Just to add a little more confusion to the whole elder care arena, Home Care doesn't always equal Home Care. There's "Home Care," and then there's "Home Health Care." What a difference one little word can make when you're trying to set up care at home for a senior.

Care at home for seniors will fall into one of two categories: Medical or Non-Medical:
 
Non-Medical Homecare  ("Home Care") 

This is exactly what it sounds like - care at home that doesn't involve a skilled nurse or therapist. Caregivers often don't have formal training, or they are minimally trained. This doesn't mean that many home caregivers are not greatly skilled and compassionate about what they do.

Non-medical home caregivers can provide companionship, supervision, light housekeeping, shopping, meal preparation, assistance with bathing and personal care, and sometimes transportation. They can remind seniors to take medication at the proper time and help to make sure prescriptions are refilled when they need to be.

Most seniors don't need the services of a nurse. What they do need is someone to help out with the things they can't reliably or easily do for themselves at home. 

Costs vary widely around the country. You can always expect to pay more for a caregiver who works through an agency.  If there are two people in the home you can also expect to pay a higher hourly rate. Many agencies have minimum daily stay requirements, usually three to four hours.

If you decide to hire privately because it's less expensive, remember that you will still be responsible for paying the employer's share of Social Security. Depending on your individual state requirements, you may also be responsible for disability insurance and unemployment insurance. You'll have income tax and other financial records to maintain, and you may be left holding the bag if your caregiver either quits or doesn't come to work one day as expected.

If you decide to look for help through an agency you may find several listed under "Home Care" in your telephone book or on the Internet. However, you would be wise to ask for a referral from a trustworthy source. Your local hospital social work department or senior center may maintain a list of reputable agencies if you don't know anyone to ask and don't have a care manager in your area.

Home Health Care ("Medical" Care At Home)

Medical home care provides medical services such as a licensed nurse or therapist who will come to the patient's home to give treatment ordered by a doctor. The costs of medical home care is often covered by Medicare if the patient meets strict criteria, including the requirement that the patient be "homebound" and not able to get out for regular medical treatment.  

Providers of medical home care usually come to the house, provide whatever treatment is necessary, and then leave. Rarely do they stay longer than an hour or so, and their duties are limited to medical care.  If the doctor has ordered an aide to help with bathing, the aide will also usually straighten up the patient's bed and bathroom. He or she won't generally do other housekeeping or prepare meals.

Medical home care is usually time-limited.  As soon as the medical condition no longer needs regular attention by a skilled medical professional the patient will be "discharged," even though there may still be a need for regular non-medical assistance. If your loved one needs care and supervision for the long haul, then medical home care will probably not be the ultimate answer.