What you will learn by reading this is a complete understanding of what private home care is.   The goal of this paper is to inform you of your decisions and you options with home care.  It will make you knowledgeable on home care and how it works.  

  • What is Private Home Care?
  • The Who, What, Where About Caregivers
  • Hourly vs Live In Care
  • Costs of Private Home Care
  • Alternative Services to Private Home Care
  • Pros and Cons of Private Home Care
  • How To Choose A Private Home Care Agency

Read this whole paper then you can make a decision on what is right for you.  As you can tell there is a lot of information, so lets get right into it!

What Is Private Home Care?

Private home care is a service that provides both home health aides and nursing staff into a senior’s residence for a limited or indefinite amount of time to help a person with their activities of daily living (ADLs) and medical care.

Home Health Aides and CNAs – These are trained non-medical caregivers that can provide help with these ADLs.  They can provide the following:

  • Transportation (social events, doctor’s appointments, grocery shopping)

  • Fall prevention

  • Personal Care (bathroom, shower, clean up etc)

  • Laundry, changing linens, and folding clean clothing

  • Preparing meals and cleaning up meals

  • Chores/Errands with or without the senior (Grocery shopping, post office, social events)

  • Light house cleaning

  • Companionship

  • Medication reminders

  • Dementia care

  • Parkinson’s care

  • Heart failure care

  • Cancer care

Nurses are available to provide care that is more medical in nature.  They can do everything a home health aide can but additionally provide these common tasks:

  • Medication organization (For the week, two weeks, or month)

  • Wound care

  • In house check ups

  • Diabetes care

  • Injections

  • IV
  • Blood Pressure

  • Health assessments

Most families interested in private home care in the Concord area are in need of home health aides with nurses needed on an as needed basis.  Nurse are available hourly, but this comes at a higher cost per hour.



I can only explain what we do.  All companies are different.  Minute Women caregivers go through a hiring process.  They are screened with a background check, six reference checks, and an interview process.  They are trained at the beginning and during their career with Minute Women.  We have consistent drop ins from our nurses to make sure they are doing their job properly and providing the best possible care for our customers.

Most home health aides are female and people of color.  It is just the demographics of the people who apply to our jobs.  This becomes important because some older people do have prejudice and we need to know before we place a caregiver in a situation that will not work out.  

The caregivers should have liability insurance, general insurances, and be bonded.  This would be covered by the agency that you hire for the home care services.

Finally, you will have the opportunity to interview over the phone or in person with your caregiver.  This allows you to be in control of who comes into your home.  



Many new caregivers have had formal training, obtaining their certification to be a CHHA (certified home health aide).   Also available are CNA’s (certified nurses assistants) who have gone to school and been trained for their services.  At the beginning of a caregivers employment with a company they should be trained to the expectations of the company they are working for.

During their career, they should involved in continued education and refresher courses to ensure the caregiver is continued to be trained.  They will learn new techniques and proper ways of providing care to specific segments of people (heart disease, stroke etc.) and that way are specialized in the care they can provide.

When it comes to companionship there is not as much care giving training.  A companion is going to provide simple tasks, such as meal preparation, transportation, and companionship.



Note: The following example is a simplification of how home care companies find aides. Not all companies are the same.  Some aides are hired as quickly as possible, others take the time to interview, background check, reference check, and train their caregivers. 

I imagine at this point you have investigated other home care companies along with Minute Women.  To explain how scheduling works, imagine a large group pool of aides.  Each home care hires their aides in their own unique way as mention before.

As jobs come in, we call qualified aides that can fill those specific jobs.  Sometimes those aides get called from multiple home care companies with different jobs, different hours, in different locations.  When jobs end, those aides then go back into that large group pool and wait for another home care company to call with another job.

The reason I explain this is because of hourly care. Often people call up looking for one, two, or three hours of care per day. Most home care companies have a minimum of three or four hours of care at a time.

The reason for this minimum is the likelihood of caregivers being interested in a caregiving job drops when it is under four hours of care per day.  They are doing this for their livelihood so they are interested in cases with the most amount of hours.

This blocked time is usually separated into AM and PM time frames.  Jobs in the morning are before noon and after twelve with PM shifts.  When customers look for a 10am – 2pm shift, it takes up a caregivers AM and PM shift, thus making the job less desirable.

Many caregivers will take these jobs, but let us know they will leave this job if another caregiving case (either from us or another company) provides them more flexibility and more hours in their schedule.

This is not to say asking for an 11am – 1pm shift can not be filled, all home care companies will do their best to fill it.  I explain this so you know that it is harder to fill these jobs with one consistent caregiver.  The caregivers may change, and the pool of caregivers willing to take a case in blocks under four hours or during the middle of the day decreases.  Usually lower hour jobs need multiple caregivers to fill it.

Finally, know that over time laws do apply to hourly caregivers.  So if you are looking to receive more than forty hours of care per week, you should expect to have more than one caregiver unless you are willing to pay time and a half.


 Hourly vs. Live In Private Home Care 

Hourly case usually have a minimum of four hour blocks to twenty-four hours per day.  If someone needs around the clock hourly care, it is separated into two twelve hour shifts.

Once you have over 10-12 hours of care a day, it is worthwhile looking into live in care.  Live in care is when a caregiver lives in a private room in the home and is there twenty-four hours a day, sleeping through the night.  They can stay for weeks at a time, or five days in a row, with a new live in caregiver on the weekends.

The benefits of live in caregivers are that you have the same caregiver day in and day out.  They are there all the time to provide care.  There won’t be late excuses, emergencies, breakdowns, or other problems that come with commuting employees.  It is also a flat day rate instead of a hourly rate, which can be substantially less when comparing the two for twenty-four hours a day.

The only stipulation for live in care is that the caregiver must be able to get a solid night of rest.  They can get up once or twice in the middle of the night to help a senior, but they need to be able to sleep to do their job the next day.  They also need a private room with a tv, and they eat with the senior.  No private bathroom is needed.


Cost of Private Home Care

What everyone asks is ‘how much is this going to cost?’

The simple answer.  Hourly care will cost anywhere from $20 – $30 per hour.  Live-in rates range from $250 – $325 depending on the level of care that is needed and region of the country you live in.  The east coast, including Massachusetts, is on the high end.

If you are interested in finding more about costs of care, this is a great resource for you to look at. MetLife Cost of Care Survey.  This will inform you on the cost of home care, assisted living, nursing homes, and adult day care in your state and region of your state.


 Ways to Pay

 The three most common ways to pay for care are:

  • Out of Pocket (Check, credit card, cash)

  • Long Term Care Insurance

  • Veterans Aid and Attendance (if your loved one is a Veteran or the widow or spouse of one, click on the link)

Many people ask if Medicare, Medicaid, or private insurances can pay for home care.  The answer is more than likely no.  Certainly investigate, but almost all private home care companies will not accept insurance.  There is a possibility that you could be reimbursed by your insurance company, but you would need to investigate that yourself.

(Note: Medicare does pay for some, but not the kind we are talking about.  I will explain that next.)


Private Home Care vs Other Senior Care Options

This will explain how private care compliments other senior care options, like nursing homes, assisted living, medicare home care, and adult day.

In the last section I mentioned medicare home care (in Boston more commonly VNA – visiting nurse association)


VNA/Medicare Home Care

VNA and Medicare Home Care provide care when a doctor orders that a senior qualifies for it.  Medicare then pays for nurses, therapists, and home health aides to come to a senior’s home to help them get better.  What most people don’t realize is that these visits are not long.

Most VNA or Medicare home care companies will visit a senior from anywhere from 15 minutes to an hour, two to three times a week, on average.  Some get more, some get less.

When someone gets VNA/Medicare home care, it more than likely needs to be supplemented with private home care aides (and possibly nurses).  If someone is a fall risk, has dementia, recovering from stroke or heart attack or has a broken bone they will need more than three hours a week of help.

Private home care companies work with your VNA to see when they will be coming in, so you do not get double the coverage.  Our aides will be there when the VNA is not.  This way you are getting the most amount of coverage for the dollar.

You do not need to be discharged from a rehabilitation center or a hospital to receive Medicare home care.  You just need a doctors orders.


Assisted Living Facility (ALF)

Assisted living facilities can be great!  They offer something private home care can not, a socially active community where people of the same age can be together.  Some of you might be thinking between Minute Women and an assisted living community.  Pick which best works for you.

Private home care and assisted living facilities work together is in two ways.

1) If you are on a waiting list to be moved into an ALF, it sometimes can be for weeks or months before the room is open.  You can use private home care to make sure your mother or father is safe until they are ready to move in.

2) ALF are designed for seniors who need less than two hours of one on one care per day.  If your loved one needs more than two hours of care per day, you will get a call from the facility informing you of this.  They will explain that your family member needs too much care.  You will then have two options, move your loved one out, or hire a private home care company to come in to take care of you loved one.


Skilled Nursing Homes (SNF)

Like ALFs, nursing homes rely on the same principle, many people who need care, but not so much that a small group of aides and nurses need to be with them 1 on 1 all the time.

The fact is that once some is in a nursing home, they more than likely will not need private home care, but it does happen when someone needs so much care that the facility requires additional private home care.

An example of this would be a dementia patient that would likes to wander, but is a fall risk.


Adult Day Care

Adult day care is exactly what it sounds like.  You drop off you loved one in the morning and pick them up in the afternoon or early evening.  

Not all families have the flexibility to be there to drop them off and pick them up.  Private caregivers can help with getting them ready, transportation, and bring them home and caring for them until their adult children arrive home.


Drawbacks with Private Home Care

As stated before this book is to inform you on everything, so here are the pros and cons of home care.  Everyone seeing things through differently, sometimes what is a negative to one person would be positive to another.

  • The biggest drawback with home care is that a person is coming into your home to help a loved one in intimate and personal ways.   Trusting this individual is important.  They have access to the whole house, to medications, fine items, and are alone with your loved one.

  • There is not as much social activity. There is less social activity then in an assisted living or nursing home.  So if you hope is to have your loved one in a community with many people their own age, then this would be seen as a drawback.

  • You are paying someone to be available at a moment’s notice.  There will be times when the caregiver not as active as you like.  Their job is not to clean the whole house, organize the garage or mow the lawn.  Their job is to be available at any point in time your loved one needs them.  Understandably, customers can get frustrated when they see a caregiver knitting, reading, or watching tv with their loved one, but this does happen.  Now, this does not mean a caregiver can sit in front of the TV all day, if there is work to be done they are expected to work, but there are down times, it comes with the job.

  • The cost.  It does get expensive, and for most it is out of pocket.  Your finances and how long you will be needing private home care all factor into how much money you can spend on a home care company.  Generally paying for private home care is less expensive than alternative out of pocket options.


Positives of Private Home Care

  • You are receiving personalized care from a trained healthcare worker to provide assistance when you can not be there to do so.

  • It relieves stress.  Everyone that comes in and talks to me is at the end of their ropes.  Most of the time people are caring for their parent and their children at the same time.  If this is you, you are known as the “Sandwich Generation.”

  • Quality time is restored.  Instead of being your parents servant you now become their child again.  You no longer are spending you time cleaning up, showering, feeding, washing, and doing all the care giving for your loved one.  You go back to spending quality time with your parent.

  • They get to stay in their home.  Most people want to live the rest of their golden years in their home.  By offering private home care you can grant them that wish.  They will not be moved from their house to and ALF, or a SNF.


When To Contact Private Home Care

The decision to contact a home care company, to sit down and speak with a representative is a great first step.  It allows you to understand your options.  There are times when private home care is perfect for families and sometimes not.

What we suggest to families is to see if they are sure they want to move forward with this type of care.  Are there family member that are willing to help with a portion or all of the care needed?  If so exhausting those resources might be a first choice, before moving forward with home care.

Family members might be at odds when making decisions about a loved on.  They can be at odds with what type of care they wish to choose. Before sitting down with any senior care providers make sure everyone in the family is in agreement with the type of care that is needed.  So that when you meet with potential private home care companies you are there to decide on which company you want to use.


Choosing a Private Home Care Agency

There are a plethora of options depending on where you are looking for private home care.  What do you want to ask when meetings with a private home care company and deciding who to put your trust into?

Here are a list of questions you can ask when interviewing a private home care company.

  1. How long has the agency been operation?
  2. What services does the agency provide?
  3. Is the agency accredited?
  4. Is the agency certified by Medicare?
  5. Is the care giving staff available 24 hours 7 days a week?
  6. What are the fees?  What do they cover?
  7. What payment source does the agency take? (Medicare. Veterans Aid and Attendance, LTC insurance, Private Insurance)
  8. Is the agency licensed to operated in the state it resides?
  9. How are caregivers screens?
  10. Are all employees bonded and insured?
  11. What kind of training is offered?
  12. Who supervises the employees?  How often?
  13. Does the agency require a nurse or therapist’s assessment of the patients home care needs?
  14. Does the agency consult the patients doctor?
  15. Does the agency include the patient and family in care planning?
  16. Are there a minimum number of hours required per visit?
  17. Is there a maximum number of hours per week?
  18. Does the company provide and explain their invoices?
  19. How are emergencies handled?
  20. How are changes in scheduling handled?

Minute Women Private Home Care

If you are in Concord, MA or one of the surrounding towns and are interested in private home care or just needs some general questions answered we are here to help.  Even though we are a private home care company we can help you no matter what services you are looking for even including if it is outside of Concord, MA.  Give us a call at 781-862-3300 and you will talk with a live person about your private home care needs.


What are you thoughts on Private Home Care?  Ask your questions below and get involved!