Senior Living Guide
In-Home Care
In-home care brings help to where a person already lives. Non-medical home care covers companionship, meals, housekeeping, transportation, and hands-on help with bathing and dressing. Home health care, ordered by a doctor, adds skilled nursing and therapy at home and is usually short-term after an illness or hospital stay.
Many families start here: it keeps a parent in familiar surroundings and can be scaled up gradually. The trade-off is cost, which rises quickly as hours increase, and the coordination that falls on the family.
Who it fits
- Someone who is safe at home with a few hours of help a day, or a few visits a week.
- A spouse or family caregiver who needs regular respite.
- Someone recovering at home who needs nursing or therapy visits.
- A person who is firmly set on staying home and has the resources to support it.
Types of in-home care
- Companion care: conversation, errands, light housekeeping, meal prep, and transportation.
- Personal care: hands-on help with bathing, dressing, toileting, and mobility.
- Home health: skilled nursing, physical or occupational therapy, and wound care under a doctor's orders.
- Live-in or 24-hour care: caregivers on site around the clock, in shifts or as a live-in.
What it costs
Agency home care commonly runs $30–$40 an hour nationally, more in high-cost areas. At 20 hours a week that's roughly $2,600–$3,500 a month; around-the-clock care can exceed $15,000 a month, which is why many families eventually compare it against a community.
Medicare covers intermittent home health care ordered by a physician, but not ongoing custodial care. Long-term care insurance, VA benefits, and state Medicaid waiver programs often help pay for personal care at home.
How to choose
- Decide between an agency (screened, insured, backup coverage) and hiring privately (cheaper, but you become the employer).
- Ask how caregivers are matched and what happens when one calls out sick.
- Get a written care plan and ask how often it's reviewed by a supervisor.
- Verify licensing — in California, home care agencies are licensed through CDSS and caregivers are registered.
Questions to ask on a tour
- 1.Are caregivers employees of the agency, and are they bonded and insured?
- 2.How do you match a caregiver to my parent, and can we request a change?
- 3.What is the minimum shift length, and how much notice do you need to change hours?
- 4.Who supervises the caregiver, and how often does a nurse or manager check in?
- 5.What happens if the regular caregiver is unavailable?