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    Home Care: What’s Essential And What’s A “Luxury” By Lance A. Slatton

    By Lance A. Slatton


    Caregiving is an important public health issue and impacts the quality of life of millions of individuals in the United States and across the globe. Caregivers provide critical care and assistance with another person’s social, personal, or health needs and are often unpaid family members or friends. In 2020, 41.8 million Americans provided unpaid care to an adult over the age of 50, accounting for nearly 17% of the United States adult population. Of these caregivers, 89% provided care for a relative or other loved one. 


    Financing home care can often represent a substantial burden, with many describing that the high cost of long-term care puts financial pressure on families and may even be completely unaffordable. It can be a tricky calculation if you try to provide care to an individual who needs assistance with many activities of daily living but has a limited budget. In fact, it may become necessary to categorize care into essentials and luxuries. What is crucial is to explore the finance options available to you and consider what you can reasonably afford to spend on paid home care. Then, using that information, you can determine where to splurge on paid care and where to limit expenses and have a family member provide unpaid care. In this article, I will cover areas of home care that can be taken on by family members/unpaid caregivers, while suggesting those critical areas where a professionally trained caregiver would be valuable. 


    The Essentials



    Paid home care is becoming an increasingly common alternative to staying in a hospital or residing in a care home due to the reduced costs and increased comfort. These services are typically provided by a licensed carer or nurse and can include help with everything ranging from preparing meals to administering prescribed medication. But what is essential when working on a tight budget? Below is a list of tasks for which paid home care should be considered:


    • Administering prescribed medication. This may involve promoting or reminding people to take their medicines, helping people remove medicines from packaging, and administering some or all of a person’s medicines. 
    • Health-related tasks. This may involve the use of medical devices and equipment, transportation, attendance at medical appointments, and negotiation with insurance carriers.


    Following this, if there is still room in the budget, you may also want to consider paid home care for such personal care as toileting, bathing, dressing, and getting out of bed in the morning/getting settled for the evening. 


    The Luxuries


    Once the essentials have been covered, you may want to consider paying for some “luxuries.” These are services that could be provided by family members/unpaid caregivers but are a ‘nice to have’ from paid caregivers if financing permits. These include: 


    • Providing comfort around the home. This could include providing comfortable and clean clothes, ensuring furniture is comfortable, removing barriers and obstacles, providing gentle lighting, and keeping the home environment clean.


    • Cooking meals. Eating habits can substantially influence health, particularly in vulnerable individuals. Therefore, cooking nutritious meals, and ensuring those being cared for eat regularly, is important.


    • Hygiene. Bathing may be required if providing care to an individual who struggles with activities of daily living, especially if they suffer from incontinence. However, frequent washing with soap can have the opposite effect and lead to rashes, dermatitis, and infection. Therefore, many people may perceive this caregiving responsibility as ‘an essential’ for a paid caregiver.


    • Mental stimulation. This can often be a time to engage in quality activities with the individual you are caring for and may involve doing crossword puzzles, playing a board game, or simply having a chat.


    • Physical activity. Although this can often be a challenge when looking after an individual who struggles with movement, physical activity goes hand in hand with mental stimulation and, if capable, it is important to encourage exercise to maintain and strengthen muscles.


    • Home safety. This may be seen as a simple task, but getting input from a paid home care provider or a healthcare professional on what is necessary to provide a safe environment is important. Home safety could be as simple as moving items to within reach, or arranging furniture to minimize obstacles.


    When considering the care of a loved one in the home, ideally all aspects of care should be provided with competence and loving support. However, given that so many cannot afford to hire licensed professional help in the home, family members and informal caregivers often take up the slack. What I’ve tried to do in this post is articulate those areas where having a paid and trained carer would be valuable, if you have the budget. “Splurging” on this care may seem unnecessary or out of reach, but when the health, safety, and comfort of your loved one depends on care at home, it’s valuable to understand when a trained professional would be considered essential and when such paid help is a luxury. Either way, the goal is to ensure the needs of your loved one are met as much as possible.


    Lance A. Slatton CSCM is a healthcare professional with over 18 years in the healthcare industry. Lance is a senior case manager at Enriched Life Home Care Services in Livonia, MI. He is also host of the podcast All Home Care Matters, a podcast and YouTube channel. By subscribing to All Home Care Matters, you will gain access to a wealth of information and tips that can help you provide the best possible home care for your loved one. Lance writes a monthly column on McKnight’s Home Care website and he was named a 50 under 50 for 2023. Lance can be reached at