Ten Things Caregivers Need to Know about Home Care


Published: 11/09/2012

by Carrie Steckl, Ph.D.


Home care can play an important role in providing the care that your loved one needs. However, home care comes in many shapes and sizes – not to mention costs – and choosing home care can be confusing. Here are ten things caregivers should know about home care so that they can choose the best type of help for their loved ones.


  1. There are three types of home care: skilled care, personal care, and companion/homemaker services. Some families use more than one type of home care to meet their needs.
  2. Skilled care is the most advanced type of home care. Doctors must order skilled care when they think it is medically necessary. It might include wound care, monitoring of a serious illness, or certain types of rehabilitation. Depending on the type of skilled care, the services might be provided by a nurse, physical therapist, rehabilitation therapist, or other specialist.
  3. Personal care includes help with personal tasks such as bathing, grooming, eating, and going to the bathroom. Personal care may be provided by a home health aide or a personal care attendant (the agency may use a similar name, such as home aide). The availability of personal care can make a huge difference in the life of a caregiver who, for instance, cannot physically lift her spouse or who endangers her own health by exerting herself too much when helping her parent bathe.
  4. Companion/homemaker services include non-medical care such as spending time with the person who needs care so the caregiver can have some respite, taking the person to medical appointments, or performing light housekeeping. Companion/homemaker services are perfect for caregivers who are spinning several plates and need to be two places at one time.
  5. State regulations dictate what types of care can be provided by certain home care workers. For instance, some states allow personal care attendants to take a client’s temperature and blood pressure, while others do not. Most states only allow nurses to administer medications. Be sure to ask the agency what their employees can and cannot do.
  6. There are three general types of agencies that provide home care: home health agencies, home care agencies, and non-medical/companion agencies. Some agencies offer more than one level of home care.
  7. Home health agencies are licensed by the state and certified by Medicare and Medicaid to provide skilled care. Home health agencies also usually offer personal care, either through their own employees or through a partner agency.
  8. Home care agencies primarily provide personal care. Many of them also offer companion/homemaker services, and some of them offer skilled care through partnering with other agencies. Some states require home care agencies to be licensed if they offer services that are covered by Medicaid.
  9. Non-medical/companion agencies provide companion/homemaker services. They are not usually licensed or covered by insurance (unless a long-term care insurance policy includes this coverage). Non-medical/companion agencies are not as well regulated regarding the training of their employees or the provision of services.
  10. There might also be employment or registry agencies in your state that offer referrals to private individuals who provide home care. Be sure to ask how their listings are vetted to ensure that only names of qualified individuals are provided.


To look for home care services near you, try searching our database here.


Source: Next Step in Care/United Hospital Fund (2012). Home care: A family caregiver’s guide. http://nextstepincare.org/uploads/File/Guides/Home_Care/Guide/Home_Care.pdf