About Respite Care
For those who are caring for their senior loved ones but who occasionally need a break, whether to take care of their own personal needs or to go out of town for a little while, respite care can be a great option. Respite care is a short-term solution that provides supervision for seniors as well as necessary medical care, help with hygiene needs such as bathing and dressing, and more. These services are typically provided outside of the home in a facility such as a nursing home, where the individual may have access to a private room or a shared accommodation.
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More About Senior Respite Care
For caregivers who need a temporary break to manage other areas of their life, respite care provides a safe, comfortable environment for seniors. Caregivers have peace of mind, knowing their loved one is supervised and receiving personalized attention.
What Is Respite Care?
Sometimes called temporary care, respite care is a flexible, short-term care option offered by senior care facilities, volunteer or religious organizations, and home care agencies, depending on the needs of your loved one.
Respite can last a few hours, a few days, or longer depending on the situation. It can be scheduled regularly or as needed. The best aspect of respite care is that it's designed specifically for the needs of the caregiver and their loved one.
Each type of provider has different levels of care. They are typically clustered as:
- Companion Services
This service is often provided by a volunteer or home care agency. The respite care provider's goal is to be a friendly presence while you're away. They get to know your loved one and plan activities to keep them happy and safe.
- Personal Care
Your loved one will receive assistance with activities of daily living, such as dressing, bathing, meal preparation and other essential duties.
- Housekeeping Services
For in-home respite care, many volunteer organizations and home care agencies also assist with general household tasks such as laundry, cleaning, shopping and transportation. You can determine what's needed and develop a personalized plan.
- Nursing Services
If your loved one needs medical care, they will need respite care in a senior care facility, such as a nursing home or adult day care. If they want to stay in their home, you can use a home health agency that offers skilled nursing. Respite care in these settings could include administration of medications, medical tests, monitoring of health status, pain management, rehabilitation or wound care.
- Specialized Care
Respite care providers may have specialized training and experienced caregivers for clients with Alzheimer's or dementia. There are also respite providers for cancer or hospice patients, who have experience with palliative care.
Benefits of Respite Care
Respite care provides a break from normal routines for both caregivers and the individuals they support. Both can feel a degree of burnout from their time together, and respite care can provide each party the opportunity to recharge. In many cases, it also provides opportunities for those needing care to experience a different environment where they can interact socially with others. Respite care is an economical way to provide supervision and personal care for an elderly loved one, preventing the need for permanent long-term care away from the home.
Respite Care vs. Adult Day Care
These terms are often used interchangeably, but there is a slight difference. Adult day care is one form of respite care. The main difference between respite care and adult day care is the setting. Respite care can occur in any type of care setting such as a nursing home, residential center or at home. Adult day care services are provided at community-based centers and group settings. Unlike adult day care which is restricted to 4-12 hours per day, respite care can extend to overnight care and include 24-hour care.
Assessing Respite Care Needs
Since there are so many options, here are some questions to ask yourself and your loved one to help you get clarity on what you need.
- Do you need respite care in the home or out of the home? Would it be beneficial for your senior to get the change of scenery and social interaction?
- How long do you need respite care? Do you need overnight care? If so, adult day care would not be an option, since it's only provided during the day.
- How often do you need respite care? While you're working? Occasionally as a break?
- Does your loved one need companion services, personal care and/or housekeeping? Make sure the provider offers the combination of services you need.
- Does your loved one need medical services? Should you choose a provider with a specialty like Alzheimer's/dementia?
- Do you need transportation to get your loved one to the respite care or adult day care facility?
Assessing Caregiver Needs
Evaluating your own needs is just as important. Caregiving can take a toll on even the most healthy and resilient individual. The American Medical Association created an 18-question caregiver self-assessment to help physicians assess the stress-levels of family caregivers. Caregivers are asked to respond either "Yes" or "No" to a series of statements, such as "During the past week or so, I have felt completely overwhelmed." Be sure to schedule respite care as much as you need, for the safety and health of your loved one - and yourself.
Special Respite Resources
Because there is such a high demand for respite care, and the numbers are expected to continue to increase, here are a few helpful ways to seek and evaluate respite resources and care:
- ARCH National Respite Network and Resource Center - Search for local respite sources in your area. They also offer a comprehensive set of guidelines for all respite models and services. You can use this as a checklist for evaluating respite care providers.
- Senior Companions - This organization matches volunteers age 55+ with seniors in need of help with daily living activities.
- Interfaith Caregivers, or Faith in Action - You may want a respite organization that is faith-based.
- Elder Helpers - Volunteers are prescreened and entered into a searchable database where families in need can search and seek a helper free of charge.
Respite Care Costs
Although there are many options for respite care (such as using volunteers, friends and family), inevitably you may need care from paid aides or nursing staff. The costs for respite care can vary widely because there are so many different types and durations of care needed. Proper costs are best determined on a case-by-case basis.
According to survey data compiled by CareScout in June 2017, the national average cost per day for care services are as follows:
- $70 for Adult Day Care
- $123 for Assisted Living Facility Care
- $131 for Homemaker Services
- $135 for Home Health Aide Services
- $235-267 for Nursing Home Care
These figures give a general idea of the daily rates that respite might be. However, respite costs are still best determined when working out a specific care program with health or medical staff.
Paying for Respite Care
As with any elder care need, often expenses are paid for out-of-pocket or by a combination of other methods such as Social Security, pensions, Veterans benefits, insurance, home equity, and various savings.
Financial Help from Charities
Local Alzheimer's Association chapters, Parkinson's Foundation, United Way and other community organizations usually offer respite care scholarships based on financial need. Sometimes it is required that the individual not be receiving respite funds from other agencies, Medicaid, nor have a long-term care insurance policy eligible to cover the same costs.
Some organizations provide grants for care. Used like a voucher, the grant funds can be redeemed for respite from pre-approved respite providers. Grants vary by organization and state, but the typical value is between $400-$1200. Some organizations require a co-pay for a grant. For example, a 10% copay would be $80 for a grant voucher for care valued at $800.
Funding may be available through the National Family Caregiver Support Program, which is administered through your local Area Agency on Aging (AAA), if you are caring for someone over the age of 60 or someone of any age with Alzheimer's or other dementias.
Medicare and Medicaid
Respite care is not covered under Medicare, but depending on the state, Medicaid can be an option if the senior has a condition such as Alzheimer's, dementia, or Parkinson's. Medicaid will pay for respite services if certain criteria are met such as needing a nursing-home level of care. The individual's income and assets must be below certain guidelines.
Programs of All-Inclusive Aid for the Elderly (PACE) is a joint program between Medicare and Medicaid. It is designed to help 55+ adults stay in their homes instead of entering nursing home care. PACE programs might pay for all services covered by Medicare and Medicaid that are medically necessary for care, including:
- Adult day care
- Respite care
- Nursing care
- Home care
- Activities, meals and exercise
- Social Services
- Other specialty medical care and therapies
To discover more about PACE and see if it is offered in your location, you can visit the PACE website.
Long-Term Care Insurance
Long-term care insurance is a policy purchased through a private insurance company. Like health insurance policies, the price varies greatly depending on age, general health and amount of coverage needed. Coverage could be denied for people with pre-existing conditions such as Alzheimer's disease or Parkinson's disease. Not all insurance will deny based on these conditions, so it is important to explore different insurance companies.
Aid and Attendance Benefit for Veterans
According to the VA website, the Aid and Attendance (A&A) benefit is a special benefit for war era veterans and their surviving spouses. It is a tax-free benefit designed to provide financial assistance to help cover the cost of long-term care in the home, in an assisted living facility or in a nursing home. This benefit is for those who require the regular attendance of another person or caregiver in at least two of the daily activities of living. An adult day care center falls into that category in most cases. To learn more about the eligibility requirements and to apply for these veteran benefits visit VeteransAid.org online.
In situations when costs aren't covered through other means, paying via private funds is an option. Sources of private funds for respite care include retirement accounts and 401Ks, savings accounts, annuities and insurance plans (including life settlements), trusts and stock market investments. Social Security can also be used as a means of paying for respite care and other long-term health care needs.
Respite Care Regulations
Since respite care occurs in many settings and by different providers, there are no regulations that apply globally. We've described the regulations for each type of respite care provider.
- Adult day cares are not regulated nationally like long-term care facilities. Each state has its own laws, regulations and licensing standards. The National Adult Day Service Association maintains a list of adult day care regulations state by state.
- Home health agencies are regulated state-by-state. The level of oversight can vary greatly. When Medicare patients receive home care, Medicare will only pay if a Certified Home Health Agency (CHHA) provides the services. You can find a list of all home health agencies that have been registered with Medicare on data.medicare.gov.
- Nursing homes are regulated by the Department of Health in conjunction with the U.S. Centers for Medicare and Medicaid Services (CMS).
- Assisted living communities are not regulated nationally like nursing homes. Each state has its own laws, regulations and licensing standards. The National Center for Assisted Living (NCAL) maintains a summary of all state regulations, updated each year.
Additional Respite Care Resources
- When Respite Services May Become Necessary
- Respite Care: In Home vs. Facility
- A Respite Care Checklist For Every Caregiver
- All About Senior Respite Care