Understanding the Different Types of Elder Care

Elderly woman in nursing home

As people age, they may require some level of assistance or care to help with issues such as health problems, decreased mobility, or other age-related factors. Fortunately, a number of elder care options exist that can help senior citizens enjoy the best quality of life possible. Learn about the different types of elder care options available to you.

In-Home Options

Most senior citizens want to maintain their independence for as long as possible. Remaining in their homes is an important priority to many. A variety of care options can help seniors to remain at home.

Help Around the House

Some senior citizens have only minor needs, such as help around the house or yard. In these cases, it's possible to hire people to provide specific work around the house. Seniors can hire an array of household helpers, including:

  • Housekeepers
  • Yard workers
  • People to pay bills
  • Cooks

Keep in mind that there are a variety of financial factors to consider:

  • The cost of this help is typically an hourly rate.
  • It may only be a few hours a week, or it may be full time.
  • Health insurance will most likely not cover any of the cost for help.
  • Workers in this capacity may earn minimum wage or a few dollars per hour above this rate.
  • Seniors may also be able to find volunteer organizations that provide in-home help.

Hiring help around the house works best for senior citizens who are mostly independent but are just finding it more difficult to maintain certain tasks around the house. This type of care will not work for seniors with significant health or mobility issues, or for senior citizens with dementia.

Hiring household help can:

  • Keep the senior citizen independent for longer
  • Allow the senior to complete tasks he feels capable of doing while having someone else complete other tasks
  • Be fairly affordable

However, the drawbacks of in-home help include:

  • It is not a solution for senior citizens needing a great deal of additional help or healthcare.
  • There is potential for abuse.
  • No certifications are required, so careful screening is essential.


Some seniors may require companionship. Seniors may need companions for an array of reasons, such as they have no relatives living nearby, or they need help completing tasks such as going to doctors' appointments and grocery shopping. Companions are typically with senior citizens during the day, although some also live with the senior citizen to provide assistance at night. If a companion is required to provide medical assistance such as helping administer medications, then she should have some type of a nursing credential such as CNA. Otherwise, companions don't necessarily need credentials to work with the senior.

Tasks may include:

  • Companionship
  • Help around the house
  • Nighttime assistance
  • Transportation
  • Help caring for pets
  • Help paying bills
  • Help maintaining schedules

Financial factors to consider when hiring a companion include:

  • Companions may work part time or full time, depending on the needs of the senior.
  • Costs vary depending on hours, tasks, required skills, and area of the country.
  • Costs range from a few dollars above minimum wage per hour to $5 or more above minimum wage.
  • Credentialed professionals will cost more.
  • Health insurance most likely will not cover a portion of these costs.

This type of arrangement works best for a senior citizen with minimal care needs who just needs some additional help or companionship. It is not the right arrangement for a senior citizen with significant physical or mental health issues.

The pros of hiring a companion include:

  • Someone is there to monitor the senior for loneliness or depression.
  • Someone is available to drive seniors to appointments and other places.
  • The senior citizen can have help for tasks as needed.
  • Hiring a companion can make life easier for the senior citizen.

The cons of hiring a companion include:

  • There is potential for abuse if applicants are not carefully screened.
  • Compared to hiring for household help, it is fairly expensive.
  • Unless hiring a certified healthcare professional, a companion is not trained to administer any medical care.

Home Health Care

Seniors with medical conditions that can be managed at home may be able to opt for home health care. Many agencies offer screened and trained professionals to perform this type of work. Home health care worker tasks include:

  • Tracking and administering medication
  • Providing occupational or physical therapy
  • Monitoring health conditions
  • Assisting with activities of daily living
  • Providing meals
  • Skilled nursing tasks
  • Helping around the house

Because home health care requires specific medical certifications and skills, costs may be significant.

  • Costs vary depending on the level of care required and the licensing of the healthcare provider.
  • Some costs may be covered by Medicare, Medicaid, and supplemental insurance. For more information about who is eligible for Medicare Assistance, visit Medicare.gov.
  • According to LongTermCare.gov, the average cost of home health care in 2010 was $21 per hour.

This type of situation works best for seniors who have need for skilled nursing care due to medical conditions. It may not be appropriate for severely ill seniors, or those with dementia requiring round-the-clock monitoring and supervision.

Pros of home health care include:

  • Allows the senior some level of independent living.
  • Senior lives in comfortable and familiar surroundings away from more institutional settings.
  • A skilled healthcare provider is on-premises to help with health management and emergencies.

Cons of home health care include:

  • It is a reasonably expensive form of elder care.
  • There is potential for abuse.
  • It may require expensive medical equipment or machinery.
  • Health insurance may not pay for all costs, or the senior may not be eligible for health insurance payment of home health care.
  • Some seniors require a higher level of care than is available with home health care.

Hospice Care

Hospice care is end-of-life care that allows a terminally ill senior the ability to spend the last days of her life in comfortable and familiar surroundings. The goal of hospice care is to make the senior as comfortable as possible. Hospice care is available in the home around the clock. Hospice care includes:

  • Making the patient comfortable and administering medications to mitigate symptoms
  • Social workers, clergy, or counselors to help the senior citizen and family members prepare for the upcoming transition
  • Physical or occupational therapy, if necessary
  • Respite care
  • Skilled medical care

Hospice care is appropriate for senior citizens who are in the end stages of disease. It is not appropriate for seniors without a terminal illness.

Costs of hospice care are mostly covered by Medicare and Medicaid provided eligibility is established. Some minor fees may apply such as a per diem for respite care.

Pros of hospice care include:

  • Help in preparing the senior citizen to accept their coming death
  • Dignity for dying seniors and their families
  • Help minimizing symptoms and maintaining comfort
  • Highly skilled teams of professionals
  • Low cost to senior citizen

Cons of hospice care include:

  • Care is in-home and palliative in nature, not curative
  • May be emotionally difficult for families

Care Facilities

In some cases, elderly people may be in a situation where it is more appropriate to live in a care facility. Different levels of facility are available based on the needs of the senior citizen.

Independent Living Communities

These communities are either apartments or housing communities available for people 55 and older. No children are allowed in these communities. However, independent living communities offer the most independent type of life for older adults. Some services may be available such as:

  • Meal plans in a common dining room
  • Community activities
  • Available transportation for appointments and activities
  • Available household help (fee-based) for additional services

These types of communities are for seniors with few medical needs who are able to live independently. Costs typically mirror the cost of housing in the area, although meal plans will require an additional fee. These services are available but not required, and medical insurance does not cover them.

Pros of independent living communities include:

  • Fully independent living
  • Affordable
  • Available activities, transportation, and services

Cons of independent living communities include:

  • Do not provide medical care
  • Not covered by any insurance

Assisted Living

Assisted living facilities provide some medical care for seniors who do not yet require the full-time healthcare found in a skilled nursing facility. In an assisted living facility, seniors may receive help with things such as:

  • Administering medications
  • Maintaining medication schedules
  • Physical or occupational therapy
  • Licensed nursing services
  • Social activities
  • Full-service meals
  • Health monitoring
  • Transportation

Assisted living works well for seniors who have medical problems but can still live reasonably independently. It is not appropriate for people with critical illnesses, no mobility, or dementia.

The cost of assisted living is higher than independent retirement communities, but less expensive than a nursing home.

  • The cost of assisted living is about two to three times what rent on a one-bedroom apartment in the area might cost.
  • Some long-term care insurance may cover some of the costs of assisted living. Medicare and Medicaid do not.

Skilled Nursing Facilities

A skilled nursing facility, or nursing home, helps senior citizens who are unable to manage their care. In a nursing home, senior citizens will receive the following care:

  • Around the clock health monitoring
  • Medication monitoring and administration
  • Working with the doctors to coordinate medical care
  • Physical or occupational therapy
  • Emergency healthcare support
  • Meals and activities

Nursing facilities are appropriate for seniors who are not mobile, cannot care for themselves, are ill, or have dementia. They are not appropriate for seniors who can care for themselves or are able to live independently.

Costs of nursing facilities are quite expensive.

  • LongtermCare.gov notes a semi-private room in a skilled nursing facility cost an average of $205 per day in 2010, while a private room costs an average of $229 per day.
  • If the senior citizen is eligible, Medicare, Medicaid, and supplemental insurance will pay for some of the costs associated with skilled nursing facilities.

Pros of a skilled nursing facility include:

  • Care is available whenever the senior needs it
  • Many nursing homes focus on quality of life, offering activities and socialization.
  • Skilled caregivers are onsite 24/7.

Cons of a skilled nursing facility include:

  • The setting is institutional.
  • Privacy is limited.
  • The care is very expensive.
  • Not all seniors are eligible for skilled nursing facilities.

Choosing the Best Type of Care

It is an emotional decision when it comes time to choose care for elderly loved ones, but is often a necessary part of life. Making an informed decision can help keep the quality of life as high as possible.

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Understanding the Different Types of Elder Care