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After deciding to have your parents (or elderly relative) continue living in their home (as opposed to assisted living), you may have to choose between in-home-care options. Deciding between home care and caregivers for your loved ones’ needs merits the consideration of various factors.
Home care provides medical and non-medical assistance to the elderly in their home. In contrast, caregivers provide mainly non-medical home services. Home care services are offered by specialized agencies, whereas caregivers are usually directly employed by families.
Read on for more in-depth information on the key differences between home care and caregivers, how to choose the right option for you, and the pros and cons of each alternative.
Key Differences Between home care and caregivers
‘Home care‘ and ‘caregivers’ both refer to services for the elderly or people with special needs offered at their homes. However, these two terms have several differences.
The table below summarizes the primary differences between home care and caregivers:
| Type of Care for Seniors | home care | caregivers |
| Main Focus | Medical and non-medical care | Personal (non-medical) care |
| Services Included | Doctor-prescribed at-home medical services, like rehabilitative therapies, care for injuries, etc.,as well as non-medical services | Daily activities, like daily errands and chores |
| Personnel Training | Trained and licensed professionals (nurses, therapists, etc.) | No mandatory training |
| Personnel’s Employment | Through a home care agency | Directly by the family |
| Costs | Slightly higher | Slightly lower |
| Funding | Sometimes covered by insurance (for medical assistance) | More rarely covered by insurance |
Let’s discuss the above differences in more detail below.
Main Focus
The main focus of home care is providing medical or non-medical assistance to seniors at home through an agency. Their service is offered only by agency-employed, trained/specialized professionals. Medical assistance is usually referred to as home health care, though home care can also focus on non-medical services.
In contrast, caregivers usually provide only personal, non-medical assistance to seniors at home. They focus on helping the elderly with everyday activities and offer them company. There are cases where caregivers can be professionally qualified to provide medical services as well, though these are rare. These services are sometimes offered by relatives or people the family trusts — meaning these services may or may not be financially compensated.
Services Included
Home care and caregivers provide different kinds of services.
Home care services mainly concern doctors’ prescribed rehabilitative therapies, such as:
- Physical therapy or physiotherapy: This aims to relieve pain and strengthen muscles to help them function better.
- Respiratory therapy: This is for patients with pulmonary diseases.
- Occupational therapy: This helps older patients who experience cognitive or physical changes.
- Speech therapy: This is meant for patients with speaking difficulties due to brain damage or other causes.
- Health care social work: This assists the elderly with general health issues.
- Other specialized services offered by registered or licensed nurses, like care for injuries, conducting medical examinations, monitoring vital signs and keeping records of them, making injections, drawing blood, catheter care, etc.
In addition to the above, some home care agencies can provide even non-medical services similar to the ones offered by caregivers.
On the other hand, caregiver services include activities that usually don’t require licensing or formal training. These services include assistance with daily activities like:
- Preparing and serving meals
- Bathing, grooming, dressing
- House cleaning
- Laundry services
- Managing medication in accordance with the doctor’s prescription
- Companionship, etc.
Caregivers may perform some simpler, semi-professional services like monitoring heart rate, fever, glucose level, and blood pressure by using the prescribed appliances according to the instructions. However, they cannot perform any activities that require licensing or training. Should their ward have a medical emergency, it’s their responsibility to contact qualified medical professionals as soon as possible.
Personnel’s Training
The training requirements for the staff performing the services is another essential difference between home care and caregivers.
Home health care providers are licensed/registered health professionals. They can be:
- Physical therapists
- Respiratory therapists
- Occupational therapists
- Speech therapists
- Nurses
- Nursing assistants
- Social workers
Home care agencies are responsible for guaranteeing their staff is trained and certified in accordance with the legal requirements. Other non-medical services can be offered by home care staff without any licensing requirements.
On the other hand, caregivers are usually not required to be trained or licensed to perform their services. Instead, they usually handle activities related to daily errands and chores. Sometimes, caregivers can be relatives of the elderly being assisted. Do You Need a License to Take Care of an Elderly Parent?
Personnel’s Employment
If you decide home care is the best choice for your elderly parent or relative, you must contact one of the many home care agencies. The latter does all the HR work with regard to finding the people qualified to provide the specific medical care required. If you’re unhappy with a staff member, the agency may replace the care provider with another one. Of course, there has to be a good reason for the replacement since the process will involve a lot of paperwork.
On the other hand, if you decide to go with caregivers, you usually have to hire them directly by signing an employment contract, specifying the rights and duties of the parties, and managing the employee’s payroll. The contract must also specify who will be liable for what and to what extent so that everyone will be on the same page in the event things go wrong.
Costs
The cost of both options may vary depending on:
- Where the patient lives: If the patient lives in a high-end neighborhood, the price of the services will be higher due to the higher cost of living in the area.
- The agency/caregiver engaged: Different agencies will have different rates.
- The specific care services required: Some medical procedures are costlier than others.
- The amount of time the service providers will be offering the service daily: If the services are offered on an hourly basis, more time translates to higher costs.
- The equipment needed for the provision of services: Specialized equipment will warrant higher prices.
In general, the cost of home care tends to be higher than the cost of caregiver services, primarily because it involves medical services that require licensing and training. There are also additional services like recruiting and managing the payroll of the staff.
According to the Genworth Cost of Care Survey for 2021, the US national monthly median cost of homemaker services is $4,957. In contrast, the US national monthly median cost of home health aid is $5,148.
Funding
One of the main challenges the elderly and their families face when it comes to in-home help is finding funding for costly services. Generally, home care services that concern health-related assistance can be covered (partly or fully) by governmental or insurance policies.
Some federal government health insurance programs include:
- Medicare: Funds home care services to people who have contributed to Medicare.
- Medicaid: Provides critical health coverage for several categories of people.
In addition, all enrolled veterans are eligible to benefit from the government-funded VA Home Based Primary Care if they meet the requirements.
Other private insurance policies like long-term care insurance can also partly or fully cover medical services.
On the other hand, since caregivers usually don’t cover medical services, they’re less likely to be covered by insurance. In most cases, they are privately funded. However, there are exceptions. For instance, the In-Home Supportive Services (IHSS) Program, applicable to Californian residents, offers funding even for non-medical assistance.
Home Care vs. Caregivers: Which Should You Choose?
When choosing between home care and caregivers, the answer depends on the needs of your loved ones and the time and effort you can dedicate to finding assistance.
If your elderly parent has health issues that require daily professional monitoring, could pose a risk to their life if not dealt with immediately, or is recovering from surgery, home health care is the best option to choose.
You can choose home care, even for non-medical services, if you lack time to deal with interviewing, employing, and managing the payroll of a caregiver. Home care agencies handle the staff’s employment. However, this may cost you more than hiring a caregiver.
On the other hand, if your senior parent doesn’t have medical issues that pose a risk to their life or need everyday monitoring and is looking for companionship and help with everyday activities, you can hire a caregiver. The latter is usually more flexible concerning the work hours and (non-medical) services included.
Depending on the changing needs of your loved ones, you can switch from one service to the other.
Home Care vs. Caregivers: Pros and Cons
Home Care Pros
- Choice between medical or non-medical services
- Best choice for seniors who need constant medical care
- Home care agencies will be professionally liable regarding the health of their patient
- Home care agencies will deal with the employment and payment procedures for the staff
Home Care Cons
- Less flexible regarding the medical services they can provide, as they may be licensed only for specific medical treatments or therapies
- Less flexible regarding the minimum and maximum of hours for their staff, as you have to choose between the packages they offer
- Slightly more expensive
Caregivers Pros
- More flexible regarding the services they can provide, as they’re generally non-medical
- More flexible regarding the work hours, as they can be more easily altered according to their patient’s needs (as long as you include it in the employment contract)
- Best choice for seniors who need help with everyday activities and companionship
- Slightly less expensive
Caregivers Cons
- Not properly trained to provide medical care in cases of emergencies
- Interviewing, hiring, and managing of the caregiver’s payroll is managed by the family, which can be costly and time-consuming
- Usually don’t have professional liability insurance
Frequently Asked Questions
Can You Have Home Care and a Caregiver at the Same Time?
If you think your loved one needs in-home medical assistance and help with daily activities and companionship, you can hire a home health care agency and a caregiver. Alternatively, you can choose both medical and non-medical assistance from your home care agency.
However, both options would be costly, as insurance policies or other funding cannot fully cover them — especially since non-medical care (either by a caregiver or home care agency) is only sometimes covered.
Can Family Members Be Home Care Providers or Caregivers?
Many family members often help and assist their elderly relatives as caregivers. They help them with daily activities like cooking, feeding, bathing, grooming, offering company, etc. When provided by family members, this service can be paid or unpaid.
However, unless the family members are licensed nurses or other registered medical professionals, they cannot provide medical home care services to their relatives.
How Can a Family Member Become a Caregiver?
Family members of the elderly can choose to become their caregivers.
You have to:
- Be above 18 years of age.
- Live at the same residence or near the home of your senior family member.
- Be available for the time your family member needs help.
You can be eligible for free training, classes, programs, councils, and research projects for the services offered by the Aging and Disability Resource Center (ADRC) or other local agencies where you live.
How To Make a Home Conducive to In-Home Assistance
To make your senior family member’s home safe and friendly for in-home assistance:
- Do not over-furnishing the home, so there will be spaces for the elderly to move freely.
- If possible, replace sharp-edged furniture with round-edged ones.
- Use abundant lighting in all the living areas of the house.
- Use non-slip wax for the floors.
- Use home safety products like grab bars, bathroom grab bars, shower benches, bed canes, etc.
- Make sure your loved ones have access to walkers, tray tables, etc.
If you decide to contract a home care agency or caregiver, discuss which equipment they recommend or would best fit the needs of the elderly patient.
Final Thoughts
Both home care and caregivers offer assistance to the elderly in their homes. However, they differ in several ways.
Home care provides mostly medical care by licensed nurses, therapists, and social workers. It can also offer non-medical services. If you choose home care, you can contact one of the home care agencies which hire the staff and have professional liability insurance.
On the other hand, caregivers offer mostly non-medical assistance and usually don’t need licensing. They provide services like running daily errands and chores and offering companionship. Most of the time, they’re employed directly by the elders’ families.
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