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How can home health care help family caregivers?

Some older adults need in-home skilled nursing care, either temporarily (after being discharged from the hospital) or long-term, to manage an ongoing health condition.

Having a skilled nurse come to your parent’s home may help them age in place, rather than requiring them to move into a long-term care facility. Your parent may feel more comfortable in a familiar setting, which may have positive effects on their overall mood and interactions with people, including you.

If you live near your parent, you may get to spend more quality time together in your parent’s home. If you live a distance away, having in-home skilled nursing care may give you peace of mind that your parent is in good hands.

In-home skilled nursing services may help your parent stay in better health, and it may decrease the chances that they will need to be readmitted to the hospital after being discharged.

In most instances, home health care costs aren’t covered by insurance; you may have to pay out-of-pocket. Costs vary by location, but 

, Medicare may cover the cost of skilled nursing care for a limited number of hours over a short time frame – usually 3 weeks or less. (Someone may be eligible for this type of care after a hospital stay, for example.) Only people who are homebound who are under the care of a doctor may be eligible, if a doctor certifies that they need one or more services, such as:

 for older adults who are aging in place and who have a medical need for these services. However, Medicaid is only available for people who have a financial need. The rates that Medicaid pays for home health care services vary by state.

 may be able to get nursing and medical care services in their own homes if the VA determines that there’s a medical need for the services. There may be a copayment.

In-home skilled nursing services may be covered by a 

, but each plan may have different coverage. If your parent doesn’t already have a long-term-care plan, it’s too late to get one.

Home Health Care: What You Need to Know

Search online for your local Area Agency on Aging. The U.S. Administration on Aging’s 

 can help you find the name, number and website for the one in your area. You should be able to find the names of local home health agencies that offer in-home skilled nursing services through that agency.

 may help you find local home health agencies that offer in-home skilled nursing services that are Medicare-certified.

When you call individual home health agencies, ask questions like these to find the right fit for your parent’s needs:

Are you able to accept Medicare, Medicaid, or other types of insurance?

When do nurses visit? What happens if my parent needs help in the middle of the night?

Is it possible to request the same nurse at each visit if my parent likes someone in particular?

How often do nurses communicate with family members to give status updates or discuss problems?

How do I find home health care for my loved one?

Explore the ins and outs of home health care, including services, costs, and benefits, along with factors to consider when choosing the right provider. Our concise guide equips you with essential knowledge to confidently make informed decisions about your loved one's care.

Home Health Care Unveiled: A Comprehensive Guide for Families

Home Health Care

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50 million people worldwide are living with dementia, and this number is projected to triple by 2050. Dementia has physical, psychosocial, and economic impacts on not only those with the disease but also on their family members (i.e., family caregivers). There are 15.5 million family caregivers supporting people with dementia in the U.S., a sizable portion of the population.

One of those caregivers is Catherine who has been kind enough to share her caregiving journey with the Olera team as part of our Aging in America campaign. This campaign is our effort to recognize the struggles that family caregivers face while navigating the complex world of caregiving in America. Catherine told us a lot in her interview (watch below), and one key thing she mentioned was that, when caring for a loved one with dementia specifically, "there has to be a system before the crisis hits.” In the U.S., where the lion’s share of elder care falls to family members, her advice is important for other caregivers who often feel unprepared for a crisis like hospitalizations, rehab, or placement in assisted living, and arranging for the daily care needs a loved one requires in the home.

How to Create a Dementia Care Plan Before a Crisis Hits

In her interview, Catherine explained, “Now that my husband has dementia, it never leaves. It's a subconscious stress.” She described how the daily tasks of caregiving, like bathing, cooking, driving to appointments, keeping her husband active and social, and home maintenance, can all fall entirely on one person–the primary caregiver–with little or no backup. That’s why Catherine urges others to create a system for care (like a “care plan”) to help relieve caregiver stress, especially before crises like falls, infections, or advanced cognitive decline set in.

Catherine’s story underscores the importance of having a thoughtful and intentional “dementia care plan”, so we thought we would focus our article on that. If you're currently caring for someone with dementia like Catherine is, we want to help by writing about what a 

 could (and should, in our opinion) include. We thought we would break down components of a dementia care plan into four essential elements. Addressing these four elements early in the caregiving journey (or even before, as a young or middle-aged person looking ahead), familiarizing yourself with the American elder-care ecosystem, and coordinating with both family and professional support systems, can all reduce chaos during health declines, help prevent caregiver burnout, and improve the quality of life for both the person living with dementia and those caring for them.

Dementia is an umbrella term that describes a decline in mental ability that interferes with daily living. This may include difficulty with tasks like paying bills, driving, or remembering appointments, and eventually impacts physical functions such as walking, bathing, or cooking.

Alzheimer’s disease is the most common form of dementia, but others include vascular dementia (often caused by multiple strokes), Lewy body dementia, Frontotemporal dementia, and Parkinson ’s-related dementia. Regardless of the type of dementia, most forms of dementia eventually lead to the need for help with activities of daily living (ADLs) like cooking, feeding, bathing, dressing, paying bills, transportation to appointments, arranging activities, and supervision. As a first step in the dementia care plan, 

talk to your primary care provider about the type and stage of dementia. 

This is important as much for understanding the condition as it is in establishing care with a primary care provider who can be there with you throughout the various stages to help coordinate and understand the medical aspects of the disease.

Dementia often affects a person’s capacity to make decisions. That’s why it’s critical to establish legal documents early, including a power of attorney (POA) for health, finances, and legal affairs. In addition, a will (details your wishes for assets and executor of estate) and a living will (details your wishes for medical treatment if incapacitated) are critical to have documented. Talking with your loved one and other family members early on, ideally before advanced cognitive decline sets in, to designate a clear decision-maker for these things and working with a lawyer to officially document these wishes is important to avoid confusion if a crisis is to occur.

As Catherine said, there needs to be “a strong leader for the team.” That leader should have legal authority to make decisions on health or financial matters to avoid confusion and delays in emergencies.

Financial planning is equally important. Senior care in the U.S. is very expensive, and health insurance is confusing in what it does and doesn’t cover. Consider who will pay for in-home assistance (for bathing, cooking, cleaning), assisted living, or skilled nursing care, if those are supports that you are considering outside of family-provided care. Understand that:

Home care averages $30/hour (help with bathing, supervision, transport, and other ADLs)

Assisted living can cost $3,000–$5,000/month

Medicaid often covers skilled nursing, but only after assets are depleted and eligibility is met

Medicare most often only covers medical expenses like hospitalizations, prescriptions, and short stays in rehabilitation centers

These are rough but realistic estimates. Long-term care insurance, private pay, and Medicaid are the primary funding sources for home care, assisted living, nursing homes, and medical care (like doctor visits, rehab, or hospitalizations), but its confusing what you need, when, and how it is going to be paid for. Medicare and Medicaid do 

 cover all of these costs. They typically cover medical care and nursing homes, but not professional home care aids or assisted living for ADL support. Those costs are typically private pay. Keep this in mind when planning your finances for professional support and determining what needs will be supported by the family members. There are many resources online, including our senior care website (olera.care), which can help you better understand how to pay for senior care.

Once legal and financial planning is thought through, determine who will be responsible for:

Hire and coordinate in-home help or care services (to supplement family-provided care)

Provide transportation to medical appointments

Manage crisis response, hospitalizations, and rehabilitation center transitions

Having a “strong leader,” as Catherine mentioned, prevents delays during emergencies or transition periods as care needs increase.

4. Identify and Familiarize Yourself with Local Support Services

Before a crisis occurs, research your area's assisted living facilities, home care agencies, and skilled nursing centers. Learn:

What services are offered in your area, and what ADL or medical support they can provide

Their availability, cost (and modes of payment accepted; insurance or private pay), and acceptance policies

Whether they’re highly rated (through online reviews or personal referrals)

What are their caregiver skills and qualifications?

Transitions to higher levels of care (acute functional decline, post-hospitalization rehab, sudden need for assisted living, nursing home, or memory care) often happen suddenly like after a hospital discharge, where you have limited time to research facilities or providers, so being familiar with local facilities or agencies in your town can save time and stress if a sudden need emerges.

The 4 elements of a dementia care plan

A solid dementia care plan reduces chaos, improves patient and caregiver wellbeing, and ensures a more thoughtful response when needs escalate. As Catherine shared, “[Caregiving], is 24/7. What if I get sick? Who’s going to take care of us?”

Many caregivers share this fear but lack a dementia care plan. However, planning is so important to avoid surprises or being caught off-guard, and it isn’t pessimism to plan for the worst, but instead is 

 Setting up a solid dementia care plan now is how you can help answer Catherine’s  “what-if” questions ahead of time and be more prepared for the future.

We encourage you to use this four-part framework to start creating your family’s dementia care plan. Also, you can visit aginginamerica.com to share your story and how you approach dementia care planning with other American Caregivers. Our Aging in America campaign is committed to sharing real-life caregiver stories, insights, and tools. Together, we can navigate aging in America with compassion, wisdom, and humanity.

Lessons from Catherine’s Story:

 is a MD and co-founder of Olera.care. He writes about dementia, Alzheimer's, and other age-related conditions. He is a Texas A&M MD/MBA alum. Olera specializes in merging clinical practice with innovative solutions for the aging population.

Author Bio

Learn how to build a proactive dementia care plan before a crisis hits. Discover the 4 essential steps and watch how Catherine handled her caregiving journey.

How to Create a Dementia Care Plan Before a Crisis Hits in 2025

This article discusses the benefits of home health care for family caregivers and the costs associated with it.

Home health care can help older adults age in place and provide peace of mind for family members.

Home health care costs vary by location and may not be covered by insurance.

Medicare, Medicaid, and VA health care may cover some of the costs of home health care.

Article Summary

 for older adults who are aging in place and who have a medical need for these services. However, Medicaid is only available for people who have a financial need. The rates that Medicaid pay for home health care services vary by state.

 may be able to get nursing and medical care services in their own homes, if the VA determines that there’s a medical need for the services. There may be a copayment.

How much does home health care cost?

Are you able to accept Medicare, Medicaid or other types of insurance?

Is it possible to request the same nurse at each visit if my parent likes someone particular?

Explore the process of choosing the best home health services for your loved one with our concise guide. Learn essential factors and tips to ensure you make the right decision, providing personalized care and support in the comfort of home.

Home Health Care in Oncallhealthcareprofessionals.com, New Jersey

Talk to an advisor

Need help caring for an elder loved one? We've got you covered.

Important things to know about Home Health Care

How to Create a Dementia Care Plan Before a Crisis Hits

Home Health Services: Choosing the Right Care for Your Loved One