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Unraveling the Home Care Myths

A professional caregiver can serve as a second set of eyes and ears to help keep seniors safer at home.
A professional caregiver can serve as a second set of eyes and ears to help keep seniors safer at home.

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September 8, 2011

Despite increasing health problems, Dad wants to stay at home. He won’t budge. One mention of that beautiful assisted living facility (ALF) down the street and the conversation ends. But his home of 45 years is just too big for him to clean and you can’t always get there to help when he needs it. Or perhaps it’s your Mother who just isn’t interested in cooking anymore and even getting out of the house, for that matter. Talk of hiring extra help, though, falls on deaf ears.

The simple fact is that most elderly want to stay at home – upwards of 90 percent in several industry surveys, as a matter of fact. But some seniors seem leery of home care. Perhaps you are too. That may be because there are a few misconceptions that often surround care for the elderly at home. Check them out to learn if you know all you should about home care.

Home Care Myth Busters

Myth No. 1 Home care is only for the very ill.

It’s true that seniors at home who are very ill or recovering from a serious operation may seek the services of a home health aide. But home care actually covers two different types of care:
Home health care provided by licensed medical professionals, for which you need a prescription, can cover a wide range of medical and therapeutic services. Home health care may be needed for post-operative rehabilitation, skilled assessments and teaching, occupational and speech therapy, wound care, mobility training, pain management or IV therapy/injections.

Then there’s non-medical home care, such as personal care, homemaker or companionship services provided by professional caregivers. Non-medical home care often revolves around the activities of daily living (ADLs) such as eating, dressing and bathing. Or the instrumental ADLs such as driving, shopping and doing housework. Sometimes an older adult may benefit from both types of home care services.

Myth No. 2 Home care costs too much.

Some families seem intimidated by the costs of home care. In reality, home care is one of the most affordable options, partly because of the flexibility of an hourly service. In fact, a 2010 survey conducted for the Home Instead Senior Care® network revealed that 22 percent of the network’s clients employ caregiver services for just four hours or less a week. About 20 percent employ them between four and eight hours a week. Furthermore, this research reveals that 49 percent of family caregivers overestimate the cost of non-medical care on average by $6 an hour.

According to Genworth’s 2011 Cost of Care survey, home health care costs held steady in the past year at $18 an hour for homemaker services and $19 an hour for home health aide services. If your loved one just needs a few hours of non-medical and companionship service each week such as meal preparation, light housekeeping, medication reminders and shopping, non-medical home care can be ideal. While home care is still primarily private pay, more long-term care policies are covering this service.

In contrast, the recent Genworth study reported that the cost of a private room in a nursing home jumped 3.4 in the past year to an annual total of $77,745, while the cost of ALFs increased 2.4 percent to $39,135 annually.

Myth No. 3 I have no say about who comes into my home.

Reputable caregiving companies will try to match caregivers with seniors of similar interests. For instance, many Home Instead CAREGiversSMare seniors themselves who share the same hobbies and histories as their clients. You should make sure that a company’s caregivers are screened, trained, bonded and insured. The agency should conduct background and reference checks of their caregivers, and offer flexibility in setting up a schedule. Credible companies will also offer back-up and replacement caregivers.

Myth No. 4 Home care will take away my independence.

Unfortunately, it can be difficult to convince some seniors that the opposite is true. However, the elderly who stay home alone as they age run the risk of falls and other problems. Among those age 65 and older, falls are the leading cause of injury death, according to the Centers for Disease Control (CDC). They also are the most common cause of nonfatal injuries and hospital admissions for trauma, the CDC reports. A professional caregiver can serve as a second set of eyes and ears to help keep seniors safer at home. A caregiver also can transport seniors to special events or even just the grocery store, which can help decrease isolation. Home Instead CAREGivers also often enjoy activities with their clients such as gardening and concerts.

Myth No. 5 All caregiving services are the same.

“Let the buyer beware” has never been more true than with home care. Not all caregivers or caregiving companies are the same. Caregivers can be grouped into three different categories including agency employee, independent contractor with a registry and independent caregivers. Most agencies hire caregivers who are screened, trained, bonded and insured. The agency pays the caregivers and handles all taxes and other employment obligations such as worker’s compensation, liability coverage and performance issues.

An independent contractor with a registry is recruited, screened and referred to the senior by the registry. The older adult becomes the employer and is responsible for all employment responsibilities such as hiring, scheduling, handling any performance issues, and paying federal and state payroll taxes. The older adult assumes the risk as the employer. It’s unlikely these caregivers are receiving any support, training and continuing education.

Finally, independent contractors, otherwise referred to as the “gray market,” are responsible for marketing themselves. The consumer must assume the responsibility for criminal and background checks. The older adult becomes the employer and is responsible for hiring, scheduling, handling any performance issues, and paying federal and state payroll taxes. The independent contractor will also not be covered by workers’ compensation, liability and bond insurance.

While there’s lots to think about, there are many options in today’s market for seniors and their families. For more information about non-medical home care, please check out The Home Care Solution, A Guide to the Best Choices for Seniors and Those Who Care About Them (U.S. Edition PDF, 1.2 MB or Canadian Edition PDF, 1.18 MB).

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Thoughts and stories from others
  1. March 22, 2016 at 7:57 pm | Posted by Cheryl Calhoun

    I have worked as a home health care provider for over 15 years! It is a job that I enjoy and love! However, I had a situation that I had to finally lay down some boundaries and wish I had done so from the beginning. I always do now. When working with seniors, sometimes their loneliness is a big part of their problems. Often we are not only their primary health care provider (on a daily basis) but we are often their source of companionship. While there is certainly nothing wrong with this one must maintain a sense of boundaries and space. It is important for a number of reasons,it is important not only for you, the caregiver but as well as your client. This ensures that everyone is on the same page and minimizes any hurt feelings on the part of the client but also feelings of overwhelmingness for the caregiver. Sometimes we can't always be their "very Best Friend", and if there are any mental conditions in addition to physical, then it is of the utmost importance to begin this from the first day! All/any of my clients always knew and could certainly feel that I was very genuine and sincere about their health, happiness and needs. I always felt that a part of my job was to enhance my clients life as best as I could. I continue to feel this way however, there has to be limits and boundaries. Otherwise confusion, inappropriate expectations and occasionally hurt feelings can arise. None of these things are good for anyone! Ensuring that both parties knows what to expect and what the boundaries are and what is and is not appropriate should begin from the first day but always in a gentle and non confrontational manner. Enjoy your job!


  2. November 29, 2015 at 9:48 pm | Posted by Lynne

    I'm passionate about my work as a caregiver, but I have a couple clients who's only need is housework. I'm a cleaning lady to those clients and it's very frustrating. Is this a common complaint from other caregivers?


    • May 24, 2016 at 1:10 pm | Posted by Liz

      Lynne, Have you talked to your Staffing Coordinator? Let your home office know that you prefer other types of assistance and see if they can pair you with seniors who need the kind of help you enjoy. Good luck!


  3. July 22, 2015 at 9:44 am | Posted by Donna

    My father has recently moved into a care home because his Alzheimers deteriorated to such a level that he was no longer safe at home. Although the situation leading up to this was very stressful for myself and my siblings the current situation is also very stressful. My father is not settling and constantly wanting to come home. We have been informed that he has become aggressive in his plight to get home. It is mostly in the evenings but not always(sundowner)


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