How to Get Extra Care at Home When You Need It

Assistance with personal care, finances, errands, and more can help older people protect their independence and live at home longer. Here’s some advice about where to turn.

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When it comes to hiring help around the house for yourself or a family member, the first step is deciding it’s time.

Some people act early, setting up a support system before things start to slip, says Carolyn Clevenger, DNP, a gerontological nurse practitioner and professor at the Emory School of Nursing. Others wait until after a worrisome occurrence, like a fall while cleaning or getting lost during an errand. Families also sometimes take action if they see piles of unopened mail, moldy food, or dents in a car, says Amy Goyer, a family and caregiving expert for AARP and the author of “Juggling Life, Work, and Caregiving” (American Bar Association, 2015).

If you’re trying to convince a family member that assistance is necessary, emphasize that the goal is to protect their independence.

Types of Help Available

It can be difficult to figure out on your own exactly what kind of help is needed, Goyer says. Instead, start with some expert advice.

Reach out to your local Area Agency on Aging. It can connect you with home- and community-based services and may also be able set up an in-home assessment.

You can find a geriatric care manager via the Aging Life Care Association, who can help you make a long-term plan, says Camille Vaughan, MD, an associate professor of medicine and director of the Emory Center for Health in Aging.

More on Healthy Aging

A certified aging-in-place specialist (find one through the National Association of Home Builders) can recommend home renovations to make things safer or more comfortable.

Each person has distinct needs that require different kinds of help and expertise, Vaughan says. Here are some types of help you might consider.

Companionship: Sometimes a helper is needed to combat loneliness and get you out of the house more often.

Finances: You may want to have a family member or close friend handle tasks like finances and bill paying if those are falling through the cracks, Goyer says.

Medication management: To learn strategies for managing prescriptions, talk to your pharmacist or primary care provider. Vaughan suggests also considering an online system like PillPack, which will deliver meds to you already sorted by when you need to take them.

Other home help: An extra hand with cleaning, shopping for groceries and putting them away, meal prep, yardwork, and driving can also make a difference.

Personal care: Many people need help with bathing, toileting, or dressing.

Physical or occupational therapy: This is often recommended by a doctor to help you recover after surgery or a fall, and it’s done on a short-term basis. Check with Medicare or your insurer to see which providers are an option.

Finding and Paying for Help

There are two primary ways to find home help, Goyer says: either hiring people directly or going through an agency.

Many people rely on word-of-mouth recommendations from family, friends, or faith communities to hire someone directly. You can also check websites like Care.com to find caregivers in your area, Clevenger says, though you’ll be responsible for vetting them appropriately. You can often save money by hiring someone on your own. Just be very specific about how you want things done.

If you go through an agency (compare options at medicare.gov/care-compare), you might not get the same person every visit, but the agency should be able to provide coverage when your usual helper is sick. Agencies should also be able to offer a wide variety of services.

Most services aren’t fully covered by health insurance or Medicare, Vaughan says. Long-term-care insurance can help, as can Medicaid. Veterans Affairs also provides assistance for home care for those eligible for VA healthcare, she adds. And your local Area Agency on Aging may offer free or low-cost help with meals, cleaning, yardwork, and more.

Editor’s Note: This article also appeared in the December 2021 issue of Consumer Reports On Health. The name of the "Aging Life Care Association" has been corrected.


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Kevin Loria

I'm a science journalist who writes about health for Consumer Reports. I'm interested in finding the ways that people can transform their health for the better and in calling out the systems, companies, and policies that expose patients to unnecessary harm. As a dad, I spend most of my free time trying to keep up with a toddler, but I also enjoy exploring the outdoors whenever possible. Follow me on Twitter (@kevloria).