What is Live In Care?

What is Live in care?services_activities_image

Live in care is one of the most popular services we offer for those who need continuous help, but don’t want to live in a skilled nursing, assisted living or AFH. Live in care is a great solution for couples who want to remain together, or for anyone who wants to age in place. 

Why not just go to a nursing home? 

In a skilled nursing facility you have very little control over who the caregivers are, or what sort of schedule you are on. By receiving care at home- you are in control. You decide what to eat, when to sleep, when to bathe, what to watch on TV … it is all up to you- all in the comfort of your own home.

Most people do not want to live in an hospital like setting- they prefer the privacy, comfort and familiarity of their home. 


How much does live in care cost?

Live in care costs around $400 per day, depending on the level of care required- and with the stipulation that the caregiver gets 8 hours of sleep each night. 

What if the client needs to get up during the night? 
If the caregiver is called upon during the 8 hours of sleep time, then the client must pay an hourly rate for any amount of time the caregiver is working (for example, if they needed 10 minutes of help at 2am, the client would be billed for 15 minutes at $30/hour).  IF the caregiver is woken up many times and does not receive a minimum of 5 hours of uninterrupted sleep, the client then must pay for all 8 hours of “sleep time” at the hourly rate of $30/hr for that portion of time.  This is in addition to the $400/day. This would mean if the client wakes up frequently, worse case scenario would be $400/day + 8 hours @ $30/hr = $590 per day.

The second option would be to do the live in as above, but also bring in an additional caregiver who would be awake throughout the night to assist the client as needed. This would be billed at 30/hour, but ensures the live in caregiver will get the required 5 hours of uninterrupted sleep.  $400/day + 6 hrs @ $30/hr.= $530 per day.

A third option would be if the client either does not have space for a caregiver to sleep, or they require around the clock care ( 2-12 hour shifts or 3-8 hour shifts daily).  Then all 24 hours of the day would be billed at an hourly rate ($30 – $34/hour depending on level of care required).  This option is certainly the most expensive for families running at a minimum of $720 to a maximum of $816 per day.

Wow, that sounds expensive! 

Yes, care can really add up, but keep in mind that care in a private room in a Skilled Nursing can be as much as $8000-15,000 a month*, and unfortunately Medicare does not pay for this- unless you have had a qualifying 3 night hospital stay** , and even then care is only covered at 100% for 20 days. 

Many clients have Long Term Care insurance that will help with costs. Capability Homecare can refer you to a trusted LTC agent if needed. 

Would it be the same caregiver all week?

Because of overtime laws,  there would be 3 caregivers who would share the duties. Each would work 3 consecutive days to maintain consistency. 

Where does the caregiver sleep?

The caregiver must have her own room for sleeping. 

What are some of the duties the caregiver would do? 

Caregivers assist clients in a variety of ways-

  • incontinence/ personal care 
  • bathing 
  • dressing 
  • ambulation/ fall prevention 
  • medication reminders
  • meal preparation, assistance with eating
  • housekeeping 
  • transportation
  • and more

Who are typical clients?

We assist seniors who have Alzheimer’s, dementia, stroke, Parkinsons, Cancer, COPD, heart failure,   MS and more.

We also help those who have just been discharged from the hospital or SNF.

There really is no such thing as a typical client, which is why we create a customized care plan for each client. 

This sounds great- how do I get started? 

Call our office today to get started- 425 679 5770. Our friendly staff will gather as much information as possible, then we will schedule a home visit to do a formal assessment. Once we fully understand your needs we will write up a detailed plan of care and schedule your personal caregivers. 



Top 10 Did You Know?

Homecare services can be confusing sometimes, so today I want to share with you 10 things that you may not know about Capability Homecare.

  1. Did you know that if you have an elderly parent that you take care of- and you need to go out of town- Capability Homecare can provide caregivers to stay with them to ensure they are safe and well cared for in your absence?
  2. Did you know that almost 1/3 of our clients are on hospice care? Capability Homecare can be with the patient 24/7 to help support the hospice team and provide care during those critical times?
  3. Did you know that if your elderly parent is recovering from a surgery or procedure (hip replacement, knee replacement, mastectomy, back surgery…) and need help for those first few weeks, Capability Homecare provides caregivers to assist through the recovery process?
  4. Did you know Capability Homecare provides live in caregivers? Caregivers stay overnight in your loved one’s home and are there 24/7 to assist with whatever they need. This is a great alternative to moving into an Assisted Living and perfect for couples who want to stay together.
  5. Did you know that Capability Homecare offers Nurse Delegation? This is a much more affordable way to have skilled services!
  6. Did you know that Capability Homecare provides help for seniors with dementia and Alzheimer’s? If couple wants to stay together (instead of one moving to memory care) we have experienced caregivers who can assist with the day to day needs.
  7. Did you know Capability Homecare offers FREE online training for families who are caring for a loved one? It’s so easy- just log in and learn.
  8. Did you know that Capability Homecare helps with tasks such as light housekeeping and grocery shopping? We even can make meals to last all week!
  9. Did you know we pride ourselves on having a diverse office staff that can truly relate to our clients? Our internal staff have over 60 years of combined experience! We aim to always provide exceptional caregivers that enrich the lives of our clients.
  10. Did you know Capability Homecare is locally owned and operated- and not part of a franchise? We’ve been in business for over 8 years and are proud of the excellent reputation we have built!

Call us today to find out how we can help you! 425 679 5770

How Much Does Senior Care Really Cost?

As far as senior care goes, when it comes down to it- one thing people really care about is how much does it cost?
So today I want to share what senior care actually costs. All figures are averages– and depending on circumstances (level of acuity), cost can increase significantly. Rates were based on Genworth’s Annual Care Costs report.*

Homecare– (this is what Capability Homecare  provides)

  • Caregivers are assigned to a specific client and assist with medication, mobility, personal care (assist with toilet, catheter & ostomy care), bathing, meals & nutritiion, housekeeping, transportation, skin care, and ADL’s.
  • For 8 hours a day of service- it can cost around $240 a day (average cost is around $30 per hour, most agencies have a 4 hour per week minimum). Care can be short term or long term. Care is usually paid for privately or with LTC Insurance.

Assisted Living

  • Facilities that provide supervision or assistance with activities of daily living (ADLs); coordination of services by outside health care providers; and monitoring of resident activities to help to ensure their health, safety, and well-being. Meals, housekeeping and care are provided. Caregivers assist residents, but are not assigned one on one.
  • Depending on how much care is needed- costs can range from $6000 a month to upwards of $7000+. Memory care is often more expensive. AL is paid for privately or with LTC Insurance.

Adult Family Home

  • Homes that have been configured to provide housing, meals and care for between 2- 6 senior residents. They are often for people with dementia, but each home is very different and specialize in their own specific care.
  • Because there are so many homes in the Greater Seattle area, we recommend using a Placement Specialist to find the best fit for your specific needs.
  • Most homes have a home doctor/ or nurse practioner who regulary visit the residents (billing Medicare)
  • Cost can be around $6000- $7000 a month.

Skilled Nursing Facility

  • This is more of a hospital type setting. Often seniors will share a room with another person. There is a MD on staff as well as nurses, caregivers, social workers and rehab staff.
  • If there has been a hospital stay (with 3 midnights) Medicare will pay for services- for a limited time. Sometimes, after Medicare stops paying, people chose to continue on at a SNF and live in the Long Term Care wing. The average daily cost for private pay in a SNF is $320 (semi private) and $420 (private) a day.

Adult Day Care

  • Drop off daycare where seniors can socialize with other seniors, enjoy a meal and participate in an activity or outing. Seniors enjoy the companionship of other seniors and have access to staff.
  • Average cost of Adult Day Care is around $100 a day.

Home Health

  • Services include Wound Care, PT, OT, Speech therapy, Social Work and sometimes a bath visit. Clinician comes to the client’s home to provide services on a short term basis.
  • This is generally covered by Medicare- and must be received under doctor’s orders and meet certain requirements (patient must be considered homebound). Different than Homecare- but the two services complement one another and often get confused.


  • Must be determined by MD and meet certain criteria. Nurses and caregivers provide comfort care for terminally ill patients.
  • Medicare benefit.

Long Term Care Insurance

  • Often a great way to pay for many of these services. It does require advance planning (usually around 10 years), but can be a lifesaver if needed. Be sure to buy from a trusted agent and do your homework!

Elder Care Attorney

  • Speak to an Elder Care attorney who can help protect your assets and do long term planning for your estate.
For more information about any of these options, please call Capability Homecare. We have many trusted partners that we would be happy to refer you to. 

National Fall Prevention Awareness Day

With today being Falls Prevention Awareness day, I thought I would share some important tips of preventing falls.

According to the National Council on Aging, there are 5 things one can do to prevent falls:

  1. Talk to your doctor and get an assessment of your risk of falling

  2. Review your medication with your doctor, sometimes side effects may be causing falls

  3. Find a good balance and exercise program

  4. Get your vision and hearing checked every year

  5. Ask your family for help and support

This last one really hits home with me because my grandfather had a couple of falls and in hindsight we should have seen it coming.

Shortly after my grandmother passed away we started noticing changes in my grandfather. Not anything significant, but we did recognize that he moved a bit slower and lacked the energy we were used to seeing. Since he had just lost his wife, we figured this was just part of the grieving and aging process and thought nothing of it, until my mom started getting phone calls in the middle of the night. “Judy, can you come over here?’ he would ask- and in a panic my mom would drive over to his apartment to help him out.

It was usually something small he needed help with- sometimes he was waking from a dream and was frightened, other times he had been incontinent and needed help. My mom would settle him down, get him cleaned up and back into bed safe and sound. This was mildly inconvenient for my mom, but not a huge deal since the phone calls were fairly infrequent. Until the night when the phone call was more serious, he had broken his hip and this changed everything.

Looking back, we should have recognized those early phone calls for what they were- a cry for help. He was a prideful man, and fiercely independent- and we wanted to honor that in him by allowing him to live independently- but at the same time, here was a person who was clearly in need of some assistance.

Because of the lack of support, he had a fall. Luckily, he was able to call 911 and was taken to the emergency room. He had broken his hip and would need surgery. This meant that his life was going to change dramatically. He could no longer live in his apartment- instead he was moved to a skilled nursing facility where he could have more supervision and medical care to recover from his surgery.

Unfortunately, being the strong willed person that he was, he still kept trying to get out of bed on his own- and about 2 months after the first fall- ended up falling for a second time and breaking his hip on the other side. This meant another surgery- and even more recovery.

At this point my family decided to hire private care through Capability Homecare to supplement the staff at the skilled nursing. He needed more supervision than the SNF could provide.

Having someone by his side to help with getting ready and into bed was important. And once he was asleep, knowing someone was right there in case he got up un the middle of the night allowed him (and my mom) to sleep soundly knowing help was nearby. He could get up and use the restroom when he wanted, knowing the aide would assist him in getting there and help with cleaning up any accidents. In the morning when we woke up, someone was right there to assist him in getting out of bed and dressed for the day. This brought peace of mind to the entire family and is a decision I only wish we had made earlier.

If you have a loved one who you think might have had a fall (or two), or be at risk for a fall, consider hiring a caregiver to give them the support they need. Many falls can be prevented- and a caregiver can be on hand to ensure that your loved one is safe.

Capability Homecare can help with bathing (most falls occur in the bathroom), or help with preparing and eating meals, they can help with ambulation (getting in and out of bed and chairs) and can help getting up or down stairs. They can assist your loved one with the ADL’s that may no longer be easy to do all alone.

Let Capability Homecare help keep your loved one safe.

Part 3, A Patient’s Rights

It’s important to understand that as a patient in a Skilled Nursing Facility you have rights.

These are copied directly from the medicare nursing home website, which can be found here.

You have the right to be told in writing about all nursing home services and fees (those that are charged and not charged to you) before you move into the nursing home and at any time when services and fees change.

The nursing home has to notify you before your room or your roommate is changed and should take your preferences into account.

The nursing home must provide you with any needed social services, including the following:

  • Counseling

  • Help solving problems with other residents.

  • Help in contacting legal and financial professionals

  • Discharge planning

If your health allows, and your doctor agrees, you can spend time away from the nursing home visiting family or friends during the day or overnight, called a “leave of absence.” Talk to the nursing home staff a few days ahead of time so the staff has time to prepare your medicines and write your instructions. 

You can’t be sent to another nursing home, or made to leave the nursing home, unless any of the following are true:

  • It’s necessary for the welfare, health, or safety of you or others.

  • Your health has improved to the point that nursing home care is no longer necessary.

  • The nursing home hasn’t been paid for services you got.

  • The nursing home closes.

You have the following rights:

You have the right to appeal a transfer or discharge to the State.
The nursing home can’t make you leave if you’re waiting to get Medicaid.
 Except in emergencies, nursing homes must give a 30-day written notice of their plan and reason to discharge or transfer you.
 The nursing home has to safely and orderly transfer or discharge you and give you proper notice of bed-hold and/or readmission requirements. 

You have a right to form or participate in a resident group to discuss issues and concerns about the nursing home’s policies and operations. Most homes have such groups, often called “resident councils.” The home must give you meeting space and must listen to and act upon grievances and recommendations of the group. 

If possible, I would recommend printing these out and keeping a notebook with pertinent information in it (including either a copy (or a note of where it can be located) of your power of attorney (both medical and durable), a list of all medications, lists of phone numbers of families and all doctors, and any other information that you think should be included.

Part 2 Skilled Nursing Facilities in Seattle

One of the most important things to understand when thinking about Skilled Nursing is that you have a choice.

You have control over where you or your  loved one will go- and it’s important that you carefully consider all your options before making a decision. The last thing you want to do is to have to move!

We are very fortunate in the Seattle area because we have so many wonderful SNF’s to choose from.

Last week I talked about things to look for when selecting a skilled nursing- refer to that list to help you evaluate each one. As I mentioned last week, be sure to tour as many as you can- and don’t be afraid to ask questions!

If you are assisting your parents in selecting a place a SNF, I would say one of the most important criteria is proximity to your home. Chances are you will be visiting daily (and sometimes even in the middle of the night) and you will want it close to home! Trust me on this one.

Below is a list of my favorite Skilled Nursing Facilities in the area. I have included ones from all over- and personally toured all of them.


Kline Galland


Life Care of Kirkland

Bothell Health Care

Springs at Pacific Regent



Issaquah Nursing and Rehab

Covenant Shores Health Center

Cascade Vista


Emerald Heights

Park West

Providence Marionwood

Washington Care Center

Ballard Rehab

Another thing to consider- if finances allow- is to hire extra help to provide overnight care. We did this with my grandfather, and while it was expensive, it also gave us peace of mind knowing that if he needed to get up in the middle of the night (which he frequently did), or had issues with incontinence (which he frequently did) someone was right there to assist him.

Keep in mind, many SNF’s have less staff overnight, so be sure to ask about the patient to staff ratio. If the patient is a fall risk, or has incontinence issues- it may be worth the extra money to have private help.

Be sure to read next week when I discuss the rights for patients in nursing homes!

What to Look for in Skilled Nursing

 Part 1 in a 3 Part Series on Skilled Nursing

What to Look For

Back in the old days most people knew they would one day end up in an ‘old folks home’ as we used to call it.

Today many people are choosing to age in place and bring the care they need into the privacy of their own homes.

Yet, some people do need skilled nursing care– and in those cases a Skilled Nursing Facility is the perfect option.

By definition, a skilled nursing home is:

A place where “… care of every patient be under the supervision of a physician, that a physician be available on an emergency basis, that records of the condition and care of every patient be maintained, that nursing service be available 24 hours a day, and that at least one full-time registered nurse be employed… ” Source: The Free Dictionary.

Skilled nursing facilites offer care in a variety of ways:

Some offer care for those who have been discharged from the hospital, yet aren’t quite ready to return home.

Others use skilled nursing facilities for their Long Term Care needs- meaning this is where they will live the rest of their lives- receiving nursing care and sometimes hospice care.

Whatever your reason for needing a skilled nursing facility, there are many things you should consider before deciding on one. As soon as you know (or think) that skilled nursing is going to be needed, talk to as many people as you can (not just the hospital discharge planner) to find out which one best suits your personal needs.

If possible, it is highly recommended that you tour each facility on your list and look for certain things such as:

  • Is it well maintained inside and out?

  • Is the decor pleasing and warm?

  • Is the facility free from odors?

  • If there are odors, are they handled quickly?

  • Do all rooms have private bathrooms?

  • Are there electric beds?

  • Is the attitude of the nursing staff caring and friendly?

  • Are meals nutritious and appealing?

  • Is the kitchen clean and orderly?

  • Does a registered dietician, or professional service, plan meals?

  • Are there individual and group activities and a monthly calendar?

  • Are arts and crafts offered?

  • Are there special outings?

  • Are non Medicare patients allowed to visit home?

  • Do they have an active volunteer visiting program?

  • Do they provide in-house physical therapy?

  • Is speech and occupational therapy available?

  • Are therapists licensed?

  • Are religious services, or transportation to churches offered?

  • If privately owned, is the owner available?

  • If managed by an outside service, how do their other facilities compare?

  • What is the reputation in the surrounding community?

  • How does the facility treat residents with similar needs?

List provided by medicare.gov