Senior Care Focus 17-3

Home Help vs Nursing Care: Benefits Compared

Could you use high-skilled, quality elder care at $14/ hour? Well, it’s available, and you might be surprised who offers this cost-effective, high level quality of care—it’s not from “Home Help Servicers”! While Home Help Servicers—from individual home helpers to home help service companies—help, to a limit, able elders who can still live at home, some elders need more care with their daily activities that Home Help Servicers are unable, not willing, ill-equipped or just not certified to provide. And while some Home Help Servicers may offer “additional services” for an extra cost to provide a “higher level of care,” the new, increasing fees may approach and even exceed those of a Licensed Skilled Nursing Home. Furthermore, these services may not be certified as effective, safe or high-skilled comprehensive care. Additionally, Home Help Servicers may only employ home aides, whereas Licensed Skilled Nursing Homes are required to use Certified Nursing Assistants (CNAs) who are locally trained and certified to provide quality health care.

There are essentially “six levels of care” that our elders minimally should receive whether at home, in hospital or in a nursing home. When high-skilled care is comprehensive, it helps contribute to an elder’s dignity, happiness and quality of life—both physical and psychological. The acronym C-A-L-A-S-H, which helps us to remember the six levels of care that enhance an elder’s life, includes “C” for Clean, “A” for Active, “L” for Loved, “A” for Assisted, “S” for Safe, and “H” for Healthfulness. “If your elder isn’t receiving all these levels of care at home, then you should consider a change,” says Mr. John E. Kasarda, Administrator, Little Brook Nursing Home in Califon, NJ. Additional elder care information can be found at:

To further complicate matters, Home Help Servicers may deplete your funds quickly, leaving few options for your elder to transition into a public-funded (Medicaid) elder care facility. What do you do then? The best thing to do is to move your elder to a Licensed Skilled Nursing Home that provides certified, high-skilled care as soon as the need for specialized care arises and well before they run out of funds. That way, your elder is fully cared for and settled. There are two reasons to choose a Licensed Skilled Nursing Home over a Home Help Servicer:


If the levels of care that your elder needs are not being provided by a Home Help Servicer, then seek out a Licensed Skilled Nursing Home that can provide them immediately! A Licensed Skilled Nursing Home can coordinate and tailor the care your elder requires for his or her unique and changing needs; the staff will monitor his or her health and vital signs, manage medications, provide physical therapy and restorative nursing programs, and help toilet, bathe, clothe and feed him or her. Look for a Licensed Skilled Nursing Home that:

(a) INDIVIDUALLY Coordinates and Tailors Care. Seek a Licensed Skilled Nursing Home that will provide your elder with high-skilled care, including assistance with activities of daily living (i.e., dressing, bathing, eating, etc.), attending social functions and activities, eating three healthy, diet-tailored meals, fluids and snacks daily, living in a comfortable environment, etc. There are many things that Home Help Servicers do or don’t do that can cause very serious problems for elders (e.g., not treating elders with incontinence can result in poor hygiene and appearance, deadly infections and/or hospitalizations);

(b) CONTINUALLY Monitors All Health Vitals. Find a Licensed Skilled Nursing Home for your elder who has complex medical conditions requiring regular monitoring—for instance, diabetic elders require regular testing to track their sugar levels. Home Help Servicers do not provide much medical care, if any: that’s not their role and they don’t have the authority to do so. Home Help Servicers typically can not have medical professionals on-site 24/7, so there is no possible way for them to provide “round-the-clock” medical care to clients. This is why many Home Help Servicer clients are continually in and out of hospitals for conditions that could be treated within a Licensed Skilled Nursing Home; and

(c) PROPERLY Administers Medication. Home Help Servicer aides can not administer medications, unlike Licensed Skilled Nursing Homes, which are required to use licensed personnel who have extensive training to give the right dose, of the right medicine, to the right elder, at the right time to avoid the risk of elders being under- or over-medicated. For many elders, good health and wellbeing require daily nursing attention.


Beware of increasing fees for servicing needs, as these fees may escalate and exceed, by almost double, that of a Licensed Skilled Nursing Home—$24/hr compared to $14/hr. Many Home Help Servicers offer “higher levels of care” for an extra cost which may exceed the levels of care they are qualified to provide. Furthermore, many Home Help Servicers ask their clients to pay privately for an additional “aide” or “companion” for “round-the-clock” services and, all too often, once the client’s monies run out, clients are told that the Home Help Servicer can no longer meet their needs. If you’re paying $9,000 or more monthly, then just compare the benefits, levels of care and hours of coverage versus the cost. While these increasing fees may appear to be associated with your elder’s increasing needs, your elder may not be receiving certified, effective, safe, and high-skilled comprehensive care for those additional fees.

Home Help Servicers serve the needs of able elders to a limit. Elders have enjoyed long lives and some will need a nursing home to care for their needs. These needs require unique, specialized assistance: assistance that only certified professionals—a nurse, a CNA, a physical therapist, a dietary chef and a geriatric physician—can provide. “It is very important that you see these health professionals working together to provide your elder’s care,” says Mr. Kasarda. An elder’s golden years should be about living in peace, happiness, dignity, comfort, safety, and good health.

Editor: Dr. JP Hampilos of Senior Care Focus, LBHI; Excerpts from an interview with John E. Kasarda, Administrator, Little Brook Nursing and Convalescent Home

Senior Care Focus, Issue No. 17.3

© 2018 Little Brook Home, Inc.