Understanding Home Care Services – Seminar Summary

Senior Learning Institute Seminar presented by Allen Serfas, President & Co-Founder of Assistance Home Care

This morning, I had the opportunity to speak at the St. Louis Senior Learning Institute seminar at the Maryland Heights Community Center. I appreciated the thoughtful questions, the open discussion, and the chance to talk about a topic many families face, often without warning.

Home care often becomes part of the conversation when families begin asking difficult questions.

How do we help Mom stay safe at home?
How do we support Dad without burning out the whole family?
How do we know when it is time to bring in help?

These are deeply personal decisions. They carry emotion, stress, and often a sense of guilt.

I understand that experience firsthand.

A Personal Experience That Shaped Our Mission

My wife Sally cared for her mother for five years while raising our three children. Her mother was living with Alzheimer’s disease. During that time, we saw the strain that family caregiving can place on one person.

We also saw something else.

Most people want the same thing as they age. They want to remain at home.

That experience helped shape our story and why we started Assistance Home Care 15 years ago. Our mission has always been simple:

When moving isn’t an option, we are committed to honoring a person’s wish to stay at home with compassion, dignity, and respect.

Understanding the Difference Between Home Health and Home Care

One of the first topics we discussed during the seminar was a common point of confusion.

Many families assume home health and home care are the same thing. They are not.

Home health typically involves skilled medical services following a hospital stay. These services may include nursing care, physical therapy, occupational therapy, or speech therapy. They are often covered by Medicare or insurance for a limited period of time.

Home care services, on the other hand, provides non-medical support with daily life. This can include help with:

• Getting out of bed

• Bathing and dressing

• Meal preparation

• Medication reminders

• Transportation to appointments

• Light housekeeping and laundry

• Companionship and routine support

These services help individuals remain safe, comfortable, and independent at home.

When Families Worry a Loved One Will Not Accept Help

Families often tell us, “My mom will never accept help,” or “My dad does not want a stranger in the house.”

Sometimes that concern is valid. But in many situations, the resistance is stronger in the family’s mind than in the client’s.

Over the years, I have seen many families expect objections to home care, only to discover their loved one adjusts far better than anticipated.

Often, the real challenge is not whether care is needed.
The challenge is whether everyone is ready to accept it.

The Reality of Family Caregiving

Family caregiving frequently falls on one person.

Even in large families, one adult child or spouse often becomes the primary caregiver. That person carries the logistics, the emotional weight, the late-night worry, and the interruptions to work, marriage, and parenting.

In many cases, home care is not only about helping the client.

It is about giving the family peace of mind.

Why the Caregiver Match Matters

Another important point we discussed is the importance of the caregiver match.

A caregiver does not have to be a bad person for a situation to be a bad fit. Connection matters. Eye contact matters. Listening matters.

Families should never feel stuck in a care situation that does not feel right.

Good communication with the agency is often the fastest way to improve care and find a better match.

The Importance of a Detailed Care Plan

Families also benefit from being clear about what they want and need.

A thoughtful care plan helps everyone succeed.

Simple details can make a meaningful difference, such as:

• What time your loved one prefers to wake up

• Whether they prefer a morning or evening shower

• Routines that help them feel calm

• Triggers that may cause frustration

• The overall goals of care

These details create consistency, reduce misunderstandings, and help caregivers provide more personalized support.

Understanding the Cost of Home Care

We also spent time discussing the cost of home care, because families deserve straightforward answers.

Home care is typically paid for through a combination of options such as:

• Private pay

• Long-term care insurance

• Certain veterans benefits

• Limited Medicaid programs

• Community respite programs

While costs can vary, families should be cautious about making decisions based on price alone. Lower rates can sometimes reflect lower caregiver pay, less training, or fewer support systems.

In home care, caregiver stability directly affects the client experience.

Simply put, happy caregivers help create stable care.

Private Hire Caregivers vs. Professional Agency Caregivers

Another important discussion centered on the difference between hiring a caregiver privately versus working with an agency.

Hiring privately may appear less expensive at first glance. However, families often do not see the full picture.

Private caregivers may not be thoroughly screened, trained, supervised, insured, or backed up if something goes wrong.

If a caregiver becomes injured in the home, liability can become a serious concern. If the caregiver does not show up, the family may have no backup plan. If boundaries become blurred, there may be no third party to help resolve the situation.

A reputable home care agency provides structure, oversight, accountability, and backup support. Those protections often become invaluable when unexpected situations arise.

Supporting Loved Ones Living with Dementia

Dementia care is another topic that always brings strong emotions because so many families are living it right now.

One reminder I often share is that behaviors associated with dementia are not personal.

If someone living with dementia says, “I want to go home,” correcting them can increase distress. It is often more helpful to join their reality, walk with them, talk with them, and gently redirect the conversation.

Music can also be a powerful tool. The right song can bring comfort, memories, and connection in ways that other approaches cannot.

Small moments matter.

A short visit matters.
A calm tone matters.
Patience matters.

The Power of Honest Conversations

One of the things I appreciated most about this seminar was the honesty in the room.

Families asked real questions. They shared frustrations, worries, and lessons learned.

Those conversations help people realize they are not alone, and they help others prepare for the journey ahead.

Planning Ahead Makes a Difference

Home care works best when families begin planning before a crisis forces the decision.

Ask questions early.
Interview multiple providers.
Speak with trusted referral sources.
Read reviews from both clients and employees.
Build a thoughtful care plan.

And if something does not feel right, speak up.

Aging at home is possible for many people, but it rarely happens by accident.

It takes planning.
It takes support.
It takes the right team.

Thank You to the Senior Learning Institute

Thank you to the St. Louis Senior Learning Institute and everyone who joined us this morning at the Maryland Heights Community Center. I truly appreciated the opportunity to spend time with you and be part of such an open and meaningful conversation about aging and caregiving.

If your family is beginning to explore home care or needs support now, our Team at Assistance Home Care is always here to help guide you through the process.