Timing In-Home Care to Get the Maximum Benefit

by Kristen Heck, President, Loyal Care

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Reasons abound on why families postpone hiring private duty care for loved ones. Resistance to the idea is often a hurdle to overcome. In other situations, primary caregivers overwhelmed with caring for themselves, their families, and aging parents are simply too weary to begin searching for private duty care.

Timing In-Home Care to Maximize Benefits | credit: iStockPhoto.comStudies show that aging adults who are able to stay in their homes live longer and with a higher quality of life. At some point, though, some level of outside care could become necessary. Adult children typically answer the first call for help. Non-medical, in-home care professionals answer the second call as the level or frequency of care needed moves beyond a certain point.

The timing of when you hire a private duty care professional matters. “Having to make care arrangements during a crisis can be very difficult. It’s hard to make the best decisions in that circumstance,” says Nancy Kair, Loyal Care’s Services Manager. A situation Nancy often encounters is the need to downsize a home after a crisis, when a loved one is unable to participate in the packing and decision making on what to keep or who to give items to. “If our client is already dealing with a health crisis, this just adds to his or her stress,” she adds.

What is the Maximum In-Home Care Benefit?

Simply stated, it is the ability for your loved one to remain in the home for as long as possible.

If you or your loved one are considering private duty in-home care but don’t know how or when to start, Nancy suggests to establish a relationship with a caregiver sooner than later. That way, an established trusting relationship can easily segue into an increased level of care and service if or when that becomes necessary.

Set the Stage

If you lead a busy and stressful life right now, be realistic on what it will take to provide the best care for both yourself and your loved one as time goes on. The health of the caregiver is as important, if not more, than the health of the loved one.

Suggest early on to your loved one that there may come a time you’ll want some help with caregiving. Resistance to that idea is natural and should be expected. The sooner you talk about the possibility of hiring private duty care, the more time you’ll have to come to mutual agreement on what constitutes that care.

Getting Started with In-Home Care

Hiring private duty care to help your loved one downsize might be a way to get started. Your loved one pretty much directs the caregiver on what to pack, how to pack it, and where to put the boxes. AIso consider hiring companion care or personal assistance. These services can be fulfilled outside of the home through transportation for running errands or getting your loved one to and from meetings or visits with friends and family.

“Personal assistance and companion care are opportunities,” Nancy says, “for our clients and in-home care staff to build trusting relationships that may become more important as the client ages and needs more care.”

Related Reading

Getting Started with Professional Caregiver Services by Loyal Care

Caregiver Stress: How to Move Beyond the Burnout by Loyal Care

Why Choose In-Home Care? by Loyal Care

Loyal Care is a non-medical, in-home provider of private duty care located in Kalispell, MT. We serve individuals, including Medicaid-eligible, who need short-term, long-term, or long-distance home-based care.

For information about our home-based care services, please visit www.loyalcaremt.com.


Getting Started with Professional Caregiver Services

by Kristen Heck, President, Loyal Care

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You clearly understand the benefits of in-home care for an aging loved one, and you’d like to encourage that he or she give it a try. Yet, you anticipate resistance to the idea. How, then, do you approach the issue?

Suggesting a service outside of the home, such as rides to and from events, meetings, and errands may be a great starting point.

Aging in the home: a longer and more fulfilling life.For many people, putting up resistance is a common reaction to the prospect of change. Sometimes a great deal of comfort is derived from things just as they are. Face it, life can get complicated. Our strong urge at times to keep things uncomplicated (or unchanging) might be born out of a basic human need to simplify our lives. And as we age, our resistance to change seems to grow. Status quo, often, brings comfort and a sense of well-being.

Considering, then, the comfort and well-being a home can provide, the results from a 2011 AARP study will come as no surprise:

“Nearly 90 percent of people over age 65 want to stay in their home for as long as possible, and 80 percent believe their current residence is where they will always live.”

Often for that to happen, primary care givers come to find they simply need a break from caring for a loved one, or that a loved one’s life will become more enjoyable through in-home care.

Preparing for the Conversation

First knowing why you might meet resistance at the suggestion of in-home care can be helpful. In its article Caring for the Elderly: Dealing with Resistance, United Methodist Homes suggest resistance to in-home care is based on pride, guilt, fear, anger, and denial. Knowing your loved as you do, you might be able to link one of those feelings to specific circumstances in your loved one’s life—a link that might form the basis of resisting in-home care.

Think it through. Empathizing with your loved one over these feelings might open up pathways of conversation that deepen your relationship, build trust, and open possibilities of using professional caregiver services.

Getting Started

Nancy Kair, Loyal Care’s Services Manager, suggests buying your loved one a gift certificate and propose he or she use it for a service that can be provided outside the home, such as rides to and from meetings, visits with friends, or running errands around town. Using these types of personal assistant or companion care services might at first be preferred over those provided within the home.

At Loyal Care, engaging any of their personal assistance or companion care services is only an agreement, not a long-term commitment. Clients pay for each service used, and they can increase or decrease the number of services used at any time. Nancy says this arrangement works very well, for the client maintains a feeling of control. “In fact,” she says, “we require a minimum of two hours of care, but that can be spread out over one week or one year.”

Making Personal Connections with Professional Caregivers

Nancy also suggests taking your loved one to the office of the in-home care service to meet staff members. She says, “Often first-time users of our services will want to visit our office to find out what we’re all about. Once they see our professional offices and meet our staff, they start to warm up to the idea of in-home care. The opportunity to make a personal connection on neutral ground really makes a difference.”

Does your loved one need a personal assistant or companion? Contact us! We’ll help you get started. Frequently we begin serving clients by taking them to and from meetings or to visits with friends and neighbors.

Related Reading

Caregiver Stress: How to Move Beyond the Burnout by Loyal Care
Why Choose In-Home Care? by Loyal Care
Caring for the elderly: Dealing with resistance by the Mayo Clinic Staff

Loyal Care is a non-medical, in-home provider of private duty care located in Kalispell, MT. We serve individuals, including Medicaid-eligible, who need short-term, long-term, or long-distance home-based care.

For information about our home-based care services, please visit www.loyalcaremt.com.

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Caregiver Stress–How to Move Beyond the Burnout

by Kristen Heck, President, Loyal Care

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You’ve heard that you can love others unconditionally only after you love yourself. The same notion is true for caregivers. You can care for others unconditionally only after you care for yourself.

The time and energy demands required to care for a loved one can be overwhelming. Adding dimension to that is the awkwardness in managing the role reversal of an adult child caring for parents. Over time caregiver burnout might ensue—physical, mental, and emotional exhaustion manifested by the chronic conditions of stress.

What compassion fatigue feels like.Compassion Fatigue

Perhaps you’ve noticed your compassion for caregiving has faded to going through the motions of care. The special attention you once paid to dignify the life experiences of your loved one has been replaced with a short temper.


And you can’t help yourself. You want to return to the level of care you know you’re capable of, but don’t know how, or when. It seems time is no longer on your side, just an all-consuming apathy you wish would vanish with one good night’s sleep.

It’s In the Tone of Voice

Bridget Wirth, an R.N. and Loyal Care’s Administrator, listens for signs of compassion fatigue when working with caregivers. “When I hear exasperation in a caregiver’s voice,” she says, “or a disrespectful tone, or tiredness in a response, it grieves me to hear that, because I know it’s not the person, only that the caregiver really, really needs a break.”

So often those that need and want care think they can arrange for that care themselves, and then manage it, too. “‘Oh, my daughter, she can help me,’ a client will explain to me,” Bridget says, “while the daughter is struck with panic, feeling she can’t do one more thing and desperately wants me to intervene.”

“Listen to your tone of voice,” Bridget advises stressed caregivers. “If you find that it has a sharpness and you want to move it back into kindness, realize you’ve got compassion fatigue, and  take that very seriously.” To do so, Bridget says you’ve got to take care of yourself.

Self-Care is First Mindset, and Then a Behavior

It takes a lot of mental energy to change a behavior, such as making time to care for yourself. “And with their mental energy already shot, caregivers desperate for physical, mental, and emotional relief don’t know where to start,” Bridget explains.

She suggests that once you realize you’re not in control of your emotions, it’s time to find ways to restore a compassionate environment. “Begin by changing attitudes about your caregiving schedule and behavior around caring for yourself,” she offers.

To get started on that attitude change, Bridget suggests caregivers envision actually caring for themselves in some way, large or small. Here are some scenarios to help you adopt a new mindset about caring for yourself.

  • Speak with someone you respect and trust. Ask for feedback on what action you might take to improve your situation. If it is something you can see yourself doing, act on it.
  • Make changes in your schedule.  Set aside small amounts of time to do something you love—something you know that will refresh you.
  • Examine your expectations while considering all of your resources—your own and those of your loved one. What is stressing your or your loved one’s mental, emotional, and physical energy most? What about your or your loved one’s financial resources, what is stressing them most? What one small change can you make to relieve stress?

Take Action

By combining your resolve to care for yourself with specific actions to do so, over time you will adopt your new behavior for self-care. Asking others for help during this time will breathe fresh energy into your caregiving. Who can you turn to?

  • Family members, friends, and spiritual or religious advisors.
  • Community or church group leaders conducting workshops designed to help you make the most of your caregiving time and self care.
  • The staff at County healthcare services.
  • The staff at non-medical, in-home care services, such as Loyal Care.


“Taking care of yourself while caring for others is not an option,” says Bridget, “it’s a requirement, and it’s really the only way to maintain the compassionate environment you created at the onset of  your caregiving.”

Related Reading

What is Compassion Fatigue? by the Compassion Fatigue Awareness Project
Heart Disease and Caregiver Burnout by WebMD

Loyal Care is a non-medical, in-home provider of private duty care located in Kalispell, MT. We serve individuals, including Medicaid-eligible and Veterans, who need short-term, long-term, or long-distance home-based care.

For information about our home-based care services, please visit www.loyalcaremt.com.

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Home-Based Care Trends & Issues

by Kristen Heck, President, Loyal Care

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The home-based care industry is booming. Aging baby boomers, their adult children living an hour or more away, rising healthcare costs—they all affect the demand for home-based care and the quality and types of care available.


In-Home Care--Patterns, Trends, IssuesAn entire blog could be devoted to trends and issues in the home-based care industry. Its fast growth has the attention of individuals far beyond primary caregivers and those receiving or looking for care: regulators, entrepreneurs, public-policy makers, city and county social services, the Census Bureau and Department of Labor, advocacy organizations, digital health care developers, the list goes on.

With all this attention, the industry will change in many ways, with the primary objective of ensuring the safety and well-being of individuals who receive care.

In this post we present a few trends and issues we feel are basic to understanding where the industry is headed and what that means for you as a caregiver or recipient of care.


Eight thousand baby boomers turn 65 every day.[1] They will live longer than their parents. In fact, men turning 65 today are expected live an average of 17.4 more years; women an average of 20.3 more years. Today, 89 percent of the elderly want to be cared for at home for as long as possible.[2] That trend is expected to continue.

Adult children typically become primary caregivers, even when they have to travel long distances to provide care. And individuals who have cared for an aging parent often become professional caregivers or begin a home-based care career. Most caregivers are women, but men are increasingly becoming caregivers, too.

All this points to steady increases in demands for home-based care. It also means more people will enter the industry to provide care, oversee it, broaden services, advocate for legislation to protect individuals receiving care, adjust labor laws to reflect the needs of caregivers and the industry, and provide more ways to pay for long-term home-based care.

Financial Costs

Right now the cost of home-based care remains steady. Over the last six years, the U.S. average hourly rate for homemaker services increased two percent during that period; home-health aide services, one percent. In Montana for that same period the average hourly rate for both homemaker and home-health aide services increased five percent.

As demand continues to increase, so will costs. But home-care costs are expected to remain significantly lower than nursing home facilities. Currently it costs about $18,000 per year (for 20 hours a week of care) for home-based care compared to over $69,000 for nursing home care.[3]

Primary caregivers may find they have to dip into retirement savings or their children’s college funds to cover caregiving costs, or they may lose income because of too much time away from work caring for a loved one.

What all this means for you are more offerings of long-term care insurance as a way to pay for home-based care, possible changes in Medicare laws to remove restrictions for home-based care, and more financial education that will help families become better prepared to manage long-term care costs.

Medicare.gov provides a long-term planning tool that will help you determine costs of long-term care.

Non-Financial Costs

For primary caregivers, the biggest non-financial cost is stress. Finding balance among personal, family, work, social, and caregiving responsibilities is a tall order.

Siblings, spouses, and family members may bicker over time spent (or not) caring for their aging loved ones, or what level of care should be given.

Many primary caregivers live an hour or more from their aging parents. Time spent traveling to and from their parents’ homes and wondering how to best care for loved ones from afar adds even more stress.

In search of stress relief, primary caregivers will seek respite care as a way to gain a life balance. And to better manage care of loved ones from afar, primary caregivers will also seek long-distance care services as a way to gain peace of mind.

For more information on the non-financial costs of caring for a loved one, read our blog post: The Cost of Care: Making the Most of Your Home-Based Care Dollars


Some states require caregiver licensing and training, some don’t. Individuals may be inclined to hire caregivers working as independent contractors because their hourly rate is usually lower. These independent contractors may accept requests to work “under the table.”

Some of domino effects of all this are:

  1. an increasing number of elder-abuse cases
  2. individuals not realizing they have legally become an employer when hiring a caregiver directly (and not through an agency) and therefore responsible for caregiver screening, background checks, and payroll taxes.
  3. caregivers not paying into Social Security—a “forced” savings in a way—jeopardizing the amount of their Social Security benefits received upon retirement.

Compared to last year, the number of companies offering home-based care increased by 50 percent. Regulators and advocacy organizations are taking closer looks at how to legislate for senior and elder safety while they receive home-based care. That will likely include some regulation on caregiver screening and better enforcing home-based care laws that already exist.[4]


As you conduct your search for home-based care, ask caregivers or hiring agencies what trends and issues you need to know about and how they will affect your ability to either receive or give quality care.

[1] [2] [3] National Private Duty Association (NPDA), Private Duty Care Fact Sheet (PDF)
[4] Bloomberg Business Week, Home Care’s Booming, and So Is Regulation

Loyal Care is a non-medical, in-home provider of private duty care located in Kalispell, MT. We serve individuals, including Medicaid-eligible and Veterans, who need short-term, long-term, or long-distance home-based care.

For information about our home-based care services, please visit www.loyalcaremt.com.


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Why Choose In-Home Care?

November 15, 2011
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With in-home care services, you get to choose only the services you need, and when and how often you receive them. When appropriate, Medicaid and Medicare are encouraging individuals to use in-home personal care and in-home health services (also called Long-Term Support Services, or LTSS) rather than receiving comprehensive services offered by assisted living communities […]

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The Cost of Care: Making the Most of Your Home-Based Care Dollars

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A Short Overview of Long-Term Care (LTC) Insurance

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The U.S. Department of Health and Human Services provides comprehensive information on Long Term Care (LTC) insurance—the types of programs available and potential options on how you might pay for them. Here, we give you a quick overview on LTC insurance benefits. To help you get started on your search for Long-Term Care (LTC) insurance, […]

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