Navigating the Costs of Professional Caregiving

Navigating the Costs of Professional Caregiving

There are 53 million family caregivers in the United States today, according to the National Alliance for Caregiving. Those caregivers put forth tremendous effort in every way – physically, mentally, and emotionally – to give their loved ones the care they need. And there’s a serious cost tied to that, with 45% of family caregivers saying their caregiving has a financial impact.1

Some of those costs might be very minimal, such as the price of a medical alert system with fall detection that can help keep a senior loved one safe. But there are other costs that are tough to navigate, from aging in place home modifications to helping your elderly parent out with their medication needs.

But the time might come when no matter how amazing a family caregiver is, a different level of care is needed to sustain the day-to-day needs of an elderly parent. This is especially true if that parent suffers a serious medical issue, such as a stroke or heart attack, or severe dementia.

The necessity of hiring a professional caregiver can be inevitable. And the costs of care can be a serious financial blow during the caregiving journey.

According to, the average cost of a professional caregiver ranges from $9 per hour to over $400 per day, depending upon your location, the level of services required, and the type of caregiver. Let’s break that down a bit so you can see where those numbers come from.2

Adult Daycare Centers

These safe places for your elderly parent focus on health care and social programs for adults who need caregiving during the day. This is a good idea if you can’t safely leave your parent alone in their home or when they can’t manage their daily activities on their own. Adult daycare centers provide social stimulation and interaction that can make your parent’s life much richer while giving you some time back into your day.

The cost: Between $40 and $100 per day, on average.

Home Health Care

These professional caregivers handle a wide range of services; their skills vary, from a personal care assistant who can provide housekeeping and cleaning services to a skilled nurse who can handle the most intense medical issues your parent might have. These individuals are often hired through an agency and might be certified or licensed. You might be able to hire one independently, but keep in mind that you will lose the protections of an agency if you do so.

The cost: Anywhere from $15 to $50 per hour or $150 to $350 per day, on average.

Assisted Living Care

This can include a wide variety of professional caregiving options, from an independent living community in which your parent has a medical clinic nearby and can reach out for help if necessary, to an assisted living facility where they are surrounded by nursing staff on a regular basis, to memory care facilities, where they are monitored around the clock. The level of care helps determine the cost.

The cost: An average of $4,000 per month for community-based care.

When Your Parent Hasn’t Saved Enough

If your elderly parent has saved a great deal of money for the purpose of their needs later in life or they had the foresight to purchase long-term care insurance, you can breathe a sigh of relief. Though these funds might not cover everything, they can certainly cover a large chunk of the professional caregiving costs.

But it’s common that these safety nets aren’t in place, and you could be scrambling to figure out how to pay for the care your senior parent needs.

According to a 2021 survey by AARP, almost eight in every 10 caregivers dig deep into their own pockets on a routine basis while caring for a loved one. In fact, the average contribution in a given year is $7,242. Keep in mind that’s an average; family caregivers tend to spend about 26% of their income on caring for others. About half of that money is going to household expenses, such as helping to pay the mortgage or paying for aging in place home modifications.

And at the same time, caregiving can cut into the income that a caregiver might make. About a third of the respondents in the AARP report dealt with work-related problems, such as having to take leave or change their schedule, with the result of about $10,525 in income lost during a given year.3

That sounds like a lot of money. So what are some options for family caregivers who are already giving so much of their financial help to their elderly parents and then are faced with the additional costs of hiring professional help?

Questions to Ask as You Seek Out Professional Care

Not sure where to start? That’s okay – moving into a new phase of care for your elderly parent can be daunting. Here are the questions you need to ask yourself as you embark on this new journey.

What supports does your senior loved one really need?

As you’ve seen from the short list above, the options for professional caregiving are quite varied. Maybe you need a few hours of respite care to recharge, or perhaps your parent needs someone to clean the house for them. Maybe they need someone to check on them a few times a day, including giving them medication and taking their vitals. Or perhaps they need someone watching over them all the time.

Think hard about what you really need. Then you can look at what you can afford and decide if you can move forward with that or if there are adjustments to be made.

Should you hire through an agency?

Hiring a professional caregiver through an agency offers numerous benefits. Though you will likely pay more than if you hired an independent contractor, you can be rest assured that there are protections you get through an agency that you can’t get on your own. For instance:

·        The agency can match you with a professional caregiver, and if that doesn’t work out, they can quickly match you with another one.

·        Agencies should have performed background and drug tests and other important vetting.

·        If you run into problems with the caregiver, there is someone there to help solve the problem.

·        You pay the agency, and they pay the caregiver. You don’t have to worry about tax forms or any other information that you might have to deal with when you hire someone independently.

·        If your professional caregiver must miss their hours, there is usually someone the agency can assign to take their place.

·        Agencies have strong protections against abuses and reporting systems in place if there is a serious problem.

When will you need in-home care assistance?

If it’s during the day, that’s the cheaper option. Hiring someone to handle evenings, weekends, or overnights is usually more expensive, whether you are hiring independently or working with an agency.

In some cases you might just need respite care – this is true if you can handle most of the caregiving on your own and simply need a break. But if you need something more than that, weigh the options carefully. For instance, overnights might be more expensive, but are you suffering from a serious lack of sleep and need your rest? In that case, the extra cash might be worth it to get better shut-eye. An affordable medical alert system with fall protection should be considered as well.

What additional services will you need?

What do you need a home health aide to handle? Really think about what would make life easier for everyone. If you need someone to free up your time by managing errands, housekeeping tasks, and even cooking occasionally, you can hire someone to handle those things. But if you have all that covered on your own and need someone to help provide for your parent’s medical needs, you might need to hire a certified nursing assistant or a registered nurse. 

An agency can come in very handy here, as you can talk to them about what you need and they can find the right kind of help. They can also assist you if needs change and help you pivot to someone who is more highly trained in medical issues.

What does Medicare cover?

Medicare covers any care related to medical needs; however, it doesn’t cover any non-medical care, which means assistance with the activities of daily living is not covered. In order to have a home health aide covered by Medicare, your parent must be homebound and prescribed the care by a doctor, something that is pretty rare to get.

What does Medicaid cover?

On the other hand, Medicaid does cover non-medical home care, so the assistance of a professional caregiver for day-to-day living falls under that umbrella. Known as Home and Community Based Services, this type of coverage through Medicaid can help you afford professional caregiving. The downside is that your parent must “spend down” to get Medicaid, and that might mean giving up the majority of their assets.

Are there options for veterans?

If your parent is a veteran, the Department of Veteran’s Affairs provides some coverage for home health assistance. What they qualify for depends upon many factors. You might find that the entire cost is covered or only a portion of it, or even that you might be reimbursed for certain home health care and products. Look into the policy to see what coverage is in force and what information you must provide to get the expenses covered.

What stop-gap measures can you can take?

While you’re trying to figure out how to afford professional caregiving, you can do several things to keep your parent safer and more secure. One of those is the use of medical alert technology. A personal emergency response system allows seniors to simply press a button when they need help, and a friendly voice at the monitoring center will be ready to assist them. They will talk to a real person, not a virtual assistant. That trained professional can assess the situation and get your parent the help they need. This provides incredible peace of mind that if you are away for a bit, the person you love is still protected.

You can also work to install aging in place solutions, including home modifications such as grab bars, non-skid flooring, and kitchen appliances and utensils that are easier to use. Bed rails can help them steady themselves as they get out of bed. A lift chair can get them on their feet without so much worry. And you could even look into walk-in tubs and showers that can make life easier and safer.

Can your parent downsize?

Sometimes the best way to pay for the appropriate care is to lower your other expenses, which might mean downsizing your parent’s home to afford the care they need. If their home is already paid off, that is a potential funding source that can help pay for long-term care. If you want to keep the home, a reverse mortgage might make sense.

And if you do choose to sell, remember that those home modifications you installed for your parent’s safety might help drive up the asking price of the property.

Some caregivers decide that it’s best to combine households. If you are thinking about selling your home to move in with your parents to be there around-the-clock, keep in mind the need to have something tucked away for your own retirement.

How much does location matter?

Where you live can have a significant bearing on how much professional caregiving will cost. For instance, the hourly rate for a home health aide in Alabama averages $18 per hour, while that same service will cost $28 per hour in California and $30.50 in Minnesota or Washington.4

The cost of assisted living facilities and memory care also has a broad range, depending upon where you live and the services you need – the difference in price can be significant even from one county to another. Shop around for the care your parent needs and if the prices locally are just too high, it might be worth considering making a move to another area of the country that is more wallet-friendly.

What other resources are available to you?

Now is the time to look into all the potential financial options. Does your parent have long-term care insurance? That’s definitely an option to pay for assisted living facilities and the like. A reverse mortgage might be an option, and you could also take out a home equity line of credit, or HELOC. Life insurance policies can sometimes be converted to cash to use for what the elderly need during their golden years.

You could also turn to other family members to help out. Though it’s hard to ask someone for financial assistance, keep in mind that as a family caregiver, you are likely paying for many things out of pocket, not working as much as you could (and thus earning less income), and devoting many unpaid hours to your parent. If you have siblings or other family members who can help out financially, now is the time. Broach the subject gently but firmly and be ready with hard numbers that show what is necessary to get the help your parent needs and deserves.

In the meantime, do your best to think ahead on ways to save money. One good way to do this is to approach healthcare in a proactive manner. Make sure your parent takes their medication on time, every time. Get them to regular doctor’s appointments and set them up with specialists if their needs demand it. Make sure they are safe in every way, from wearing seatbelts to having a senior life-saving alert system on them at all times, including when they are in the shower. The more you can avoid serious health problems, the more affordable care becomes.