Respite Care: Everything You Need To Know
Caregiving can often be as draining as it is rewarding. Caregivers may feel overwhelmed at times by the emotional and physical strain while taking care of their elderly loved one. You may think you can handle it all on your own, but with your own needs, it can sometimes become overwhelming. That’s where respite care comes in.
Respite care gives you a short break from caregiving so that you can spend some time on your own. It can help alleviate stress and improve the wellbeing of both the caregiver and the senior being cared for.
However, having someone outside the family to take care of your elderly loved one should be a thoughtful decision. You need a reliable caregiver who can provide equal emotional and physical support to your senior. Also, if you are planning to send the person in care to a facility, choose the one that can best accommodate his or her needs. Cost, level of training and services provided vary among caregivers, agencies, and respite care facilities.
It is recommended that you compare different respite care facilities or caregivers and understand the costs involved. Educating yourself with important factors associated with respite care helps you choose to find out the best caregiving support for your dear one.
Whether you have a respite caregiver who provides in-home service or you go to a facility, taking a break gives you much-needed personal time while giving you the peace of mind that your elderly parent is still properly cared for.
What is Respite Care?
Respite care provides a short but vital break to caregivers. In some families, an older adult is reliant on the minor care provided by the family. In other cases, the elderly require comprehensive care involving all levels of medical support and personal assistance.
When the caregiver or the family feels tired, a break is important to regain their energy. They may need assistance on a day to day basis. In some cases, the caregiver may need someone who can provide respite care for some time, while they travel or need some rest from the demanding task of taking care of their sick parent or grandparent. Respite care workers or facilities provide this type of support.
Respite care can vary in time from part-time a day to several weeks, or sometimes months. It encompasses a wide variety of services, including traditional home-based care, skilled nursing, home health, and short term institution care. It can take place in your own house, day-care centers, or at residential or nursing facilities that offer overnight stays.
Seeking respite care is not selfish. It eases the burden of family caregiving and prevents you from becoming exhausted, isolated, or burned out. If you’re overwhelmed by daily caregiving, your compassion and patience may wear thin. In this scenario, it may become harder to connect with the person you’re caring for.
A short break makes you more positive, energetic, and reinvigorated about your role as a caregiver. It can be an opportunity to pick new ideas to tackle problems you might be facing as a caregiver. At the same time, it provides a welcome change of routine to the elderly you’re caring for.
Demographics in the US and Canada
On average, caregivers report they provide nearly 21 hours of caregiving a week for three years. Eight in 10 caregivers are positive about their job, but more than half of them say caregiving has increased their stress, while half say that it hurts their health and wellbeing. Four in 10 say that caregiving has affected their mental health and hur their relationship with their partner or spouse.[1]
Almost half of caregivers say they have had to work fewer hours, and one-third say they have used vacation or sick time or had repeated work absences. Of the 1,500 employees, who are responsible for caregiving a senior, surveyed by the Harvard researchers, 80 percent said that such responsibility affected their ability to perform their best at workplaces.[2]
On an average informal caregiver spends around 19 hours per week on caregiving, and 1 in 10 spends more than 30 hours on caregiving weekly.[3] Despite little to no training at all, they’re have to provide medical and nursing care in the home, navigate through the complicated health and long-term care systems, and do much more.
Many Canadian caregivers say they have to deal with stress, including 26 percent of those taking care of older adults and 45% of those caring for seniors with dementia.[4]
Distressed caregivers experience plenty of adverse conditions, including deteriorations in mental and physical health, disrupted social and family relationships, and increased risk of death.
Respite CareTypes
There are different types of respite care services. It could take an informal form, which involves enlisting friends or relatives to watch your loved one so that you could take a break for your personal chores.
It is recommended you always consider formal and professional respite care, which involves hiring a paid in-house caregiver or choosing an out-of-home facility.
The type of respite care you choose depends on your situation and services available in your area.
In Home Respite Care
In-home services are typically provided by a volunteer or a paid trained caregiver. You can choose it either occasionally or daily. These services may last from several hours a day, overnight to a few days, and may be arranged by a senior care agency.
In-home respite care is a popular choice as it enables your elderly loved one to stay in their home while continuing to receive care.
The most common types of in-home providers and services are:
- Personal care services provide support with activities of daily living, such as bathing, dressing, feeding, grooming, and toileting.
- Homemaker services involve meal preparation, housekeeping, and grocery shopping.
- Skilled health care service involves giving medical assistance such as medicine administration by specially trained professionals.
- Companion care providers help with supervision, visiting and recreational activities, such as playing games and going for walks. Companions can be paid, or often, they are volunteer members of a non-profit organization.
Adult day care centers
Adult Day programs are ideal for seniors who are no longer independent and may also be isolated.
An adult day center provides services outside the home during the day, such as meals, educational and health activities, games, and socialization in a structured environment. This allows the primary caregiver to balance a job with their caregiving duties.
Staffing often varies across centers. Typically, it involves including a social worker, skilled nurse, and recreation therapist. If an elderly with dementia requires medical services, it is recommended you ask if the center provides required medical assistance.
Hours of services also vary at each center, but most remain open from seven to 10 hours per day, five days a week. Some even offer weekend and evening hours, and most adult respite care centers provide a meal or snack.
A study conducted in 2010 showed that 4,600 adult day centers existed in 2010, a 35 percent increase since 2002, according to the National Adult Day Services Association. As of publication, the association estimates that number has grown to more than 5,000 centers spread across the United States. Daycare centers provided more than 260,000 people, including participants and caregivers, with services in 2010, an increase of more than 100,000 people since 2002.
A 2010 study conducted by the National Adult Day Services Association revealed that there were 4,600 adult day care centers in 2010, which is a 35 percent increase since 2002. The U.S. Bureau of Labor Statistics reported that the need for nursing aides would grow by 20 percent between 2010 and 2020, suggesting the continuous growth of adult daycare centers, as more clients need services.[5]
Residential Respite Care
This type of care takes the form of nursing homes, group homes, or specialized facilities, such as assisted living communities. It provides an option to stay in a residential facility overnight, for a few weeks or months.
Residential respite care allows primary caregivers to take an extended break while the senior under care stays in a safe and supervisor environment designed to meet his or her personal needs.
Most often, older adults find it difficult to adjust to a new environment. But as the staff and other residences become more familiar, the elderly become more comfortable with the environment.
Emergency Respite Care
Various emergencies may arise that demand a sudden need for help. In this case, in-home respite care or retirement homes are available for help.
These emergencies include:
- Personal emergency to the caregiver, including sudden illness, an accident, etc.
- Sudden medical emergency to senior, including a stroke, a fall, or another setback.
Families of elderly people are encouraged to keep a list of emergency contact information handy to have immediate access to support as required.
Respite Care & Short Term Stay
Respite care is a short-term senior care option. But the government allows up to 63 days of respite care in every financial year. In some cases, the government may grant extensions also.
This short term stay can be taken overnight, over the weekend, one or two months, or a certain number of days as the primary caregiver becomes temporarily unavailable.
Services offered in Respite Care Facilities
The unique factor of respite care is it provides personalized care to individuals. This means family members can choose the type and level of services they need.
The type of services depends on the situation of the elderly and the primary caregiver. Seniors may need constant medical care or may need minor care with daily activities. Respite workers can provide services for any need.
Respite worker services can include providing support with personal care such as dressing, bathing, feeding, toileting, and grooming. They can also provide services for daily chores such as meal preparation, cleaning up, laundry, and shopping.
Though respite caregivers don’t provide medical care as a standard, you can find one with skilled care licensing. Such professionals assist with physical therapy and medication.
Respite care provides one-to-one attention and care for elderly persons. This involves providing attention to their needs, such as playing a game, morning or evening walk, companionship, etc. They can assist those dealing with dementia or other mental disorders.
Respite Care for Alzheimer's and Dementia
Taking care of a senior dealing with Alzheimer's 24-hour per day, seven days per week can be draining. Respite care offers relief to caregivers by providing safe and professional support to the person with disease.
There are in-home, short stay and day programs offering viable options for respite care in a safe and controlled environment with licensed nursing services. Shift time and services can vary depending on the individual’s need and schedule.
Respite Care for Strokes
Stroke patients often require additional help with mobility on a 24-hour basis. Some patients also have workout and therapy as part of their treatment.
Respite care for stroke patients varies in intensity, ranging from mild to very goal-oriented. As time passes, the condition of the patient grows more severe. For caregivers, it is important to take some time away from their duties to re-energize themselves and learn better ways to provide care.
Shift length is determined by the needs and schedule of the family and caregivers. Generally, shifts for in-home care ranges from 24-hour or a few days to four-hour shifts. Many in-home shifts at night for 12 hours so that the primary caregiver can sleep well.
Some facilities accept patients on a per-diem basis that means caregiver admits the patient for a particular length of time, such as a weekend.
Respite Care for Cancer
Respite care for cancer patients addresses the patient’s specific needs. Cancer is a large family of disease, and each patient requires unique type and level of care.
Respite care of cancer patients can be physical, emotion and mental, as issues like grief and anger are common. Cancer patients need highly-specialized and trained caregivers.
Respite care of such patients can include both in-home and inpatient settings. Shifts often range from four hours to 24 hours and can be provided by a team of caregivers. You can hire licensed nurses, such as RNs or LVNs. Cancer patients may need end of life care which is often provided by a hospice.
Respite Care for Disabilities
Respite care to elderly with disability allows primary caregivers to regroup and learn new caregiving skills. This ;level of care can be provided in a respite care facility or in-home. It requires specialized caregivers who meet the mental and physical care needs of the patient.
Ready to search for a Respite Care Facility?
Respite Care Costs
An average cost of respite care is difficult to define because of the many options available and length of time variations. In areas with fewer options available, the cost can be substantially higher. However, respite care provided by family or friends may come completely free of charge.
Use the following tool to figure out respite care cost details by state and region. The tool displays average costs for different types of respite care.
| Type of care | Average Cost in Region |
|---|---|
| Skilled Nursing Facilities Private Room Annual Rate: | $91,279.20 |
| Skilled Nursing Facilities Semi-Private Room Annual: | $77,573.45 |
| Assisted Living Facility Monthly Rate (2 bedroom): | $5,699.17 |
| Assisted Living Facility Monthly Rate (1 bedroom): | $5,048.10 |
| Assisted Living Facility Monthly Rate (Studio): | $4,361.03 |
| Registered Nurse Per Visit Rate: | $134.31 |
| Licensed Practical Nurse Per Visit Rate: | $121.60 |
| Home Health Aide Hourly Rate: | $22.63 |
In the USA, the national average cost of caregiving someone into your home or home health aide is around $130.[6]
Adult day care services cost $70 per day[7], while the daily cost for assisted living facilities is $120, excluding additional charges. The daily cost of skilled nursing care is between $230 for a semi-private room and $260 for a private room.
The annual cost of respite care:
| Type of Service | Average Cost |
|---|---|
| Homemaker service | $47,900 |
| Home health aide | $49,100 |
| Adult day care | $18,200 |
Cost of respite care in Canada:
Respite care costs in Canada are often similar to what you pay for long-term care. For a short-term stay, the price is based on the length of the stay, level of care required, and location.
| Province | Respite Care Offered | Cost |
|---|---|---|
| Ontario | Home health care | Free, if you qualify with Local Health Integration Network ( LHIN ) |
| Ontario | Home care | $30/hour or m |
| Ontario | Licensed skilled nurse | $55/hour |
| Ontario | Short stay respite care | $36CA/day, up to 60 consecutive days. The Ministry of Health and Long-Term Care funds it. |
| Alberta | 4 weeks of respite care in a provincially-funded care center | Free, Limited to four weeks/year. |
| British Columbia | Government-subsidized long term care home | 32.59/day |
Respite Care Laws and Regulations
Recognizing the needs of America’s caregivers, the United States Congress, in 2006, passed The Lifespan Respite Care Act of 2006 (HR 3248). The Life Respite Task Force brought success to this legislation, and it includes a large group of national and state, state respite care coalitions organizations, family caregiving, and support groups and many more.[8]
The law provides funds for states to develop lifespan respite programs to give families access to quality and affordable respite care. Lifespan respite care program is a coordinated system of community-based respite care services for family caregivers of children and adults who need special care.
In 2014, Oklahoma enacted the Caregiver Advise, Record, Enable (CARE) Act. The law requires hospitals and rehabilitation facilities to allow patients and guardians to designate a caregiver after discharge from treatment. These centers can consult with the caregiver to describe the patient’s aftercare requirements. As of August 2017, 38 states enacted similar acts to put caregivers at ease.[9]
To now legislative support for family caregivers in Canadian jurisdictions, click here.
Free Respite Care Resources
Use the following resources to locate respite care and short-term rehab services for seniors. Educate yourself with the cost, types, and services offered by these facilities.
The ABCs of Respite: A Consumer Guide for Family Caregivers: Guidance to family caregivers on how to access personal needs for respite and access available services, such as funding sources.
Federal Funding and Support Opportunities for Respite: Building Blocks for Lifespan Respite Systems: State Lifespan Respite Care Programs and their partners with basic information and guidance on the funding sources.
Respite: Time Out for Caregivers: Different types of respite and ways to overcome obstacles.
National Caregiver’s Library: Reference source, including links and checklists to government resources in the U.S.
Special Services At Home Program (SSAH), Canada: The Special Services at Home program helps families who are caring adults with a developmental disability. It is funded by the Ministry of Community and Social Services.
Choosing a Respite Care Facility
If you select in-home respite care, it is recommended that you schedule a meeting with the caregiver in your home. You can ask questions to gain an understanding of his/her passion and skills.
Enquiring about training, background, care philosophy, and experience gives a great idea of the caregiver’s perspective towards his/her job. It is advised to be specific about the characteristics of persons with dementia. If required, you can interview several providers until you find the right person with whom you and your elderly feel comfortable.
If you are looking for an adult day center or a residential facility, you can visit the facility in person and take time to meet the staff and look around.
You use the following checklists when screening different respite care options for your senior loved one. These lists are not comprehensive but may serve as a beginning point for you to consider additional preferences and priorities. Make copies of the list and use it while exploring your best option.
Checklist for an in-home care provider
Offers specific services you need:
- Companionship: supervision, visiting, leisure activities
- Personal care: bathing, dressing, exercising, toileting
- Homemaking: housekeeping, cooking, shopping
- Skilled care: medication and other health needs
Care Provider:
- communicates in the preferred language
- trained in first aid, and dementia care if important
- is bonded
- is available immediately when you need them
- provides a back-up if they are out of town or sick
- able to manage your specific care needs
Checklist for an adult day care center
The center:
- provides respite care
- has a convenient location
- serves during convenient hours
- Offers appropriate services based on specific behavior and health needs
- has staff trained in dementia care
- offers affordable services
- Facilitates transportations
- Provides meals and snacks
- Dispenses and monitors medications
Checklist for residential respite care
Staffing
- Provides required medical care
- Provides personal care and assistance to the needed extent
- Staff able to deal with dementia patients, each with unique needs
Services
- Planned activities on the weekends or during evenings
- Activities to meet specific needs and interests
- Transportation for medical appointments and shopping for personal items
Environment
- Indoor space for easy and independent movements
- Safe and secure indoor and outdoor areas
- Family visiting area
Meals
- Regular meals and snacks
- Family and friends allowed at mealtime
- Adequate nutrition monitoring
- Staff are able to provide for any special dietary needs
- Appropriate assistance as per the person’s abilities
- No environmental distractions
Policies
- Designated visiting hours
- Discharge policy
- Enrollment in Alzheimer’s Association Safe Return® program
Questions to Ask A Respite Care Facility
With everything you do for your loved one - dressing, laundry, companionship, shopping and much more - it can be daunting to think about someone else doing all this, even temporarily. To have a peace of mind to yourself and your senior loved one, it is important that you find the right fit.
You can ensure the same by asking the following important questions to the respite care facility you are considering:
Caregiver
- How does the agency select and trains workers?
- Does the agency perform caregivers’ background check?
- What tasks can the respite worker perform?
- Will the respite provider offer activities or companionship, if requested?
- Does the care provider has a valid driver’s license?
Payment
- What fees does the care provider charge?
- What are the payment options?
- What are your available funding sources?
- Does the respite care covers insurance?
- What is the refund policy?
- Does Medicare and/or Medicaid cover respite care?
Other questions
- How are medical emergencies handled?
- What if the senior asks for services which were not agreed to in the beginning?
- How often can you receive respite care?
- What is the typical time frame for respite care?
Respite Care Facilities by State or Province
United States
Respite Care Facilities by Popular Cities
The Most Affordable Cities For Respite Care
| Rank | City | State | Cost |
|---|---|---|---|
| 1 | Wilmington | NC | $3,692 |
| 2 | Tucson | AZ | $3,774 |
| 3 | Tampa | FL | $3,812 |
| 4 | Mesa | AZ | $3,856 |
| 5 | Orlando | FL | $4,132 |
| 6 | Baltimore | MD | $3,950 |
| 7 | Fayetteville | NC | $4,045 |
References:
- Howard Gleckman. May 18, 2016. Using Big Data To Help Understand The Lives of Family Caregivers. Forbes.com
- Joseph B. Fuller, Manjari Raman. January 17, 2019. The Caring Company. Hbs.edu
- Maire Sinha. September 2013. Portrait of caregivers, 2012. Statcan.gc.ca
- Unpaid caregiver challenges and supports. cihi.ca
- Nancy Wagner. June 18, 2013. Is the Adult Daycare Industry Growing in the U.S.?.. smallbusiness.chron.com
- Cost of Care. genworth.com
- April 2018. Paying for Adult Day Care and Adult Day Health Care. payingforseniorcare.com
- Rep. Ferguson, Mike [R-NJ-7]. Introduced July 12, 2005. H.R.3248 - Lifespan Respite Care Act of 2006. Congress.gov
- Larry Schumacher, Next Avenue Contributor. May 1, 2014. How The CARE Act Would Help Family Caregivers, forbes.com