An older couple sit on a couch at home and smile to the camera while hugging.

As older adults age, some require extra assistance to be independent. These individuals may benefit from home care. Home care providers lend a hand with a wide array of needs, from activities of daily living and personal care to skilled nursing care and occupational, physical, and respiratory therapy. There are several forms of home care for seniors. Some are only available through a physician’s order, so it’s essential to understand each type’s costs, requirements, and benefits. We will cover the main types of home care that seniors can use as they age in place. 

Non-medical home care

Non-medical home care is also known as personal care and companionship, home health aide services, companion care, and assistive care. This home care comprises quite a few services, and caretakers can even move in with the resident to provide 24/7 care. Older adults and their families can find non-medical care assistants who will help with tasks like

  • Assistance with activities of daily living, such as dressing, bathing, grooming, and using the bathroom.
  • Promoting home safety by providing fall prevention and aiding ambulation or transferring (from bed to wheelchair, wheelchair to the bathroom, and more).
  • Shopping, meal planning, and preparation.
  • Housekeeping, errands, laundry, medication reminders, and driving to appointments.
  • Companionship, engaging in hobbies and activities.
  • Supervision for individuals with Alzheimer’s disease and other forms of dementia

Paying for non-medical home care

Older adults typically pay for non-medical home care out of pocket, through long-term care insurance, or Medicaid. Medicare also finds certain home health services eligible for coverage. Other funding options include

  • Health insurance (in some instances)
  • Veterans benefits
  • Workers’ compensation

How to arrange non-medical home care

A doctor does not need to prescribe some non-medical home care. Caregiving service organizations can be public agencies, for-profit companies, or nonprofit organizations. Some organizations will help older adults find a home provider based on the certifications, services, and hours they prefer. 

Private nursing care

Private nursing care, also called home-based skilled nursing, long-term nursing care, hourly nursing, or adult nursing, is designed for individuals with an injury, chronic illness, or disability. This type of home care focuses more on medical needs than personal needs. For example, private nursing care services might include care for: 

  • Ventilators
  • Feeding tubes
  • Catheters
  • Vital sign monitoring
  • Medication administration
  • Tracheostomy 
  • Ostomy/gastrostomy 
  • Diseases and conditions such as spinal cord injuries, traumatic brain injuries, amyotrophic lateral sclerosis, and multiple sclerosis

Paying for private nursing care

Private nursing care costs can be high. The Genworth Cost of Care Survey in 2022 found that the median hourly wage for an in-home health care professional was $27. On average, older adults need 44 hours a week of assistance, meaning the total weekly cost would be $1,188. Older adults and their families can pay for private nursing care in several ways:

  • Out-of-pocket (the person receiving care pays the caregiver directly)
  • Veterans benefits
  • Health insurance
  • Workers’ compensation
  • Medicaid (applicants must meet qualifications)

How to arrange private nursing care

Private nursing care can typically only be prescribed by a doctor if the individual uses Medicaid, Medicare, or private insurance. The physician may offer a recommendation, or an individual can hire a private nurse directly or through an agency. 

Home health care

Home health care is similar to private nursing care, but people often use it to recover from an illness or injury. Home health care is also known as intermittent skilled care or visiting nurse services. Home health care services may include

  • Short-term nursing services (IVs, catheters, surgical wound care)
  • Patient education
  • Injections
  • Physical therapy
  • Speech therapy
  • Occupational therapy
  • Nutrition therapy
  • Medical social services

Paying for home health care

Because specific requirements must be met for care (see the section below), Medicare or private insurance may at least partially cover short-term home health care services. 

How to arrange home health care

A doctor may require clinical assessments to prescribe home health care, which may require clinical evaluations to confirm that the person needs the care. Many insurances also require the agency to meet specific standards.