ACE Home Health & Hospice

10 Tips for More Affordable In-Home Care

by Steve Brooks, WeCare Home Assistants

According to a 2009 study by Genworth Financial, the median annual cost in the San Francisco Bay Area for in-home non-medical services is $52,624, based on 44 hours per week. The cost from a Medicare-certified (home health) agency would be $217,360 and the cost of a private room in a nursing home would be $102,018.

People are often alarmed about the cost of in-home services today and wonder how they can possibly afford it. There ARE alternatives out there to help. First, it pays to have an agency handle the caregiver employment, no matter what the source of payment. Whether it’s a two-hour shift or 24/7 live-in care, a full-service agency provides several advantages that you won’t get from hiring directly or a referral agency…for not that much more. For one thing, a full-service agency provides a pool of caregivers to select from because chemistry is so important in personal care, and there’s a ready back-up should a caregiver call in sick or need time off.

Then there’s the employment issue. As a responsible corporate citizen, a reputable agency won’t pay “under the table” and will contribute towards the employees’ federal and state taxes and Social Security. In order to retain the best employees and their families, the agency will also provide employee benefits like medical insurance and paid time off. Reputable agencies also provide Workers Compensation insurance so the client won’t have the financial risk should a caregiver get injured on the job, and bonding insurance to cover caregiver theft and fraud (which rarely happens when an agency performs criminal background checks on its employees). All this takes money, of course, and different agencies have their own way to compensate for it, so be sure to ask what the starting rates are, and whether the above features are in place.

Even though hiring a caregiving agency can be cheaper than placing someone into a nursing home, sometimes the money still isn’t available. Medicare doesn’t cover non-medical care and Long-Term Care insurance may not be in place, so what is a family to do in today’s economy? Here’s a list of solutions for you to consider:

1) Negotiate the rate. An agency can often find better ways to suit your budget. For instance, caregivers are sometimes willing to accept less pay which would translate into a lower fee.

2) Sometimes a cutback in hours can provide an almost-equal level of care. Avoid agencies that continually “suggest” that more hours are needed.

3) Talk to your doctor. Sometimes they know of less expensive resources for non-medical care.

4) Call your place of worship. The office sometimes knows volunteers willing to help seniors in the community.

5) Ask family and friends. Maybe someone is available for a couple hours a week to help out.

6) Visit your local senior center. Workers there can be a wealth of information on senior care.

7) Seek out government resources. Agencies like In-Home Support Services (IHSS) can provide funds to pay for, or at least supplement, non-medical caregiving services.

8) Seek out non-profit resources. For instance, Family Caregiver Alliance ( provides grants to those needing respite (family caregiver relief) care.

9) If medical care AND personal care is needed, have two different agencies handle the needs in order to save costs.

10) Consider the available assets. Some seniors have considerable equity in their home, for instance, and reverse mortgage have benefited many. Consult with your local banker to find out more.

In the end, though, a reliable and cheerful caregiver can be worth every penny.

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