Personal Care Services at Home

Nobody writes about the actual obstacle

Every agency page lists the same tasks. Bathing. Dressing. Toileting. Transfers. Meals. All true, and none of it addresses what actually happens in the house.

What happens is that a capable adult who has washed herself for eighty years is asked to let someone she met on Tuesday help her out of the shower. She says she is fine. She says she does not need it. She is embarrassed, and being embarrassed reads as being difficult.

Families then push, or give up, or the adult daughter does it herself. The third option is the most common and the most costly, and we will come back to it.

How to introduce personal care so it is accepted

• Start with the least intimate tasks: Not bathing. Begin with meals, laundry, driving to appointments, light housekeeping, company. Trust is built on the boring tasks and then spent on the intimate ones.
• Let them keep whatever they can still do: If she can wash her own face and arms but needs help with her back and her feet, that is the arrangement. Taking over everything because it is faster is the quickest way to lose cooperation, and it accelerates decline.
• Ask about gender preference and take it seriously: Many people have a strong preference about who helps them undress. It is a reasonable thing to want and a routine thing to arrange. We ask at assessment rather than waiting for someone to be uncomfortable enough to raise it.
• Mind the language: "Bathing assistance" sounds clinical and diminishing. "A hand getting in and out of the shower" is the same service described as help rather than as loss.
• Keep the same caregiver: This matters more in personal care than in any other service. Being undressed in front of a familiar person is manageable. Being undressed in front of a different person every week is not, and it is the point at which most people refuse care outright.
• Start before the crisis: Someone who chooses a caregiver while they are still well retains authorship of the arrangement. Someone who has a caregiver imposed after a fall has had a decision made about them.

The thing families should stop doing

If an adult child is providing intimate personal care for a parent, and it can be avoided, it usually should be.

This is uncomfortable advice and we give it anyway. Helping a parent with toileting changes the relationship in ways that are difficult to undo. It is exhausting, it breeds resentment that nobody will admit to, and it uses up the relationship's goodwill on tasks a paid caregiver can do without any of that weight.

Bringing in a caregiver for the intimate work lets a daughter go back to being a daughter. That is worth paying for on its own, separately from any practical consideration.

Where personal care ends and nursing begins

Personal care is non-medical home care. That is a legal boundary, not a judgment about difficulty, and it decides who may do what.

A caregiver may remind someone to take medication, hand them the bottle and watch them take it. Only a licensed nurse may administer it. The same line applies to wound care, injections, catheters and feeding tubes: a caregiver may keep the area clean and notice a problem, but the clinical task belongs to a nurse.

If the need crosses that line, the service you want is skilled nursing at home under a physician's order, or private duty nursing if someone needs a nurse present for hours at a time. Many households use a combination, with a nurse for the clinical tasks and a caregiver for the rest, which usually costs less than nursing hours alone.

Who pays for personal care

• Medicare does not fund ongoing personal care: It covers aide visits only alongside skilled services during a home health episode, and only while that episode lasts. This is the most common misunderstanding we correct.
• Florida Medicaid Long-Term Care can cover it: If you qualify. See Florida Medicaid Long-Term Care for how eligibility screening works.
• Long-term care insurance frequently covers it: Personal care is exactly what most policies were written for. Bring it to the assessment and we will check it against the hours you actually need, at no cost.
• Private pay: Quoted in writing before anything begins, and usually the most affordable of the three services on this page because no nurse is required.

What we can tell you about our caregivers

More than 100 Focus Family Care caregivers are available for personal care across the seven counties we serve. About a third are men and two thirds are women, so a preference for a male or a female caregiver can usually be met.

From your first call, the typical time to a first visit is 48 hours. Every caregiver passes a Florida Level 2 background screening, and a registered nurse writes and supervises every plan of care.

Where we provide personal care

Across Palm Beach, Broward, Miami-Dade, Martin, St. Lucie, Indian River and Okeechobee counties, with city pages for West Palm Beach, Boca Raton, Boynton Beach, Delray Beach, Jupiter, Palm Beach Gardens, Fort Lauderdale, Hollywood, Miami, Stuart, Port St. Lucie and Vero Beach.