Ever wondered how Home Care works..?

Gilgal Home Care & Registry · King of Prussia, PA · Family Resource Guide

What Is Home Care and
How Does It Actually Work?

By Gabrielle, Founder — Gilgal Home Care & Registry  |  8-minute read  |  Updated April 2026

If you're reading this, something has shifted. Maybe your mother struggled to get up last week. Maybe your father forgot to take his medication — again. Maybe you live across the state and the worry is constant. Or maybe you're a caregiver yourself, running on empty, and you need to know what support actually exists.

Home care is one of those terms that gets used loosely — but what it actually means, who provides it, and what it costs can feel impossible to understand from the outside. This guide is designed to cut through all of that and give you a clear, honest picture.

"Home care is not a luxury. For most families, it's the most compassionate and cost-effective option available — if you know how to access it."

— Gabrielle, Founder, Gilgal Home Care & Registry

What Is Home Care?

Home care refers to supportive services provided in a person's home — their own home, a family member's home, or even a residential care setting. It is non-medical in nature, which is an important distinction. Home care aides do not provide nursing care, administer medications, or manage medical conditions. Instead, they support the activities of daily living (ADLs) that a person can no longer safely or comfortably perform on their own.

The goal of home care is simple: help someone remain in their own home, with their dignity intact, for as long as possible.

What Services Are Included?

Home care services fall into two broad categories:

Personal Care (ADL Assistance)

These are the physical care tasks that require hands-on support:

• Bathing, showering, and hygiene assistance
• Dressing and undressing
• Grooming — hair, oral care, shaving, nail care
• Toileting and continence care
• Transfers — moving from bed to chair, wheelchair, or standing position
• Ambulation assistance — walking with support or using assistive devices
• Medication reminders (not administration — that requires a nurse)

Companion Care (IADL Support)

These are the tasks that keep a household running and support quality of life:

• Meal preparation and grocery shopping assistance
• Light housekeeping — dishes, laundry, vacuuming
• Transportation to medical appointments, errands, and community activities
• Companionship — conversation, activities, social engagement
• Medication pickup and management support
• Mail management and errand running

💡 Important: Home care is NOT home health care. Home health care involves skilled nursing and therapy ordered by a physician. If your loved one needs wound care, IV therapy, physical therapy, or skilled nursing — that requires a licensed home health agency. Home care supports daily living. Home health supports medical recovery.

What Is the Difference Between an Agency and a Registry?

This is one of the most misunderstood distinctions in home care — and it has real financial implications.

Home Care Agency

An agency employs the caregivers directly. The agency handles payroll taxes, workers' compensation, liability insurance, and matching. You pay the agency rate (typically higher), and the agency pays the caregiver. The agency controls placement, scheduling, and staffing.

Home Care Registry

A registry refers and places independent caregivers directly with families. The caregiver is not an employee of the registry. This model gives families a direct relationship with their caregiver, typically at a lower cost. In Pennsylvania, registries must be licensed under 28 Pa. Code Chapter 611 — just like agencies.

Gilgal Offers Both

Gilgal is licensed as both a home care agency and a home care registry. That means we are not limited to one model — we help each family choose the arrangement that actually fits their situation, their budget, and their funding source. Some families want the structure and oversight of agency-employed caregivers. Others want the direct relationship and lower cost of registry placement. We can do either.

💡 Registry advantage: Registry placement often costs $5–$8/hr less than agency rates for the same caliber of care. Over a year, that adds up to thousands of dollars in savings.

Who Needs Home Care?

Home care is appropriate for a wide range of situations:

• Older adults who want to age in place safely and independently
• Adults recovering from surgery, a hospital stay, or a serious illness
• Individuals with physical disabilities who need daily living support
• People with dementia or Alzheimer's who need supervision and structure
• Family caregivers who need respite — regular breaks to prevent burnout
• Individuals with intellectual disabilities or autism who need community support
• Anyone going through cancer treatment who needs extra support at home

How Do I Know It's Time?

Most families ask for help later than they should. The warning signs are often subtle at first — and easy to explain away. Look for:

• Unexplained falls, bruises, or reluctance to walk
• Weight loss, expired food in the fridge, or skipped meals
• Missed medications or confusion about dosing
• A home that used to be clean starting to show signs of neglect
• Social withdrawal, depression, or loss of interest in activities they loved
• Your own exhaustion as a family caregiver — you matter too

"Most families come to me after a crisis. My goal is to help families come before one."

A conversation about home care does not mean moving someone to a nursing home. It means finding a way to support independence, dignity, and safety at home — where most people want to be.

How Do I Get Started in Pennsylvania?

Getting started with home care in Pennsylvania involves a few clear steps:

• Assess the need: Identify which tasks your loved one struggles with and how many hours per week of support are needed
• Identify funding: PA Medicaid (OLTL waiver), VA benefits, long-term care insurance, or private pay — each has different eligibility and coverage
• Find a licensed provider: All home care agencies and registries in PA must be licensed by the PA Department of Health under Chapter 611
• Conduct a needs assessment: A good provider will complete a thorough assessment before placing a caregiver
• Develop a care plan: A written plan documents exactly what services will be provided, when, and by whom
• Select a caregiver: Interview, check references, and verify all PA required clearances before the first visit

Not sure where to start?

Gilgal offers a free 15-minute consultation to help families in the greater Philadelphia area understand their options. No pressure — just honest, practical guidance from someone who knows the system.

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Gilgal Home Care & Registry is a Pennsylvania Department of Health licensed home care agency and registry under 28 Pa. Code Chapter 611, serving Montgomery, Chester, Delaware, Bucks, and Philadelphia counties. care@gilgalhomecare.org · gilgalhomecare.org