Senior Care at Home: The Questions Families Ask Us Most

Families call us with the same fifteen questions. Not similar questions. The same ones, in roughly the same order, usually within the first four minutes.

So here they are, answered the way we answer them on the phone, with the actual numbers rather than a form to fill in. Read it before you call anybody, including us.

1. How much does home care cost in Massachusetts?

Our home health aide care is $45 an hour , one to eight hours a day, with no minimum contract and no assessment fee . Overnight coverage is $540 for a 12 hour night. Around the clock is $1,080 a day .

Rates across the state generally sit somewhere in the thirties to fifties per hour depending on the agency, the town and the level of care. What varies more than the rate is what sits on top of it: minimum hours, minimum weeks, assessment fees, care plan fees, and holiday multipliers. Ask about those before you compare hourly numbers, because a lower rate with a twenty hour weekly minimum costs more than a higher rate with none.

2. Does Medicare pay for it?

For this kind of care, generally no, and it is better to hear that now.

Medicare pays for skilled care: a nurse or a physical therapist, ordered by a doctor, for a medical reason, usually for a limited stretch after a hospital stay. It does not pay for an aide who helps with bathing, meals, laundry and company, however necessary that is. That is the gap almost every family falls into, and it is why most home care in Massachusetts is paid privately.

Worth checking: a Medicare Advantage plan may include some supplemental in-home support, a long term care insurance policy may cover it, and veterans and surviving spouses should ask the VA about Aid and Attendance.

3. How many hours do we actually need?

Fewer than you fear, usually, and at a more specific time than you would pick.

Three questions settle it faster than any assessment. What happens at three in the morning? Can she get food without carrying or bending? Can she wash safely without somebody there? The answers point at a window, and the window is the schedule.

Most families start at two to four hours a day. That is $1,170 to $2,730 a month at our rate, and it is a real answer rather than a token one.

4. Can we start with just a few hours a week?

Yes. We have no minimum contract, so two hours twice a week is a perfectly ordinary booking. Many agencies will not take that, because a four hour visit minimum and a twenty hour week minimum are common in this industry.

Starting small also happens to be the easiest version of this conversation to have with a parent who does not want help.

5. What does an aide actually do?

Bathing, showering and dressing. Help to and from the bathroom, and with incontinence care. Getting in and out of bed and chairs. Meals cooked and eaten. Medication reminders. Laundry, dishes, tidying, changing the bed. Grocery shopping. Rides and company to appointments. And plain company, which families underrate and older people do not.

What an aide does not do is anything that requires a nurse: wound care, injections, catheter changes, IVs. If your parent needs those, they need skilled nursing, and that is a different service with a different payment route.

6. Is it the same person every time?

That is the goal, and you should ask any agency this directly rather than accepting a vague answer.

Consistency matters more than almost anything else, because a regular aide learns the routine and notices change. A rotating cast notices nothing, because nobody has a baseline. Vacations and sick days happen everywhere, so what you really want to know is who covers, and whether you get told.

7. How are your caregivers screened?

Background checked, trained, insured, and employed by us rather than sent as contractors. Because they are our employees, we carry the workers compensation and the liability, not you.

That last point is the practical difference between an agency and hiring privately. When you hire someone directly into your parent's home you are generally the household employer, with the payroll taxes and, at sixteen hours a week or more in Massachusetts, the workers compensation obligation that comes with it.

8. How fast can care start?

Faster than most, because we do not require an assessment visit before we can quote or schedule you, and there is no assessment fee.

Tell us the town, what is going on and the hours you want, and you get a price on that call. How quickly we can actually staff it depends on the town and the time of day, and we will tell you honestly which one yours is rather than saying yes and sorting it out later.

9. My mother says she does not want a stranger in the house.

Almost everybody says that. The refusal is rarely about the aide. It is about what accepting one would mean.

Three things help. Start smaller than you want to, because two hours is not a verdict on her independence. Name a task rather than a category, since help with the heavy cleaning lands very differently from a caregiver. And say honestly that it is partly for you, because many parents will accept for their child's sake what they will not accept for their own.

10. How does this compare to assisted living?

Assisted living in eastern Massachusetts commonly runs six to eight thousand dollars a month before levels of care charges get added, and it usually means selling or emptying the house.

Home care is cheaper up to a point and then it is not. The crossover is somewhere around eight to ten hours a day. Below that, home is almost always the better value as well as the better life. Above it, assisted living starts to make financial sense, and the honest conversation is about which side of that line you are on.

The other half of the comparison is not financial. Assisted living is a permanent, one directional move. Home care is reversible.

11. Can you help with dementia?

Yes, and the shape of the help is different. With memory loss, routine and the same familiar face do most of the work, and the hours that matter are usually late afternoon and evening, when confusion reliably worsens.

Be straight with us about wandering, about nights, and about any aggression. Those three facts change the staffing, and an agency that does not ask about them is not planning properly.

12. What about nights?

Overnight coverage is $540 for a 12 hour night. Families often arrive at nights last and should have arrived there first: it is nights that exhaust the family caregiver, and exhaustion is what ends most home arrangements, not the daytime tasks.

13. Can you help with transportation?

Yes, and it is a large part of what we do. Wheelchair-accessible transportation is $115 each way, $230 round trip within five miles, then $2 a mile. If the front steps are in the way, stair assistance is $200 a visit : two trained staff and a motorized stair chair.

We also provide medical appointment escorts, which is somebody who goes in, waits, hears the discharge instructions and reports back. That is often the part families actually need, more than the driving.

14. Who signs, and can I pay from out of state?

If your parent is competent to make her own decisions, she is the client and she agrees to the care, even when you are the one calling and paying. Billing can come to you, and plenty of adult children never involve the parent in the invoice at all.

The whole arrangement can be set up by phone and email from anywhere in the country. We do it regularly.

15. Can we stop?

Yes. No minimum contract means exactly that. Add hours if you need them, cut them when you do not, stop when the situation changes.

People find that easier to start with than a commitment, which is the point.

Talk to us

Care Remedy is a Massachusetts home health aide and transportation agency, founded in 2019, serving seniors and adults with disabilities across eastern and central Massachusetts.

Call 781-957-8076. Tell us the town, what is going on, and roughly the hours you have in mind. You will get a price on that call. No assessment fee, no minimum contract, and a straight answer about whether we can staff it.

Email info@careremedyinc.com or visit www.careremedy.com .

• Woburn (headquarters). 100 TradeCenter, Suite G-700, Woburn, MA 01801
• Brockton. 555 Pleasant Street, Suite 1, Brockton, MA 02301
• Springfield (Western Massachusetts). 1 Federal Street, Springfield, MA 01105

If you are not sure yet what you need, call anyway. Most of these conversations take ten minutes, and a good many of them end with us telling somebody they do not need us yet.