Introduction to In-Home Care

Welcome to Beacon Home Care! We’re glad you’re here. If you are just beginning your journey with elder care, this is a great place to start. We want to make sure you have the information you need to make informed decisions for yourself or your loved one. This guide will help you understand what in-home care is, the services that may be provided, associated costs, how it compares to assisted living, and more.

If you still have questions after reading through this overview (which is quite normal!), we encourage you to give us a call at (888) 973-7748 for a free, no-obligation assessment of your unique situation. We are always happy to talk to members of our community to help you find the most appropriate solution for your family’s individual needs.

What is In-Home Senior Care?

Let’s start at the very beginning (it is, indeed, a very good place to start): What is in-home senior care, anyway? Broadly, in-home care consists of both medical and non-medical services that are provided in a senior’s own home, allowing them to live independently while ensuring their safety and well-being. In-home care is appropriate for seniors who want to continue living at home, yet need help with day-to-day activities such as medication reminders, mobility issues, and other personal needs, including companionship and welfare monitoring.

Many seniors would prefer not to give up the comforts and familiarity of their own home surroundings — and in certain cases, it may be detrimental to do so. But with the right level of support and care, aging in place is a viable option for many seniors. By bringing care to the patient (rather than bringing the patient to the caregiver), your loved one gets to stay in comfortable, familiar surroundings augmented by one-on-one support working in close partnership with family caregivers.

In-home care covers a broad range of services, and, depending on an individual’s needs, may need to be provided by one or more types of agencies to ensure the patient is fully supported. Some of the different types of providers include home care agencies (or “HCAs,” like us!) who provide non-medical support for daily living; licensed home health agencies (“HHAs”), providing in-home nursing services; and the In-Home Supportive Services (IHSS) program for Medi-Cal eligible seniors in the state of California.

So what kinds of services can be provided at home? Read on…

Types of In-Home Care Services

The service providers you hire will depend on the type of care you or your loved one needs. Generally speaking, services can be broken down into two broad categories: non-medical care and skilled health care. The differences between the two include services provided, licensure, and cost. Just like you wouldn’t hire a plumber to do an electrician’s work, it’s important to get the right person for the job!

Non-Medical & Personal Care

Oftentimes, seniors and rehab patients don’t require complex medical care such as infusions or injections. Instead, they just need a little extra help with day-to-day activities, or ADLs. You may have heard the term “ADLs” tossed around as you’ve investigated your insurance coverage. But what is an ADL? ADL stands for Activity of Daily Living, and covers core personal care tasks that people may not be able to do well on their own: bathing, dressing, grooming, toileting, and mobility.

In addition to these activities, there are other “Instrumental Activities of Daily Living” (IADLs) that a non-medical professional can assist with, such as housekeeping and laundry, meal preparation, medication reminders, companionship, transportation and escort services, and respite care. 

While these services don’t require the caregiver to hold a medical license, you still want these services to be provided by licensed home care aides. For personal caregivers, licensing is provided through the California Department of Social Services, which maintains the registry of Home Care Aides (HCAs) for the state. Licensing ensures that aides have received appropriate training and have passed background checks.

When bodies are weakened due to illness or age, sometimes physical help and companionship are all that is needed to maintain a healthy standard of living. However, when medical issues arise, there may be a need for additional services that require a medical professional. This is where skilled nursing or rehabilitative care comes in.

Skilled Nursing Care & Home Health Care

Similar to Home Care Aides, skilled care professionals should also be licensed, just with a different type of license. The license required varies based on the type of service provided. Some of the licenses you may encounter include Registered Nurse (RN), Licensed Vocational Nurse (LVN), Physical Therapist (PT),  Physical Therapist Assistant (PTA), and more!

Skilled care covers a variety of disciplines, and may include medical assistance such as wound care, medication administration (including injections and IVs), or vital sign monitoring. Therapies such as physical therapy, occupational therapy, and speech therapy also fall under this umbrella.

Home Care vs. Home Health Care

Although they sound similar, Home care and home health care are very different in terms of application and insurance coverage. The main difference is home care provides non-medical assistance with daily tasks, while home health care provides skilled medical services. 

Home health care provides clinical care to help patients recover with in and out-patient services such as nursing and therapy. Home health care focuses on medical needs and is covered under insurance as prescribed. 

Home care provides at home daily living support for people who need help maintaining their independence and daily routines at home. Home care is often long-term, focused on personal assistance like bathing and dressing, whereas home health care is typically short-term, prescribed by a doctor, and delivered by licensed professionals such as nurses and therapists. 

How to Choose an In-Home Care Option

If you’ve decided that in-home care is the right option for your family, what’s next? Here are some steps that can help you make your choice:

Step 1: Assess your needs

What activities would be most helpful to have assistance with? Make a list! These can include ADLs, IADLs, medical tasks, risk management, and supervisory tasks. This will help you create an initial screening tool to find a provider who can meet your needs.

Step 2: Determine which type of provider is best for you

You may choose to work with an agency, a private hire, or an IHSS agent. Some of the things you should consider when making your choice are experience, cost, availability of backup care, and any extra work required on your behalf when considering private hires versus institutional hires (i.e., accepting responsibility for things like employee tax withholding, unemployment insurance, or workman’s comp when hiring private caregivers).

Step 3: Screen candidates

Regardless of which type of service provider you choose, you should always screen any prospective hires to make sure they’re the right fit for your needs. Some of the criteria you might use to make your evaluation include licensing, insurance coverage, availability of backup assistance in case of illness, turnover rates, and additional services such as a written care plan. You will, of course, also want to compare the overall quoted costs, including any cancellation fees, discontinuance notification timelines, and any extra service fees.

Step 4: Trial period and written plan

Ideally, you’ll be able to start with trial visits to ensure that you have found the right personality fit for your loved one.  You should also request a written care plan to make sure you understand the services to be provided, and document agreed upon responsibilities and schedule of services. Your long-term written plan should also include things like what to do in case of falls, where medication will be stored, and procedures/contact information in the case of emergencies.