When To Hire In-Home Help or Health Aides

Most people want to age in place and live at home for as long as possible. According to an AARP survey, three-quarters of people aged 50 and older hope to do so. However, managing this successfully often means hiring outside help, such as health aides who can assist with daily activities that have become challenging. You might wonder when exactly it makes sense to seek that service. How will you know when it’s time? What can aides do for you? What are the costs, and how can you make the most of their help?

Is It Time to Hire In-Home Help?

An easy way to know if it’s time for outside help is if your health takes a sudden turn for the worse perhaps as the result of a fall that affects your mobility. More often, the need for professional assistance at home isn’t so obvious. It develops gradually, as certain abilities such as cooking, cleaning, or driving become more difficult.

Even if you’re busy, happy, and able to do your own tasks and errands now, there may come a time when the balance shifts and daily activities become challenging. Dr. Suzanne Salamon, associate chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center, explains, “A lot of times these observations are made by family members or friends, and they start the discussion about getting help.”

Start Here: Ask Yourself Hard Questions

You don’t have to wait until family and friends urge you to get outside help. Dr. Salamon recommends that you periodically assess your abilities and how well you’re managing on your own. Consider the following questions:

  • Is it harder to get in and out of the bathtub because of muscle weakness or balance problems?
  • Has driving become difficult due to vision changes, arthritis, or other reasons?
  • Are you keeping up with your medication regimen, or are you sometimes unsure if you’ve taken your pills?
  • Are cooking and cleaning becoming much more of a chore than they used to be?
  • Do you find grocery shopping or errands overwhelming?
  • Do you need help bathing or getting dressed?

Be honest about your answers and let your needs guide you. “You might not need a home health aide yet. Maybe you only need a cleaning service to come in every other week,” Dr. Salamon says. “But if you need more assistance, it’s probably time to hire health aides.”

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What Do Health Aides Do?

Health aides are professional caregivers, and there are two main types:

Certified Nursing Assistant (CNA): This is a trained, licensed professional who can provide hands-on physical care, such as helping you get up and down from a chair or bed, bathing, dressing, feeding, brushing teeth, and using the bathroom. A CNA can also perform homemaker services, such as cooking, light housework, transportation, shopping, overseeing medication routines, or sharing meaningful activities or conversation.

Companion: This is a registered professional who can provide homemaker services but is not trained in body mechanics and cannot provide hands-on care.

    The best place to find aides is through a private duty care agency, which vets and employs the aides and takes care of their taxes and social security withholdings.

    How Can You Find a Reliable Private Duty Care Company?

    Dr. Salamon suggests asking for recommendations from friends, your doctor, local senior services, or your local Area Agency on Aging. Here are some questions to ask when evaluating a private duty care company:

    • How are aides screened and trained?
    • What are the costs, and what services are included?
    • How does the agency handle emergencies?
    • Can they provide references from other clients?
    • What is the process for addressing any issues or complaints?

    How Much Does Hiring Health Aides Cost?

    Private duty care is expensive. Costs average $25 to $30 per hour, typically with a three-to-four-hour minimum per week. These fees add up quickly. For example, if you need help two days per week for three hours per day, you’ll pay about $600 to $720 per month.

    Costs are not typically covered by Medicare, but they are often covered by Veterans benefits. They are sometimes covered fully or partially by long-term care insurance, state or local agencies on aging, or nonprofit groups.

    What Might Hold You Back from Getting Help You Need?

    Cost is a factor, of course. Even if it isn’t, you might not jump at the chance to hire home health aides. You might feel you don’t need them yet, or you’d be uncomfortable with strangers in your home.

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    But the sooner you can become accustomed to having professionals assist you with parts of your care as they become challenging, the better prepared you’ll be later when you might require much more assistance. Trying services now can set you up with contacts — and caring people — you might need to lean on more often as time goes by.

    How can you get over your reluctance? “Remember that you don’t have to commit to private duty care forever. Just try it for a few hours once a week. If it doesn’t go well, consider alternatives, such as eventually moving into assisted living,” Dr. Salamon says.

    How Far Can a Few Hours of In-Home Help Go?

    What can an aide accomplish if you start out with just a few hours per week? Plenty.

    You might want to set up a regular routine that includes doing laundry, changing bed linens, going on a walk with you, and making a large meal that can be frozen into smaller portions. Or you might want to focus on a theme for each once-a-week visit. For example, the aide can help you do errands one week, do some light house cleaning the next week, and help you cook the week after that.

    “This is your opportunity to get the help you need, whether it’s with jobs around the house or basic activities of daily living,” Dr. Salamon says. “In the long run, it’s the kind of service that will keep you living on your own longer.”

    The Benefits of In-Home Help

    Hiring in-home help can significantly improve the quality of life for those who wish to age in place. The benefits include:

    • Maintaining Independence: With the right assistance, you can continue to live independently in your home for a longer period.
    • Personalized Care: Health aides provide one-on-one care tailored to your specific needs and preferences.
    • Companionship: Regular visits from a health aide can reduce feelings of loneliness and isolation, providing emotional support and companionship.
    • Safety and Health Monitoring: Health aides can monitor your health and safety, helping to prevent accidents and ensuring that you follow your medication regimen.
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    Hiring in-home help or health aides can be a crucial step in maintaining your independence and quality of life as you age. By periodically assessing your needs and being honest about the challenges you face, you can determine the right time to seek outside assistance. Health aides offer a range of services that can help you with daily activities, ensuring that you can continue to live comfortably and safely in your home.

    While the costs of private duty care can be high, exploring various funding options and starting with a few hours of assistance each week can make the transition smoother. Embracing the support of health aides can ultimately enhance your well-being, providing you with the help you need to enjoy life to the fullest.

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