Whether providing care or working at paid employment, everyone needs a break now and then. People working in paid employment get weekends, evenings, holidays, and regular vacation time to rest, re-charge, and pursue interests outside their normal routine. Caregiver's don't get these benefits unless they make a conscious effort to make schedule their own breaks. However these breaks are scheduled, and whatever they are called, they are necessary for our physical and mental health.

As a giver-of-care, you will need access to more than one kind of respite care throughout your caregiving journey. You may need a few regularly scheduled hours to spend time with friends and family, to do errands, to take care of your own medical and personal needs, and to simply decompress.

Your elder may need supervision for several hours every day or several days each week so you can work.

You may need someone to fill in overnight for a time while you take a family vacation, or attend a wedding or a funeral. Heaven forefend that you have your own medical emergency and need unscheduled caregiving assistance.

If none of these things have happened to you, just wait. One or more will. It's just a matter of time.

So where do you find respite help when you're caring for an elderly adult?

Respite Care At Home

Johanna employs a non-medical home care agency to care for her husband, Paul, two afternoons each week. The agency sends a young man who takes Paul out for a sandwich at his favorite diner. They then hit a few balls at the local driving range or find something to do indoors if the weather is bad. Some days they stay at home and watch a ball game or a good western on TV. Johanna can do whatever she wants during these four hours. She says it has saved her sanity, as Paul is a "shadower," and is rarely away from her side when the caregiver is not there.

Non-medical home care agencies can provide respite care based on the needs of the care recipient. In addition to companionship and supervision, most can provide bathing assistance and light housekeeping.

For seniors with resources, in home respite care must be privately paid, either from available funds or perhaps with a long-term care insurance policy. Depending on where you live, professional care provided by a licensed provider will range from $12 to $25 per hour. You can hire a respite caregiver privately, but remember that it will be your responsibility to perform background checks and handle Social Security and other tax and insurance issues.

Check with friends, your workplace EAP, your local senior center or Alzheimer's Association for recommendations.

If your elder has a restricted income and few assets, Medicaid programs in your state may offer some home care assistance. Use the Eldercare Locator at 800.677.1116 or www.eldercare.gov to find the closest Area Agency on Aging office for help in identifying and applying for these benefits.

Adult Day Programs

Adult day care centers provide structured adult activities that designed to support an individual's abilities while providing supervision and assistance where needed. Most programs permit a participant to enroll on a part or full time basis, up to 10 or more hours every weekday. Some programs offer transportation.

The biggest advantage of a good adult day program is the professional oversight, varied activity program, and the opportunity to socialize with a diverse group of participants. The biggest disadvantage is the necessity to get your loved one dressed and out the door, which may be a challenge for those who move slowly. Attending on one or more afternoons may be the solution for those who simply cannot get there in the morning.

Adult day programs are usually flexible about attendance. If your senior is enrolled on a part-time basis and you need extra help for one or more full days, changing your schedule is often possible so long as there is space. You will need to check in advance.

Hour for hour, adult day programs are usually less expensive than bringing a one-on-one caregiver into your home. Rates usually range from about $45 to $75 per day, depending on where you live. Most long-term care insurance policies will cover adult day programs if you follow their requirements and get advance approval.

For seniors with limited income, Medicaid programs often include Adult Day Centers in their list of available support services. Check with the Eldercare Locator at 800.677.1116 or www.eldercare.gov to find the closest Area Agency on Aging office for help in identifying and applying for these benefits.

Overnight Respite Care

Respite At Home: If you are using the services of a caregiver in your home for daytime respite care, your caregiver may be available to stay overnight if necessary. Check with your provider agency or your private caregiver ahead of time so you understand how available your caregiver will be, and what the cost will be.

Assuming that it is affordable, overnight care at home will be the easiest on your senior because home is most familiar. If you are using an agency, the caregiver(s) may not be the same, however.

Medicaid programs do not generally cover 24-hour care in the home. Long-term care insurance policies often will.

Respite In an Assisted Living Residence: Many assisted living residences offer short-term respite care. If they have available space, your elder may be able to stay for several days, a few weeks, or even a month, as a respite resident. Depending on whether the residence is licensed or unlicensed, you may have to submit medical information and complete information documents ahead of time. Your elder's physician may have to provide medical information and instructions. Many asisted living residences require the results of a negative TB test.

Respite care in an assisted living residence must be arranged in advance. This solution is rarely available on an emergency basis without at least several day's notice. You will have to pay privately for respite in assisted living. Medicaid programs do not cover respite care in an assisted living residence. Check with your long-term care insurance provider in advance about coverage for this kind of care.

Respite in a Nursing Home: As with many assisted living residences, families can obtain short-term respite care in a nursing facility when there is space available. You will need to identify your preferred facility in advance and you will need to coordinate your loved one's admission with the facility and your loved one's physician. There is considerable medical documentation needed to use the services of a nursing home.

Patients receiving Hospice care are often eligible for respite care in a nursing or dedicated hospice facility. Check with your Hospice agency about the facilities they use, how often your loved one will be eligible, and any costs associated with using hospice respite. You may be pleasantly surprised at the financial support available.

Medicaid does not usually cover respite care in a nursing facility. Your long-term care policy may.

When you're thinking about respite care, look first for the services that will best meet both your immediate needs and the immediate needs of the person needing care. You may decide that using an adult day program one or two days a week, and in-home care as a supplement makes the most sense. Don't be afraid to be creative, mixing and matching available services according to your need and your pocket book.

You may need to make new arrangements as time passes. The best time to check out all your options is now, before you need them. Should there be changes in your elder's needs, or if you have an unexpected emergency, you will know where to go and what you need to do. In an emergency there won't be time to do much investigation.