​​Making decisions about the care and wellbeing of a loved one can be emotionally, financially, and logistically challenging. As family members age or face medical issues, you may consider hiring an in-home care provider to help them around the home. But how do you know if this is the right decision for your loved one? Let's walk through some important factors to consider.

The signs and signals a loved one may need extra help at home

In some families, there is an inciting incident that prompts a conversation about in-home care; but in other cases, the need for extra help may come on more gradually. Here are some scenarios where hiring a professional in-home care provider may be helpful.

• Overall health/medical challenges: If a loved one has a condition that requires a complex medication regimen or frequent monitoring, having someone to help manage this can be beneficial. And if there’s a new diagnosis of dementia, Alzheimer's, or another medical condition, this may be a cue to explore in-home care options.   
• Cognitive decline: Even if there hasn’t been an official diagnosis, signs of memory loss could signal a future need for in-home care. If a loved one has forgotten to turn the oven off many times or has been regularly losing track of their belongings, you may want to consider a professional caregiver.
• Increased risk/incidence of accidents and falls: While one minor accident may not be cause for concern, if your loved one’s had multiple or significant falls, you may want to hire a care provider to help them avoid hazards and be able to provide quick support if an accident occurs. 
• Decreased mobility: When a loved one has trouble getting around their home or running basic errands to the grocery store or pharmacy, an in-home care provider can enhance their mobility and help them get to doctor’s appointments, stores, and meetups with friends. 
• Decline in personal hygiene: If you notice a loved one isn’t taking care of themselves like they used to, they may benefit from an in-home care provider who can help them bathe, get dressed, and handle other hygiene tasks. 
• Social Isolation: A lack of socialization or companionship can have a big impact on your loved one’s wellbeing. If you notice your family member isn’t getting out as much or seems to be showing increased signs of loneliness, an in-home care provider can both act as a companion and encourage/transport a loved one to engage in social activities.

How much assistance you or your family can realistically offer

Once you’ve identified that your loved one needs some type of in-home assistance, your first instinct may be to take on the care yourself. While your intentions are good, it’s important to be realistic about the level of care your loved one requires and what you and your family are capable of committing to. You want your loved one to be well cared for without overburdening yourself or another relative. Consider your:

• Distance from loved-one: If you live an hour or more drive away, it might not make sense to try to provide daily care yourself. And if you live in another state, it likely isn’t possible at all. 
• Other responsibilities: It can be difficult to juggle caregiving alongside other responsibilities like a full-time job or childcare. If your loved one needs even just 2-3 hours of care every day, this can be difficult to fit into a busy schedule.
• Emotional toll/burnout: Providing care is a hard job for anyone, but it can be made even more difficult when you’re taking on this role for a loved one for the first time. Caregiver burnout is real: 40-70% of family caregivers report clinical symptoms of depression while 23% report that caregiving has negatively impacted their physical health. You can’t take care of someone else unless you take care of yourself first. 
• Maintaining a good relationship: When an adult child provides care for their parent, this swapping of roles can cause tension. In some cases, it may be better for your relationship to focus on being a loved one, instead of their primary caregiver. 

The level and type of care that fits loved one’s specific needs 

If you determine that you should hire an outside professional in-home care provider, you’ll need to consider your loved one’s specific needs when determining what type of professional is best suited to assist them. Before you begin to seek a caregiver, you’ll need to identify what your loved one needs help with, how often they need support, and what specific skills a person should have to provide that care. Based on the level of care required, you can narrow down which type of provider is the best fit. 

If your loved one mainly needs help with activities of daily living (ADLs) like bathing, dressing, and meal preparation, a home care aide might be sufficient. These providers focus on non-medical tasks, can often provide transportation, and may also be a good source of companionship.

If medical care is needed, a home health aide or licensed nurse may be a better fit. These professionals can help with administering medications, monitoring vital signs, and managing chronic conditions.

Some families opt for a blended approach, hiring different types of care providers to meet a range of needs, while others may bring in just one type of care provider on a part-time basis or utilize an adult day care service to provide opportunities for socializing.

The financial implications of hiring a professional in-home care provider

Of course, hiring any type of caregiver comes with its costs. In 2021, the national average for in-home care was estimated at around $5,000 per month. But how much your family will need to spend depends on the level of care your loved one needs and how much time a caregiver will spend with them. Here are some questions you’ll want to ask yourself: 

• Is in-home care the most affordable option? It’s a good idea to compare the cost of an in-home provider to residential facilities that offer different levels of care. Factor in costs for housing, meals, and transit, as well as how many hours a day that care is needed to determine what the best option is for your family. 
• What will insurance cover? If your loved one has long-term care insurance, paying a  caregiver is a great use for these funds. Medicare will cover part-time or “intermittent” care, but won’t pay for ongoing care needs. 
• Should I hire a provider directly or use an agency? When you hire an in-home care provider directly, there are a number of laws and regulations that govern what’s required of an employer – things like payroll and recordkeeping, proper tax withholding and filing, and more. Though it can be more expensive, working with a home care agency to place an in-home care provider with your loved one means that the agency takes on these responsibilities and liabilities. 

Safeguards to help protect your loved one in someone else’s care

Bringing someone into your loved one’s home can elicit some safety concerns – both for the wellbeing of your relative and for their finances. Before you sign a contract with a provider, make sure you run a background check on the individual or ask an agency to share the information they’ve collected. Recommendations from other clients and references can also provide peace of mind about the level of care and compassion someone will provide.

It’s also important to establish clear expectations of the caregiver’s role, tasks, hours, and communicate any special considerations, such as dietary restrictions or mobility challenges, before you finalize a contract with an in-home care provider.

If the caregiver will be making purchases on behalf of your loved one, you’ll want to find a way to enable them to buy things without handing over a credit card or large amounts of cash. Using True Link gives families a way to set rules on how money is spent, track daily spending habits, and ensure that a professional in-home care provider always has sufficient funds and is making appropriate purchases that fulfill their loved one’s needs. 

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Start off on the right foot if you decide to hire a professional in-home care provider

If you decide that hiring an in-home care provider is right for your family, here are some tips and best practices for an effective working relationship.