A companion for an elderly widowed father is not a nurse: what a few hours a week actually looks like

A companion for an elderly widowed father is the phrase you searched, and the word companion is doing a lot of work, so let us be exact. This is not a nurse. It is not home health. Nobody takes a blood pressure or changes a dressing. It is a person who comes to the house on Tuesday and Thursday from one to four, makes lunch with him, drives him to the pharmacy and the hardware store, folds the towels while the game is on the radio, and leaves the kitchen cleaner than she found it. To your father, it is company. To you, it is the first afternoon since March when you knew somebody was in the house.

What a few hours a week looks like

The National Institute on Aging's page on services for older adults living at home has a heading for this. Under friendly visitor and senior companion services it describes organizations whose volunteers pay short visits of less than two hours to provide support, assistance and companionship, and notes that you can also get this type of service from an agency for a fee. The same page says something quieter that every daughter should read twice: some older adults, especially people who live alone, simply need someone to check on them.

In a west county kitchen, the paid version of that looks like this. Lunch, cooked at his stove from what is in the fridge, eaten at the table with the radio on. The grocery run, with him along. A walk to the end of the street at the pace he sets. The pharmacy pickup. Laundry folded together. A look at the pill box, and a word to you if a day is still full. And an hour of talk about your mother, which is the part he will never ask for and the part he needs most.

What it is not, in plain terms

Missouri's health department describes three types of care in the home. Home health, with Medicare as the major payer, is skilled and part-time, ordered by a physician. In-home care through Medicaid is homemaker and personal care requested through the state. The third type, private duty or private pay, is paid with private funds or insurance, needs no physician order for aide personal care, respite, or companion care, and is a type of company for which Missouri issues no license. A companion caregiver is that third type. She does not do nursing tasks, does not decide what a symptom means, and does not set or change a dose. If he needs a nurse, that is a different phone call and his doctor makes it.

The money follows the same line. Medicare's home health page says Medicare does not pay for 24-hour care at home, for homemaker services like shopping and cleaning unrelated to a care plan, or for custodial or personal care with daily living when that is the only care needed. The NIA's services page says Medicare, Medicaid and private insurance generally do not cover companion visits, and that some long-term care insurance plans help. So for most families this is paid privately, and the honest thing to do is ask any company how it charges before you ask how soon it can start.

How to bring it up so it is company, not care

He will say no. The Family Caregiver Alliance's page on hiring in-home help says families often face a loved one who does not want a stranger in the house, and its advice is to tell the person that you need the help, and that accepting it is something they can do for you, not a sign that you are going to abandon them. That is the whole script. Not "you need someone." "I need someone, Dad. I cannot get here Tuesdays and it is making me sick with worry. Do this for me."

A few more things that work on a proud man. Frame it as help for the house, not for him: the laundry, the groceries, the kitchen, the things your mother did. Offer a trial: four visits, then he decides. Let him set the rules: which days, which hours, whether the person may touch the garage. Let him meet the person with you in the room, and let him say no to a person, which is different from saying no to the idea. And never use the word caregiver in front of him. The word is helper, or the person's first name. There is an entire desk about the stubborn version of this conversation at Dad Refuses Help, and it is worth an evening.

Stacking a week so there are no gaps

Build the week like a rota. Monday, Meals on Wheels at the door if he qualifies, which comes with a volunteer's safety check. Tuesday, the helper, one to four. Wednesday, the neighbour who has offered nine times. Thursday, the helper again. Friday, your call at six. Saturday, you, with a plate for the fridge. Sunday, church. Write it on the card on his fridge. A widower with a week written down is a widower who knows on Tuesday morning that someone is coming.

If Dad served

Two doors open for a veteran. The VA runs a Homemaker and Home Health Aide program in which a trained person, supervised by a registered nurse, comes to a veteran's home to help with personal care and daily activities so he can remain at home; that is arranged through his VA care, not through a private company. Separately, VA Aid and Attendance is a monthly payment added to a VA pension for qualified veterans and survivors who need help with daily activities such as bathing, feeding and dressing, or who are housebound. Whether he qualifies is a VA determination with its own forms and limits, and the desk at Aid and Attendance STL walks the whole application, with the current year's rates.

Questions daughters ask

Will Medicare pay for a companion for my father?

No. Medicare's own page says it does not pay for homemaker services, for 24-hour care at home, or for personal care with daily living when that is the only care needed. The NIA says companion visits are generally not covered by Medicare, Medicaid or private insurance, and that some long-term care policies help. Ask the company how it charges. We do not print rates.

What should I ask any company before someone comes to the house?

Exactly what its people will and will not do, especially with medicines. Who is coming, and whether it is the same person each time. What happens when that person is sick. How it charges, and for what minimum. What it does if he says no at the door. Do not ask about a Missouri license for this type of company, because the state does not issue one; ask instead how the company chooses and trains its people, and listen for a real answer.

How many hours a week does he need?

The number is his, and it should start small. Two afternoons is a common shape because it covers lunch twice and leaves him his own week. If he takes to the person, the hours grow on their own. If he does not, you have learned something for the price of four visits.