Maybe your mother came home from the hospital on Tuesday and a hospice team visited on Wednesday. Now it is 3 a.m. in Sacramento, she needs help to the bathroom, and nobody on the team is in the room. Guiding Souls Home Care does not provide hospice, assisted living or palliative care. Before the first night home, write down who will help with bathroom trips and when a paid caregiver is needed for bathing, meals or overnight help between hospice visits. Guiding Souls Home Care does not provide assisted living either.
What does hospice at home provide day to day?
Hospice is a team that visits. It does not move in. The team plans comfort care, manages symptoms, and teaches your family what to expect. Medicare says that once you choose hospice, the benefit will usually cover everything you need for the terminal illness.
In practice, that means visits on a schedule, plus a phone line for problems. Hospice also arranges equipment and the drugs for symptoms. If the team decides your relative needs inpatient care at a hospital, they must arrange the stay.
Hospice also has a short-stay option for the caregiver. Under the federal rule on special coverage, respite care is short-term inpatient care, only on an occasional basis, and for no more than five consecutive days at a time. It exists to give family a break.
Round-the-clock care is the part people misunderstand. The same rule allows continuous care of up to 24 hours a day only during a period of crisis, to keep the person at home. It must be mostly skilled care. When the crisis passes, the visits go back to the regular schedule.
Check the hospice visit schedule before deciding how much extra help to arrange. That is where a caregiver comes in: bathing, dressing, meals, company, reminders to take medication, and someone awake at night. Ask the hospice team what they do and do not cover.
What does it cost, and how do families pay for the gaps?
The hospice itself costs nothing under Medicare when the provider is Medicare-approved. You may pay for room and board if your relative lives in a facility. The extra daily help is the part families pay for.
A non-medical caregiver in the Sacramento-Roseville-Folsom area has a median cost of $40 an hour, or $7,627 a month at 44 hours a week, according to the CareScout 2025 Cost of Care Survey. Assisted living in the same area is $7,750 a month. Base your budget on the hours you need, and ask each agency for its rate in writing and minimum visit length.
Here are the public and private ways families cover daily help:
- Apply through your county for In-Home Supportive Services (IHSS) if your relative receives Medi-Cal and is 65 or older, blind or disabled; the county decides which services and hours it will pay for.
- Medi-Cal: the asset limit is $130,000 for one person through 2027-06-30. The home, one car and household items do not count. From 2027-07-01 it drops to $21,000 for one person.
- Ask about VA Aid and Attendance if your relative receives a VA pension and needs daily help; eligible veterans or surviving spouses receive extra pension payments they can use for care at home.
- Call the long-term care insurer and ask what the policy pays for at home.
If you are the one giving care, California Paid Family Leave gives up to 8 weeks of partial pay to care for a seriously ill parent, parent-in-law, grandparent or spouse. You need a health certification from the doctor.
Counties also fund caregiver support and respite. The California Department of Aging page for Sacramento County lists the Area Agency on Aging and what it funds, including senior meals and transportation.
What should you do next?
Start with the hospice team, since they know the case best. Then work down this list:
- Write down the hours when nobody is there, especially nights and mornings.
- Ask the hospice for the care plan and the list of what is not covered.
- Ask who to call after hours, and what counts as a crisis.
- Ask HICAP, California's free Medicare counseling service, to help you check your benefits. See the state Medicare counseling page for contact details.
- Ask three home care agencies for their rate in writing, the minimum visit, and how they handle a sick day.
If you hire a caregiver on your own, check the aide on the state's Home Care Aide Registry. Registration requires a criminal background check run by the California Department of Social Services.
Share the plan with the hospice team. A caregiver can tell the team what they see, such as new pain or poor sleep, and the team decides what to do about it. A home care aide does not give drugs or do skilled tasks. They help with daily life.
What happens if you call Guiding Souls Home Care?
A person answers (916) 229-8120 at any hour, including weekends and holidays. We are a non-medical agency, so we help with daily life while your hospice team handles symptoms, and our hospice support is that kind of help. The first visit to the house is free and carries no obligation. Mereani looks at the routine and the layout, then puts a plan and a clear cost in writing before anything begins. There is no contract. You can see the towns we cover on Where We Serve.
