For most people, staying home as long as possible is plan A. If this is your plan start gathering your village early. Have conversations with your adult children or others who will be part of your support system and do some research into in-home care.
You have two choices when it comes to hiring in-home care. In-home care agencies and in-home care employment registries. Both types provide hourly, and 24/7 Live-In Care. Caregivers are screened, have a background check, and have a Home Care Aide or Nursing Assistant Certification.
In-home care agencies hire caregivers. Some offer paid training and medical insurance and most have Care Coordinators and Supervisors. Supervisors often step in to supply care when a caregiver calls out sick. Agencies monitor care to make sure it is consistent and that both the caregiver and the client are comfortable with each other. The price range for a caregiver through an agency is approximately $34-44/hour for a 4-hour minimum shift. The price goes up for shorter shifts, 1 to 3-hour shifts are in the $40-$60/hour range depending on the task. Live-in costs range from $400-600/day in King County and surrounding areas. The Department of Health has a complete listing of in-home care agencies in WA and the National Association for Homecare and Hospice has a homecare locator.
An employment service or in-home care registry is another way to find excellent, qualified caregivers. Registries take the work out of the screening and interviewing of caregivers. Most have rigorous standards and minimum years of caregiving experience required. With this model, you pay a placement fee and then hire a caregiver directly. Wages paid go fully to your worker and typically range from $28-35/hour. Licensed Practical Nurses or Registered Nurses start closer to $50/hour. Most registries let you interview and begin working with a couple of caregivers before settling on the best fit.
If you are on Medicaid and looking for in-home care, the Referral Registry of Washington State and an online platform called Carina links residents who receive publicly funded in-home care services with pre-screened home care workers and Individual Providers. Medicaid can cover up to 20 hours of in-home care per week, excluding weekends.