The dictionary defines respite as 'a delay or cessation for a time, especially of anything distressing or trying; an interval of relief '. Respite services provide temporary relief to the caregiver away from the care recipient. These services may be offered in adult day services centers, nursing homes or assisted living facilities. Other types of respite services may be offered in the caregiver's home through home care agencies, area agencies on aging (AAA or "triple-A's") or other organizations. Informal respite can also be provided by friends, neighbors, relatives, etc.
Respite services have become part of the continuum of care for care recipients. A continuum of care is a progression of care required by an individual to remain independent in the community. On one end of the continuum is someone who is totally independent in the community. At the other end of the continuum is an individual who is living in a long-term care facility. Respite services provide trained individuals to give the caregiver confidence that the care recipient will be cared for safely in the caregiver's absence. Respite services allow the caregiver a brief period of time away from the dual stresses and strains of providing round-the-clock care and managing their household, job or family life.
Respite services also allow the care recipient to have a break away from the caregiver. It is easy to forget that the care recipient also feels the stresses of being dependent and can benefit from contact with new people or someone with different skills or who is less stressed. Respite is beneficial to everyone.
Types of Respite
In-home Respite Care
This includes personal care and companion services, and takes place in the care recipient's home. These services are offered by private for-profit, private not-for-profit, and local government agencies. Local Departments of Social Services, through their Adult Services programs, may offer companion or homemaker services for people who are homebound. Many area agencies on aging also provide short-term personal care in the home on a sliding fee basis. Trained volunteers often are companions for respite services. In other cases, professional care services are offered to help with the bathing, transferring and toileting.
Adult Day Care Centers
These facilities may care for any adult over the age of 18 with a physical or mental impairment. Generally a high proportion of participants are functionally dependent and many have cognitive impairments. This environment is very good for the care recipient because of the social interaction and it also gives the care recipient a break from the routine of the home environment.
Some caregivers find it difficult to get the care recipient up and ready for adult day care. Others find that extra effort well worth it to have the day and the home to themselves. Adult day care centers staff generally provide useful tips about getting the person ready and will also help arrange transportation. Once the routine of going is established, most caregivers and care recipients benefit from the regular access to professional staff, the activities and the contact with other families that adult day care provides.
Institutional Respite Care
Nursing homes, assisted living and occasionally hospitals provide respite services for those care recipients who may need to be away from their home overnight or for several days. They are also able to handle the individual who is in need of greater care. The cost and completion of the paper work in this type of facility discourages the use of them.
Things to Think About
Before deciding on what kind and how much respite care you need, give some thought to your situation. Ask yourself these questions:
- Which tasks do I need help with? (companion services, home care services that would help me with ADLs, transportation)
- Do I need someone to sit with my care recipient?
- Do I need help around my home? (yardwork, home repair, cleaning, shopping, fixing meals)
- Which tasks does my care recipient need help with while I am gone?
- Is there a family member that will help me?
- Do I have any limitations on what I can afford?
- Am I eligible to receive any respite services?
- Has my doctor written a referral for these services? Can my doctor recommend a facility which provides respite?
- Have I checked with the Area Agency on Agency? Do they have any scholarships available?
- Are there national organizations that may provide respite support? (ie. American Cancer Society, Alzheimer's Association)
- Does my church have volunteers that can help me?
- Would my care recipient benefit from going to an Adult Day Care Center?
Costs for respite services vary depending on the level of care that is required and the type of facility where it occurs. Institutional Respite care will usually be the most expensive followed by in-home Respite Care, with Adult Day Care being least expensive.
Under the Medicare Hospice Benefit, short-term in-patient respite care is covered. Medicare will cover 5% of the Medicare payment amount for inpatient respite care. You can stay up to 5 days at a time at a Medicare approved hospital or nursing home. There is no limit on the number of times that you may get respite care. The amount you pay for respite care can change each year.
Medicaid does cover respite in an adult day services center if the care recipient meets income requirements and is dependent in the activities of daily living (include bathing, toileting, eating, etc.).
Medicaid also covers short-term in-patient respite care under the Hospice Medicaid reimbursement. Medicaid will cover respite services to relieve family members or other persons caring for a hospice patient at home. Medicaid will not cover respite services for hospice patients residing in a nursing home.
Finding Respite Services
- Do a search on this website, in the 'What you need?' box, type in "respite" and your city, county or zipcode.
- Your local Area Agency on Aging or Department of Social Services (DSS) office will be able to tell you the different organizations and facilities that offer respite care. You can search for these on this website using the quick search.
- Call Eldercare Locator 1-800-677-1116, Monday - Friday 9:00 a.m. - 8:00 p.m. They will be able to guide you to the appropriate Area Agency on Aging.
- Planning for regular respite is part of taking care of yourself. It is easier to arrange regular respite and prevent caregiver burnout than to find reliable care after you are worn out or in crisis.
- When using respite services that are located away from home, such as adult day services or overnight respite, try to take along a few things that are familiar to the person in your care. Some caregivers have told us that they take along pictures, a favorite pillow or a favorite blanket because these things help keep a sense of calm and security.
- Keeping a notebook with information about the person in your care can make caregiving easier for you.