Safe & Sound At Home: Part 1- Introduction

Written by: Craig Falk


Rosa's Story

Mom fell yesterday and broke her hip. She is in the hospital recovering from surgery. The discharge planner came by and said she would need 24-hour care after she left the hospital. I can't possibly meet all of her care needs because I work full-time. the discharge planner handed me a list of 90 local agencies that provide in-home caregivers. I don't know where to begin! How can I find safe and reliable care for my mom? 

Jim's Story

My father was diagnosed with dementia a few years ago. My sisters and I share the responsibility of caring for him. It is beginning to feel overwhelming. We have families of our own to care for in addition to caring for Dad. Where can I find help? How much will it cost? I've tried to find resources on the internet, but I am very concerned about knowing who to trust. 

"Most baby boomers never planned on being caregivers for their parents and they are terrified of doing something wrong, or they are dealing with tremendous guilt." - Carol Shaneen, Case Manager, Sutter Roseville Hospital


Does Rosa's or Jim's story sound similar to your own? If so, you are probably facing difficult decisions regarding the care of your aging loved one. Whether you are the point person for your family or a guardian seeking advice, Safe and Sound At Home: How to Find the Best Caregiver, was written for you. This guide provides information on how to find a safe caregiver for your elderly loved one at home. The guide includes information and advice on the benefits, challenges and options for hiring a caregiver. Additionally, the guide outlines the steps for hiring a caregiver, the advantages and disadvantages of working with a caregiving agency, the keys to managing the caregiver-client relationship, and helpful ideas regarding complex family dynamics and financial issues. 

It is important to understand the distinction between medical and non-medical home care. 

Non-medical Care vs. Medical Care

Non-medical care in the home is also known as "custodial care," "personal care," "non-skilled," or "private duty care." Non-medical care includes such things as helping a person get out of bed, toilet and bathe, prepare meals, grocery shop and do light housekeeping. Non-medical caregivers are not required to have a professional license, although some are CNA's (Certified Nurse Assistant) or CHHA's (Certified Home Health Aide). Non-medical home care is not covered by Medicare and is the family's responsibility, both in arranging for it and paying the bill. 

Medical home care, also referred to as "skilled care" or "home health care," is a service that provides therapeutic support. Medical care is likely to involve the use of medicines (IVs, injections, or other medication), medical supplies (for wound care or diagnostic testing), or prescribed rehabilitative or therapeutic programs. Those providing medical home care will have a professional license such as RN, LVN, PT, OT etc. Medical home care, when needed is normally ordered by a doctor and is paid for by health insurance in most cases, and for a limited time. 

Some individuals need both non-medical and medical home care. 

"I've never been this old before and I have a lot to learn about how to be old." -Mary, an 87-year-old retired teacher


Options for non-medical care, both at home and in care facilities includes: 

  • A caregiver hired to provide one-on-one care in the home. 
  • Adult day-care centers that provide care off-site in a safe environment during normal work day hours. 
  • Board and care facilities; residential homes where four to six people live with a full-time caregiver. 
  • Assisted living facilities; residential, apartment-like buildings consisting of both private living quarters and public places for eating or social events. Services such as meals, assistance with personal care, medication management, activities, and transportation are available. 
  • Skilled nursing facilities or nursing homes provide medical care for short term rehabilitation and custodial, long term care. 
"People don't want to leave the hospital because they think it is a secure place for them, when in fact, it's the worst place to be if you don't want to pick something up!"- Carol Shaneen, Case manager, Sutter Roseville Hospital