Is Home Care Always the Answer?

companionIt depends. I think the best case scenario is when home care begins early, when simple part-time companion care is provided so that family can have quality time when visiting their loved one. For example, Mrs. Cleary lives alone, should no longer drive and needs assistance with household chores. The companion would come in for about three half days a week. During this time, Mrs. Cleary’s companion would do some light housekeeping, laundry, change linens, clean out the refrigerator, and plan and make some meals. One day they would go out to grocery shop, stop at the pharmacy, run errands, have lunch and perhaps fit in a doctor or hair appointment for Mrs. Cleary. These are tasks that family caregivers might try to squeeze into their day but it will take away from partaking in a more enjoyable time with their loved one.

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As Mrs. Cleary declines and her needs increase, more home care can be added. Often the level of care would transition to personal care to allow assistance with bathing, grooming, toileting and ambulation. Mrs. Cleary would have a certified nursing assistant (CNA) or equivalent with her for full days, possibly seven days a week. Next overnight care may be added if Mrs. Cleary has dementia or Alzheimer’s so that if she awakes she is comforted and does not wander. Hours of care can be added until it reaches round-the-clock care. Of course as hours increase so too does the expense.

Using average long-term care costs provided on, home care expense would be:

  • Companion, 12 hours a week at $19 per hour or $988 a month
  • CNA, 7 days per week with 8 hour days at $21 per hour or $5,096 a month
  • CNA, 7 days and nights per week at $21 per hour or $10,192 per month
  • CNA, 24 hours a day, 7 days a week at $21 per hour or $15,288 per month (most agencies would offer a discount at these hours)

Some will not be able to afford the increased cost of home care so fortunately there are options. A creative alternative is to have the loved one, if able, attend adult day care for $67 per day resulting in a savings of $438 per month. Typically personal care is provided as well as up to two meals and an opportunity for socialization. Home care could round out the balance of the necessary care hours. If that’s still too costly, a one-bedroom unit in an assisted living facility runs about $3,300 per month and a private room in a nursing home averages $6,235 per month. Our guidance to families was once the client cannot afford enough home care to safely remain in their home then alternatives should be considered.