Aging parents are often reluctant to leave the comfort of their homes to enter a care facility — despite their growing need for assistance. Fortunately, there are in-home resources available. PBS offers advice (“How to hire in-home help when your aging parents don’t want to move,” November 2014) for those looking for in-home care.


  1. There are two main types of in-home care available to you: home health care services and in-home care services. Home health care services provide medical services, such as nursing services and physical therapy. In-home care services include assistance with day-to-day activities, such as bathing or preparing meals. 

  2. Using an agency to hire a caregiver can be more convenient, as they handle recruitment, taxes, sending a substitute when the caregiver is sick, etc. The downside may be the added expense. Additionally, you may not get the same caregiver each time and you’ll have less choice in the caregiver you get. Hiring an individual directly is usually less expensive and you will have more control in choosing the right person. However, you’ll also be responsible for paperwork and finding a replacement caregiver if that individual is sick. Individual care is also less likely to be covered by Medicaid or private insurance.

  3. When preparing to hire a caregiver, use a checklist to determine what kind of help is needed. Consider all kinds of care: personal (e.g.,  bathing etc.), household (e.g.,. cooking), health, emotional (companionship, conversation) and transportation assistance (does the worker have a valid driver’s license?).


Cost is a major consideration when considering elder care for a loved one. TIAA-CREF breaks down the cost of various services and provides guidance for how to protect your nest egg.


  • Medicare Part A covers intermittent or part-time care that is necessary and provided by a skilled nurse working for a Medicare-certified HHA. Medicare Part B, meanwhile, covers in-home healthcare but only if it is necessary for diagnosing or treating a medical condition and meets the accepted medical standards. You can find out more about what is covered on medicare.gov.


  • Long-term care insurance is another way to protect your savings from rising healthcare costs. Make sure you know what your policy covers. Most policies are limited by a maximum benefit amount.


  • If you don’t have the funds to pay for in-home care, Medicaid may be able to help, although rules differ state to state. You can only receive Medicaid if you have spent down your available resources, so it may be worth converting your savings into lifetime income streams (such as annuities) or into an exempt asset, such as your home. For advice tailored to your unique circumstances, talk to a financial advisor at least five years before you expect to apply for Medicaid long-term nursing care benefits.


Have you helped an aging parent find an in-home caregiver? Share with us!