Home Care Vs. The Alternatives: How To Choose?

Many older Americans choose to move into some form of senior housing. But each year more and more choose to stay in their homes. It’s not a black-and-white choice, and whatever arrangement you choose, home care can dramatically expand your options.

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For many these days, the ideal approach to aging involves aging in place—staying in your home and taking the steps necessary to remain independent for as long as possible. Many are still choosing the better-known options: retirement communities, assisted living facilities, and other institutions designed to care for older people. But an increasing number of seniors are choosing to stay at home and get whatever help they need to remain there.

Aging at home comes with all the same challenges: Health and mobility issues present threats to independence wherever you live. But home care agencies—which provide all the services that come with an assisted living facility, but do so in the client’s own home—can enable a senior to remain at home throughout the aging process, and at a cost comparable to other options.

Because many seniors choose to age in place because of their emotional attachment to a particular home or community, home care can also give loved ones the reassurance that their family members are being well cared for without forcing seniors into an unfamiliar, and possibly distressing, environment—and home care can, if needed, keep seniors at home all the way through the end of life. What’s more, home care can also expand the range of options available to any senior, allowing them to choose to stay at home—or seek care outside of it—as best suits their situation.

Before we talk about choosing between home care and out-of-home care, we should probably talk about the types of care available to people looking for help as they age. Roughly speaking, they fall into two main categories: the types of care you can receive in your home, and the types you can only receive by leaving home.

In-Home Care

There are various kinds of help that someone can receive at home:

Home Care
Recovery Care
Respite Care
Home Health Care
Hospice and Palliative Care

Care Outside Of The Home:

Senior Living
Assisted Living
Respite Care
Concierge Care
Nursing Home

who qualifies for medicare


A Guide To Caring For Elderly Parents

Aging is a fact of life and it affects all families. As adult children, when imagining our parents as seniors, we may not fully comprehend the extent to which their aging will affect them or how it will affect us.  Indeed, if they are already seniors and still in good health and living independently we may not feel any dramatic changes or concerns.

However, the time does come when effects of aging become more evident and long-term care may be needed.

Father And Sons


An overall decline in physical and mental vitality may result in visible and even drastic changes to our parent’s appearance, the standard of life, and emotional well-being.  The more aware we are of how aging can affect them, and what options are available to them as seniors and us as caring adult children, the better for all involved.  Let’s take a moment to consider some essential things we should take into account regarding their welfare during aging and how in-home care can make all the difference



The well-being of our parents is our ultimate wish as they age and live out the last years of their lives.  Elder care means considering a family member’s emotional, mental and physical well-being.

Essentials necessary to the dignity and physical and emotional well-being of our elderly parents is to ensure their daily living requirements are met effectively.  The basic ADL activities are typically listed as:

  • Self-feeding
  • Functional Mobility
    (moving while performing activities, getting in and out of bed, in and out of a chair)
  • Dressing
  • Bathing or Showering
  • Personal Hygiene
    (includes brushing/styling hair, shaving, grooming activities)
  • Toilet Hygiene
    (includes getting to the toilet, self-cleaning, getting up from the toilet)

If they have impaired mobility and health issues that make it difficult or impossible for them to take care of these ADLs independently then you need to find them the appropriate help.  Whether it’s providing care (you or someone else who is qualified) or investing in the proper equipment and accessories to help them continue doing daily tasks independently, be aware that there are many choices and options available.


portrait of happy african family at home

Other types of daily living activities, not necessarily fundamental, but related to independent functioning are called instrumental activities of daily living (IADLs). IADLs most often refer to the following types of activities with long-term care:

  • Cooking and Preparing Meals
  • Cleaning and Maintaining the Home
  • Shopping and Buying Necessities
  • Running Errands
  • Managing Money and Paying Bills
  • Speaking or Communicating on the Phone or Through Other Devices
  • Taking Prescribed Medications

Again, it’s important to the overall well-being of elderly parents that their IADLs are taken care of effectively and consistently. If there are obstacles or difficulties with doing these tasks alone, there is help. Whether it’s you, other siblings, relatives or friends that help out, or even professional caregivers, arranging help is possible. Other sources of help include technological devices that can provide assistance or even various community services geared at helping seniors. Taking an honest look at where an elderly parent needs support is the first step and then assess at all the possible solutions in order get them the help they need.


Looking at how and where elderly parents of caring families live is critical to ensuring their well-being. Are they living alone? Do they live close to you, other siblings, or supportive relatives? Do they prefer to stay in their home or would they be open to moving into another more supportive location or living arrangement? These are all very important things to consider and discuss seriously with your elderly parents. Below we’ve listed the most common types of living arrangements available to seniors.

Aging At Home

Independent living and aging in their own home. This is the choice of most seniors and staying independent at home may require several adjustments to the home as well as getting home support from a family caregiver or professional caregivers.

Independent Living Communities

Suited best to active, independent seniors who rent or buy a home/apartments/mobile home in a community with other seniors. Amenities provided include gyms, clubhouse, yard maintenance, housekeeping and security in addition to transportation, laundry service, group meals and social activities. No medical support.

Assisted Living Communities

Seniors who are still relatively independent but may need some assistance and caregiving with their daily activities such as meals, dressing, bathing, help with medication and transportation. Rooms or apartment rental, group meals, and amenities such as social activities, exercise, laundry and housekeeping services.

Nursing Homes

Seniors who require a living environment with medical surveillance and caregiving but don’t need a hospital. (chronic conditions or for short-term rehabilitative care). Offers nursing staff on-duty 24 hours a day. Medicaid pays for care for 7 out of every 10 nursing home residents but Medicare generally does not pay for nursing home care.

Living With A Relative/Family

Seniors who need assistance with daily activities and some health care support (non-skilled) while having the companionship and care provided by living with a family member(s).


couple meeting for insurance

There are the financial impacts of making necessary changes and choices to support the well-being of our elderly parents. They may be eligible to receive additional financial support from government programs to offset their living expenses. Making sure that they take advantage of any programs they may be eligible is important. As well they may need assistance in managing their finances and retirement funds and you may need to take a more active role in assisting them so they are financially secure during their senior years.

If you are a caregiver, you may also be eligible to get tax relief by claiming an elderly parent as a dependent or deducting medical expenses. You can also make sure that elderly parents get help during tax season from various federal, state or independent groups that provide free tax assistance to seniors.

There are many groups and organizations, independent and government funded that assist and help seniors. Educating yourself means helping your elderly parents get the best support and assistance available.

You are not alone. There are so many groups and organizations, independent and government funded that assist and help seniors. Educating yourself means helping your elderly parents get the best support and assistance available. Here are a few great resources geared at helping seniors:

Government Benefits is a great website to check out. It’s the official benefits website of the U.S. government. Going straight to the source, here you can find out information on over 1,000 benefit and assistance programs covering health, disability, income, wealth (as in property owned), whether a military veteran, education level and more.

Area Agency On Aging

Area Agency on Aging is a federally mandated agency in your county or city. Staffed by professionals they know every senior program and service, including available funding sources, in your area. This is also a great starting point to gather information about programs that your elderly parent is eligible for and can use. Counselors are available to assist and even provide the necessary documents and forms to apply for programs. It’s worth the time to book an appointment and speak with them directly.

Benefits Checkup (National Council on Aging) is the nation’s most comprehensive web-based service where you can search benefits and programs for seniors with limited income and resources from all 50 states and the District of Columbia.

You can find out which programs are available for:

  • Prescription drugs
  • In-home services
  • Transportation
  • Housing
  • Healthcare
  • Financial assistance
  • Legal aid
  • Energy/utility assistance
  • Nutrition (including Supplemental Nutrition Assistance (SNAP)/Food Stamps)

Ultimately, we all take on some type of caregiver role with elderly parents, even if we don’t live with them or provide daily care. As mom or dad, they once concerned themselves and devoted their time and energy to our well-being. Now, as adult children, we find ourselves doing the same for them. No matter how you look at it caring for elderly parents means making sure they are safe, happy and taken care of. If their well-being is ensured then we have peace of mind.

Something to remember is that caring for elderly parents shouldn’t be a burden or responsibility to bear alone. Caregiver support is available. In addition to siblings and other family members, there are experts, professionals, resources, and loads of information to help you in caring for elderly parents. There are many choices and options available to allow them to age well and happily.

Finding the right mix for their welfare and happiness takes some time and is a dynamic condition that will change over time, perhaps even day to day. Don’t worry or stress out. Remember, you are not alone. Staying informed, considering their happiness and comfort and making use of as many supportive resources possible, is the best approach when caring for elderly parents.


A Guide to Caring for Elderly Parents


Tips On Fall Proofing Your Home

Reducing the risk of falls and accidents is one important way to help minimize the risk of senior hospitalization.

According to the Center for Disease Control (CDC):

1 out of every 3 adults age 65 and older falls each year.

Falls are also the leading cause of injury-related death in older adults, as well as the most common cause of nonfatal injuries and hospital admissions for trauma.

Falls are also one of the leading causes of readmission after adults are discharged from the hospital or a rehabilitation facility.

Tips on Fall Proofing your Home:

Living Room:

Walk only in well-lit rooms and always turn on the lights.

Remove boxes, newspapers and all clutter from pathways.

Install motion or sound activated lights.

Secure loose area rugs with a rubber, slip resistant backing.

Arrange furniture so that you have a clear pathway between rooms.


Keep stairs clear of packages, boxes or clutter.

Provide enough light to clearly see each stair.

Remove all throw rugs.

Secure area rugs near the bottom and tip of stairs with a rubber, slip-resistant backing.


Place a lamp, telephone and flashlight near your bed.

Sleep on a bed that is easy to get in and out of.

Install a nightlight along the route between your bedroom and the bathroom.

Replace satin sheets and comforters with non-slip fabrics such as flannel.


Place a slip-resistant rug or rubber mat adjacent to the bathtub.

Place a rubber mat inside the tub.

Replace glass shower enclosures with non-shattering material.

Keep a nightlight on in the shower.

Install grab bars on the shower walls.


Clean up any food, grease or liquids spilled on the floor.

Store food, dishes and cooking equipment within easy reach.

Do not stand on chairs to reach upper cabinets.


Keep the path between your driveway and the front door, as well as the pathway between the mailbox and your front door well-lit and clear of debris.

Install motion-detector lights so they turn on automatically when you step outside at night.

During the winter months keep salt and shovel near the front door.


Avoid wearing high heels.

Tie your shoes laces and never walk in bare socks.

Wear properly fitting shoes with rubber, non-skid soles.

How Can I Prevent Broken Bones if I Fall?

Sometimes you cannot prevent a fall. If you do fall, you can try to prevent breaking a bone. Try to fall forwards or backwards (on your buttocks), because if you fall to the side you may break your hip. You can also use your hands or grab things around you to break a fall. Some people wear extra clothes to pad their hips or use special hip pads.

How Can I Keep My Bones Healthy?

Some ways to protect your bones are:

Get enough calcium and vitamin D each day.

Walk, climb stairs, lift weights, or dance each day.

Talk with your doctor about having a bone mineral density (BMD) test.

Talk with your doctor about taking medicine to make your bones stronger.

What to do if you fall?

Do not PANIC!

Take several deep breaths, assess the situation and determine if you are hurt

If you are badly injured, do not try to get up. Call for help!


Infection Control: Beyond Hand Washing and Flu Shots

At most health systems, infectious disease specialists play a leadership role in infection control and prevention, promote hand hygiene, advocate for staffwide vaccinations, oversee equipment sterilization and conduct infection surveillance. All these measures are important in reducing health care-associated infections and the spread of infectious diseases. But hospital administrators who think the value of infectious disease expertise ends there are missing out on a significant opportunity; they also risk losing their institution’s money and reputation.

HAIs annually cause nearly 100,000 deaths and cost the health care system nearly $6.5 billion, according to the Centers for Disease Control and Prevention. While standard IC&P programs can help to reduce the incidence of HAIs, many health systems are not maximizing the full potential of their IC&P teams. Led, ideally, by infectious disease physicians who have the requisite training and expertise, IC&P teams can provide guidance in a wide variety of tasks — from consulting on equipment purchases to preparing emergency departments for outbreaks — to avoid or reduce devastating and costly infection-related problems.

Value-based Purchasing

Health system leaders are well aware that the Centers for Medicare & Medicaid Services is focused on reducing HAIs and that it now holds them to several HAI-related performance measures. Reimbursement is tied to HAI rates via the value-based purchasing system. Those who fall into the lowest quartile, based on HAI rates, are penalized. The best way to avoid that quartile isn’t always clear: It requires more than surveillance and a few standard interventions.

Infectious disease physicians can assess which interventions are working — and which are consuming valuable resources without much impact. Their expertise enables them to identify where the hospital is vulnerable, prioritize improvement practices and implement those practices.

Hospitals can be penalized if they have too many central line-associated blood stream infections and Clostridium difficile infections. Knowing this, vendors are pushing myriad commercial products and procedures alleged to address these problems, from new dressings for CLABSI to ultraviolet light for C. difficile. Efficacy varies, and whether they would be beneficial in your health system depends on a number of factors. Infectious disease physicians can evaluate the data to determine which products will help your facility, and then design an effective implementation. Without input from a specialist, you risk purchasing products that waste funds.

Preparing for New Construction

When there’s new construction, it’s a smart tactic to involve infectious disease physicians long before the ribbon-cutting ceremony. In fact, these physicians should be included at every step, from blueprints to the finishing touches. They can prevent many problems from arising because of construction: They can assess if the planned method of air handling is appropriate and whether the materials and equipment are disinfectable, for example, and they can ensure that construction dust is contained so as not to harm vulnerable patients.

An infectious disease physician can assess relevant questions. If procedures are going to be performed in the new building, are there plans for dedicated equipment disinfection and enough sinks to ensure proper hand hygiene? What is the plan for safe waste disposal? Are there clean as well as dirty sinks, and is there enough space between them? Is there room for a biohazard trash can? These types of oversights are surprisingly common, and rectifying them after the fact can be difficult and costly.

Planning for Outbreaks

No one envies Texas Health Presbyterian Dallas Hospital, which had to contend with the first case of Ebola identified in the United States. But next time, it could be your hospital facing an outbreak, whether Ebola, Middle East Respiratory Syndrome, H1N1 influenza, severe acute respiratory syndrome, measles or some as-yet-unknown infection. Your facility must have a plan to manage such an outbreak, and that plan needs to be developed by a multidisciplinary team led by an infectious disease physician.

Such physicians help to plan protective mechanisms that work for your specific facility. These mechanisms may include contact precautions, patient screening, isolation measures and other responses to protect employees, patients and the public. As the Ebola experience demonstrated, many employees felt unprepared and frightened to care for a possibly infected patient. Research shows that employees who are trained in using IC&P equipment are less fearful and more confident in their ability to safely care for these patients. Infectious disease physicians can enact proven protective mechanisms and train employees so they feel protected while providing needed care.

On a related note, health care workers can be exposed to biohazardous material in providing routine patient care. Infectious disease physicians have the best expertise to address this not uncommon problem. Blood-borne exposures put workers at risk for contracting infectious diseases such as hepatitis and HIV. Infectious disease specialists are experts in providing the best management, medications and methods of prophylaxis.

Dealing with Disasters

Many facilities will have to contend with a local emergency (whether a tornado, flood or simply burst pipes) that results in possible infection-related consequences, so it makes good sense to have an infectious disease physician involved in disaster planning.

Consider burst pipes. Response needs to be immediate, and there needs to be a quick resolution to a wide variety of problems — prioritizing patients to be routed to an unaffected location, closing units to be disinfected, and ensuring that wet walls are dried effectively or replaced to prevent mold, which could put vulnerable patients at risk. If you lose water, are your sterilizers going to work? Will you be able to appropriately manage plumbing issues as the leak is being addressed? Infectious disease experts can provide guidance.

Hospital executives might consider the following steps to better use their IC&P resources:

  • Contact your infectious disease specialist to discuss broader IC&P efforts. For more information about what these physicians do and how they can help your facility reduce the spread of infectious diseases, visit the Infectious Diseases Society of America website.
  • Familiarize yourself with CDC resources on HAIs, especially carbapenem-resistant Enterobacteriaceae: There was a recent outbreak related to endoscopes at several health care facilities in Los Angeles. Infectious disease specialists are keenly aware of this and other drug-resistant infections and will play a critical role in responding to an outbreak and guiding best practices for disinfection of equipment.
  • Become an IC&P champion yourself. It may sound simple, but leadership support and attention increases adherence to hand-hygiene protocols. Also, the CDC recommends certain vaccines for all health care workers for their protection as well as for the patients they treat. Hospital leaders should use infectious disease specialists to actively support and communicate the importance of vaccinations for staff members.

Infection disease physicians can have a positive influence throughout a health care system, yet their full potential remains untapped at many facilities. Forward-thinking leaders recognize the value of employing IC&P-dedicated physicians, often more than one, to decrease infections and increase safety. Infectious disease physicians help facilities to achieve safety; improve quality, care and outcomes; and avoid penalties in a cost-effective way.