Home care services are a small piece of the retirement industry that is going to get larger, according to Always Best Care Senior Services President and Owner Jim Smeaton.

Studies have shown that 75% of individuals 65 years of age and older are going to need some level of assistance at some point, and AARP’s 2021 Home and Community Preferences survey found that over three-quarters (77%) of adults ages 50 and older want to remain in their homes as they age. Smeaton said there is a clash here, meaning an increasing number of retirees will likely need to bring some level of assistance or care into their home as they age.

In addition to the increasing choice to age in place, assisted living communities can be financially restrictive to some individuals. Assisted living communities in Buncombe and Henderson Counties can range from $5,500 to $6,000 per month, according to Smeaton. Skilled nursing facilities can cost even more, ranging from $8,000 to $9,000 per month. There can be misconceptions about Medicare coverage in relation to these types of care. Medicare does not cover these costs, meaning these costs are paid out-of-pocket for many seniors. 

With Western North Carolina drawing a large number of retirees, the area has a larger senior population than other areas. Many seniors relocating here from other areas do not have family or adult children nearby to help as help becomes needed, meaning the need for senior service businesses is increasing. 

There are several levels of home care services seniors may need:

• Companionship services consist of things that seniors need minor help with or tasks they simply don’t like doing, including help with tasks such as planning outings and trips, preparing grocery lists, managing calendars, as well as providing opportunities for conversations and reminiscing.

• Home helper services include tasks like providing medication reminders, changing linens, preparing meals, and helping care for pets. 

• Personal care services include help with tasks of daily living such as bathing, dressing, grooming and mobility.

• Skilled care services assist seniors with feeding, incontinence care, post-surgery and wound care, and fall risk identification and reduction.

• Many home care services also offer respite care, giving regular caregivers a break from some tasks so they may take care for themselves.

There are also companies that provide help with administrative tasks like organizing tax records, paying bills, going through mail, and other paperwork that may be required as part of staying in one’s home.

“Lots of clients get very little personal assistance and more help with household chores,” Smeaton said. “Assistance is really a broad term. As we get older, it just gets more difficult to get things done.”

Smeaton said the percentage of older retirees needing some type of assistance at home is growing, especially since the COVID-19 pandemic. The level of care needed at home is also progressing. Both new and existing clients are needing more services, and some want to stay home even when dependent upon lifts and hospital beds, which means that providing care becomes more challenging as well as more costly for the clients.

Since the pandemic, hiring a staff of caregivers continues to be a challenge. There is a high turnover rate of approximately 50% in any care facility or business according to Smeaton, and many staff, like certified nursing assistants, must have certain certifications which adds to the challenge.

“I’m hiring about four caregivers per week,” Smeaton said. “If you gave me 10 new caregivers today, I can have them all working full time in about a week. They just need to have the desire and the heart to provide care, and that’s not for everyone.”

Staffing issues for home care companies and retirement communities create ripples back to healthcare systems. When local hospitals need to discharge patients that will require followup care, the patients must have care lined up. If no home care is available, they may have to go to a facility despite it not being their first choice. Also, facilities must maintain certain staff-to-resident ratios, and if local facilities are also facing staffing shortages, this creates a real problem for the aging population.

“Hiring was not a problem five years ago, but it’s key right now for all aging care businesses,” Smeaton said. “We have a full-time recruiter because just waiting for the phone to ring isn’t good enough. We are looking at what we can do to be different as an employer, and to find the right types of people for this kind of work.”