Dallas In-Home Care

There are almost as many reasons why people choose in-home care as there are people who need it. One of the most compelling reasons is the cost. The median cost of in-home care in the greater Dallas area was $119 per day in 2015, compared to $128 per day for assisted living and $215 per day for a private room in a nursing home. Getting care at home also helps seniors live in their own familiar surroundings longer—a priority for most adults over age 65.

What is in-home care like? Let’s take a look at the home care landscape in and around Dallas—what’s available, what clients think, and how you can find the in-home care options that are best for you and your family.

Dallas home care agencies

There are dozens of home care agencies across Dallas, Fort Worth, Arlington, and the rest of the Metroplex. These services are broadly divided into 2 categories: personal care (sometimes called companionship care or homemaker services) and home health assistance. Many agencies provide both types of care. State law requires each agency to be certified and listed with the Department of Aging and Disability Services Home and Community Support Services Agencies program.

To get a sense of what families expect and receive from agencies in Dallas, we delved into the SeniorAdvisor.com reviews left by clients and their relatives. Needs mentioned by reviewers included:

Hassle-free care transitions when there’s a staffing change, whether it’s due to a personality conflict or something else. “I had another service previous to them that went out of business and Approved in Home was able to take the attendant that I had and bring them into their organization; it was a seamless transfer,” wrote the husband of an Approved In Home Care client.

Getting along with clients’ pets. “Monica was great with my mother and little dog,” wrote the daughter of a Caring Senior Service of NE Dallas client.

Understanding the emotional hurdles clients and family caregivers face when hiring outside caregivers. “Each caregiver was kind, competent, and I had no problem leaving my mother in their care. Acapella [sic] was definitely a life-saver in a very stressful time for me,” wrote the daughter of an Accapella In Home Care client.

Another plus for some reviewers was caregiver availability on short notice. Many agencies have the resources to send someone to your home the same day you request help, so don’t think you’re out of luck if you need a hand with a last-minute schedule shake-up.

In-home care on your schedule

Besides last-minute care, most agencies can tailor a caregiver schedule to suit your needs. You might only need respite care when you’re ill, on vacation, or taking some time for yourself. You might want a part-time caregiver to drop in for a couple of hours each morning to make sure your loved one has help getting dressed, eating a healthy breakfast, and taking any needed medication. Full-time or live-in home care can help ease the load on family caregivers who also work full-time or who live too far away to provide regular care.

In-home care as one tool in your senior care toolbox

You probably have more than one tool to keep your home in shape, and it’s a good idea to put together a selection of senior care tools to help you or your loved one. That way you always have resources ready to provide care and to ease your worries about keeping up with care needs. Here are a few options to consider:

Hiring a caregiver yourself is an alternative to working with an agency. One upside to making a direct hire is that it’s the best way to pay relatives the market rate for the care they give. It also gives you control of the hiring and management process from start to finish. The potential downsides are that it takes a fair amount of time to seek out, interview, screen, and vet potential caregivers. You also have insurance, payroll and tax responsibilities when you hire directly.

Blend agency care with caregivers you hire yourself. This can be the best of both worlds for seniors who want to pay a family member and want that person to have enough time to work, rest, recharge, and stay healthy. You can also call on an agency to provide respite care when the caregiver you’ve hired is on vacation or away for another reason.

Use local concierge and online shopping services to do errands and routine chores. You can check out online service platforms like TaskRabbit when you need groceries delivered or Rover when you don’t have time to walk the dog. Amazon Prime Now allows Amazon Prime subscribers in Dallas to get low-cost one-hour delivery on thousands of items, including groceries, pet supplies, and household goods.

The key to making this “toolbox” concept work is careful research before you hire or shop with anyone. Look for positive recommendations from friends, good online reviews from users and strong ratings with the Dallas Better Business Bureau. Ask the agencies you talk to about their state HCSSA license, insurance coverage, and employee bonding.

Covering the cost of in-home care

Medicare will cover in-home health care under a narrow set of circumstances. To qualify, seniors must be under a doctor’s care and that doctor must be willing to certify that the patient is homebound and needs occupational therapy, speech-language therapy, physical therapy, or periodic skilled nursing care. In addition, the agency that provides care must have Medicare certification.

Private pay options include using long-term care insurance policy benefits to cover needed care or taking out a reverse mortgage on the home and using loan to pay for care. (A reverse mortgage requires pre-loan counseling from a HUD-certified agent to ensure you understand the responsibilities that go along with the loan.)

Low-income seniors who need in-home care but don’t meet Medicare’s reimbursement criteria may be eligible for help from Texas Medicaid, administered through DADS, or the VA Aid & Attendance pension for wartime veterans and their widows. Don’t overlook local services like VNA Meals on Wheels, which provides meal delivery for low-income, homebound Dallas County seniors and their pets—a great addition to your senior care toolbox.


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