it). This can be problematic for obvious reasons, especially when there are no relatives or other loved ones nearby to fill the gaps in care.
Potential for Isolation
Seniors who rely exclusively on a home care aide may also begin to suffer the detrimental effects of isolation, especially if they don’t have many visitors. Whereas seniors who live at an assisted living community have someone to talk to or chat with anytime they like, a senior relying on home care may have little opportunities for in-person companionship aside from the caregiver.
High Care and Home Care: Usually Mutually Exclusive
Professional in-home caregivers frequently have legal limitations on the kinds of care they are allowed to provide. For example, in many states, unskilled home care aides are not even allowed to touch a senior’s medication. (Visiting nurses are able to administer medications, but a visiting nurse would fall under the term “home health”, which costs more than twice as much as standard home care). And certain care needs won’t wait until a caregivers shift starts. For example, a senior who needs help toileting or who needs incontinence care would likely need live-in care, which very few families can afford and which can be logistical nightmare because of the shifts involved.
Home care can be a good stop gap measure when a senior begins to need assistance, but its price and numerous practical difficulties mean that it is rarely a suitable long-term option for seniors with high care needs.