When your elderly parents or loved one needs assisted care, they will often tell you that they would prefer to receive care in the comfort of their own home. At first, the services they need could be non-medical, such as light housekeeping, food preparation, companion, or personal care. As they age, however, the services they require could increase to include medical services that involve the expertise of health care professionals like nurses and therapists.
Every Home Care Scenario is Different
Non-medical home care, like any other elder care services, costs money. And every home care situation is unique. To give you examples, here are three common scenarios you could be facing with your loved one:
Example 1: Dad needs 4 hours of care per day
Dad is still mostly independent, perhaps living alone. But due to some mobility issues because of age or even recovering from surgery, he may need a little extra help with daily tasks. This could include help with bathing and dressing for the day, light housekeeping and meal preparation, and grocery shopping or other errand running.
Example 2: Mom needs 12-16 hours of care per day
Mom may live with a family member or adult child who is her primary caregiver, but Mom can’t be left alone due to a condition such as Alzheimer’s Disease or a disability. Her main caregiver may work outside the home during the day and has evening activities and responsibilities that they must attend to, needing someone they trust to be with Mom when they cannot be.
Example 3: Harold needs 24/7 care or live-in services
Harold should not be left alone but lives alone or with someone else who is unable to care for him, perhaps his wife. In this case, the best options might be:
- 24/7 care, where caregivers attend to Harold’s needs in 8-hour shifts
- A live-in situation, where assigned caregivers have two- or three-day shifts, but the situation also allows for them to get a full night’s sleep in their own space during that time.
This scenario is common for individuals with dementia or Alzheimer’s Disease, a severe disability with little to no mobility, or other major health issues such as paralysis due to a stroke. Caregivers are there to help with all personal and companion care needs, such as meal prep and eating assistance, personal hygiene, daily household tasks and errands, and transportation to and from doctors’ appointments.
How Do You Pay for Home Care?
We have highlighted some of the most common ways to pay for personal and companion care services.
Private pay is just that, personal funds that an individual or their family uses for home care from their own assets, investments or savings. Private pay resources can be used to cover expenses tied to a loved one’s caregiving costs.
Long-Term Care Insurance
Long Term Care Insurance (LTCI) is different from traditional health insurance because it is designed to pay for the cost of custodial and personal care (versus strictly medical care) and cover long-term care needs, support, and services as you age. LTCI is a type of insurance purchased from private insurance companies specifically to cover the costs of nursing homes, assisted living and home health care.
Benefits vary depending on the plan, so you must understand the services covered by the policy at the time of purchase. Assistance with the cost of personal home care may only be provided if the plan has an allowance for non-medical services. When purchasing a long-term care policy, be sure to plan ahead.
A reverse mortgage is a special type of home equity loan specifically designed for people aged 62 and older. Elderly individuals may choose to leverage their home equity to help cover the costs for home care, assisted living, nursing home care, and home modifications to allow aging in place. Unlike traditional home equity loans, reverse mortgages do not require borrowers to make regular payments. Instead, the loan comes due when the borrower sells the home, moves from the home, or passes away.
When considering a reverse mortgage there is a lot to understand. “What to Know About Reverse Mortgages” from AARP.org is a great article with helpful information to get you started.
Medicaid is a joint state and federal program that provides health coverage to individuals with low income. Traditionally, Medicaid has paid for long-term care in a nursing home for people with a functional and a financial need. But home care provides an alternative for seniors who require assistance to remain living at home. Home care through Medicaid can help seniors maintain their independence and age at home, and it is also more cost-effective for the state.
Home care services may be available through one’s regular state Medicaid plan, but may also be offered through Home and Community Based Services (HCBS) Medicaid waivers. Eligibility requirements and covered services vary by state, so check your state regulations for specific details.
The Centers for Medicare & Medicaid Services (CMS) recently broadened the scope of supplemental benefits Medicare Advantage (MA) plans can offer. For the first time, Medicare Advantage plans offered by private insurance companies have home care services as part of its supplemental benefits package. These services might include adult day care services, home-based palliative care, in-home support services, support for caregivers of enrollees, and others. Please know that plans vary greatly. You can find additional information and Medicare Advantage Plans at Medicare.gov.
Veteran Aid and Attendance
The Veterans Aid & Attendance Pension is a benefit that helps reduce the cost of care for older veterans and their surviving spouses. Veterans and their spouses who require the regular aid and attendance of another person (for activities of daily living such as bathing, dressing, medication monitoring, and other in-home care) may qualify for this special benefit in addition to a monthly pension.
Military service qualifications include the following:
- At least 90 days of active duty, but you did not have to serve in combat
- One day of active duty during a period of war
- Discharged from service under conditions other than dishonorable
To learn more about Aid and Attendance benefits and how your veteran can benefit from these services, visit the U.S. Department of Veterans Affairs website.
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American Council on Aging
Elder Law Answers
Home Health Care News
U.S. Department of Veterans Affairs