Practical Support for Caregivers
The services, equipment and help available to unpaid caregivers.
Last revised
Key takeaways
- Area Agencies on Aging: local hubs for caregiver support, respite, meals and in-home services
- Medical equipment: Medicare and many plans cover prescribed durable medical equipment
- Most useful single change: Call the Eldercare Locator at 1-800-677-1116 to find local services.
- Commonest mistake: Buying equipment before checking whether insurance covers it.
- See a doctor if any of the signs under "When to get help" below apply to you.
Why it matters
A great deal exists and very little of it is offered unprompted.
The numbers, in one place
| Measure | Figure |
|---|---|
| Area Agencies on Aging | local hubs for caregiver support, respite, meals and in-home services |
| Medical equipment | Medicare and many plans cover prescribed durable medical equipment |
| Home health care | covered by Medicare for eligible homebound patients when a doctor orders it |
| Occupational therapy | can assess the home and recommend equipment and changes |
What helps
- Call the Eldercare Locator at 1-800-677-1116 to find local services
- Ask the person's doctor for an occupational therapy home assessment
- Ask what equipment insurance will cover before buying it
- Ask about adult day programs and respite care
What to avoid
- Buying equipment before checking whether insurance covers it
- Waiting for services to be offered; most have to be asked for
- Turning down help because of how it feels to accept it
In depth
A great deal of help exists for caregivers in the US, but it is spread across many systems: federal and state aging services, Medicare, Medicaid, veterans' programs, private insurers, nonprofits and local community groups. Each has its own rules, application process and waiting lists. That fragmentation is why many families never receive help they qualify for. Services are rarely offered automatically; someone has to ask, often more than once.
It helps to think about support in a few categories. There are services that reduce the work, such as home health aides, meal delivery and adult day programs. There are services that make the work safer, such as occupational therapy home assessments and medical equipment. There are services that give you a break, such as respite care. And there are services that help with money, paperwork and planning, such as benefits counseling and legal aid.
Area Agencies on Aging act as a front door for much of this. They are funded partly through the Older Americans Act and run the National Family Caregiver Support Program locally, which can include information, counseling, training, respite and supplemental services. Even if you are caring for someone younger, they can often point you to the right agency for disability or other services.
Signs and symptoms
- Tasks such as bathing or getting to the toilet have become unsafe to manage alone
- The person has had a fall or near miss at home
- You are missing work or sleep regularly to provide care
- Medicines are being missed, doubled up or confused
- Bills, mail and paperwork are piling up unopened
- The person is losing weight or not eating proper meals
Causes and risk factors
- Services being split across many agencies and insurers
- Not knowing what to ask for or who to ask
- Eligibility rules that depend on age, income, diagnosis or location
- Hospital discharges that happen quickly without full planning
- Reluctance from the person receiving care to accept outside help
- Waiting lists and shortages of paid caregivers in some areas
How it is checked
Needs are usually assessed in several ways. An Area Agency on Aging may do a needs assessment to see which local services fit. A doctor can order home health care for someone who is homebound and needs skilled nursing or therapy, which begins with an assessment visit at home. An occupational therapist can assess daily activities and the home environment and recommend equipment or changes.
For long-term services through Medicaid, states use their own functional assessments, usually looking at how much help a person needs with activities of daily living such as bathing, dressing, eating and moving around. Hospital social workers and discharge planners can also assess needs before a person goes home, so ask to speak with them before the discharge date is set.
Related topics
- What the Guidance Really Says About Benefits and Financial Support (Long-Term Conditions)
- Medicaid Eligibility: Sorting the Evidence From the Noise (Medicare and Medicaid)
- Staying Independent: What the Evidence Actually Says (Healthy Aging)
- Sexual Health Services: What Published Guidance Supports (Sexual Health)
Where to go next
- The Short Guide to Practical Support for Caregivers
- What the Guidance Really Says About Practical Support for Caregivers
- Caregiver Health: The Complete Guide
- Caring for Someone with Dementia: What Published Guidance Supports
- Young Caregivers: What Published Guidance Supports
When to get help
Contact the person's doctor or local adult protective services if you can no longer provide care safely, or if the person you care for is at risk. Call 911 for a fall with a head injury, sudden confusion, chest pain, or signs of a stroke.
Where this comes from
- National Institute on Aging — Getting Help With Caregiving
- Medicare.gov — Home health services
- Medicare.gov — Durable medical equipment (DME) coverage
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.