How many hours of home care do you need?

This is the number that drives the bill, and almost nobody is asked for it. A monthly quote means nothing until you know which hours it assumed.

The arithmetic

hourly rate × hours per week × 4.33 = monthly cost — 4.33 is the average number of weeks in a month. Published "monthly" figures nearly always assume a specific hours figure; the CareScout survey we cite uses 44 hours per week.

What actually drives the hours

• ADLs — bathing, dressing, toileting, transferring, eating. Two visits a day can mean 2–4 hours; incontinence or two-person transfers push it higher
• Medication and wound care timing — fixed clock times can force extra visits
• Dementia supervision — the need is presence, not tasks, so hours climb even when hands-on care is light
• Nighttime needs — overnight coverage usually means either a waking shift or live-in, priced differently

How to estimate yours

• Walk through an ordinary day and write down each task and roughly how long it takes
• Add travel/setup time if the aide comes more than once
• Separate "must be a person" from "could be a device or a family member" — that gap is where cost flexibility lives
• Then put it through our cost calculator

What decides the official answer

For any program that pays, a state functional assessment decides the authorised hours. Family estimates and agency quotes are not the same thing as an authorised plan of care.

Common questions

Related

• Cost calculator
• Medicaid eligibility screener
• What helps pay for care
• Medicaid HCBS waivers