CA Licensed Professional Fiduciaries

Structure Your in-Home Services to Meet Your Needs and Budget


Article written by: Laura Barish President and CEO of Alta Golden (San Diego, CA)

How to structure your caregiving needs in a way that meets both your requirements and your budget.

The first thing to ask yourself is, “do I need a caregiver?”  Many adults need a little help but think that if they ask for that help they will lose control of managing their lives and/or the request for assistance means that they are no longer safe to continue living in their homes.  What we frequently see is that the older adult may not be as strong or as steady on their feet as they used to be so simple tasks like carrying laundry from the dryer, washing and putting away dishes, writing out checks to pay the bills, or driving safely to a doctor appointment may be problematic.  With just a little help, however, safety and stability is restored and maintained.

Driving is a key aspect of independence but, if the individual is recovering from an illness or the eye sight is failing, they may not be safe behind the wheel.  Many adults struggle with the idea of losing their independence if they can’t drive and it is a very valid concern.  Many of our clients no longer drive but having a caregiver to take them out or to run errands allows them to stay in their homes and have all needs met.

Now, what is the best way to structure your caregiver support.  Hopefully you have selected an agency that is flexible in the options provided.  Let me give you some examples of what we do for our clients.  One of our newer clients lives in an independent living community.  They first started asking for 2 hours each morning to help with bathing and dressing and 1-2 hours in the evening to help get ready for bed.  After a week they realized they only needed the morning hours and the schedule was adjusted.  We touch base with them periodically to make sure their needs haven’t changed.

Another client has us come in every morning from 8-10am and then again from 2-4pm.  We provide a combination of assistance with dressing and meal prep along with socialization, shopping, and helping with activities.

Other clients have us come in one or two days a week for a few hours; and others have us 7 days a week for 8 hours a day.  We even have one client that uses us once a month for two hours.  We also have clients needing 24-hour care, and we do that too.  The key is that each client is different and has different needs.

My recommendation is to come up with a list of the tasks and activities with which you need assistance, what time of day each task occurs, how long each takes, and on what days of the week each is performed.  This will tell you what your schedule needs to look like.  If you can make minor shifts in your ordinary routine to allow activities to be grouped so you can compress the support schedule this will help you save money.

One of our clients was surprised when I signed her up because she only wanted help on Monday and Friday but the agency she had previously been using insisted that their minimum support was 3 days a week.  Remember – you are the boss.  Don’t let the agency dictate your needs.  A good agency will help you structure your support plan, not dictate the schedule to their convenience or bottom line.

Also, insist that you have consistency in the caregivers assigned.  You can’t get good support if a different caregiver is sent over each day.  Your caregiver is your personal assistant and, like a good personal assistant in an office environment, they need to learn the duties of their job and you are the boss.

Well, that’s it for today.  I’m arranging some guest blogs with great information to facilitate your safety and independence.  One of our guests this week will be a Fiduciary–hopefully that will be tomorrow’s input.  In the meantime, have a fabulous day and don’t forget to visit us online at or give us a call if you have any questions 858-779-9254.

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