What Is Custodial Care In A Nursing Home?

Learn about custodial care in nursing homes. Discover who provides it, how to pay for it, and examples of custodial care services.

What Is Custodial Care In A Nursing Home?

If you or a loved one are considering moving into a nursing home or are already living in one, you may have heard the term "custodial care" thrown around. But what exactly does it mean?

Definition of Custodial Care

Custodial care is a type of long-term care provided in a nursing home that focuses on helping residents with their daily living activities. These activities can include things like bathing, dressing, eating, and using the bathroom.

Unlike medical care, which is focused on treating illnesses and injuries, custodial care is non-medical in nature. It is designed to help residents with basic tasks that they may no longer be able to do on their own due to age or disability.

Examples of Custodial Care

Some common examples of custodial care include:

  • Assistance with bathing, dressing, and grooming
  • Help with eating and drinking
  • Assistance with using the bathroom
  • Help with mobility and transferring (such as getting in and out of bed or a wheelchair)
  • Assistance with medication management
  • Help with housekeeping and laundry
  • Assistance with transportation to appointments or events

Who Provides Custodial Care?

Custodial care is typically provided by nursing home staff, including certified nursing assistants (CNAs) and personal care aides. These staff members are trained to provide the support and assistance that residents need to maintain their quality of life.

How Is Custodial Care Paid For?

Custodial care is not typically covered by health insurance or Medicare. Instead, it is usually paid for out-of-pocket or through long-term care insurance.

However, some low-income individuals may qualify for Medicaid, a government program that provides health coverage for those who cannot afford it. Medicaid may cover custodial care in some cases, depending on the individual's income and assets.

The Importance of Custodial Care in Improving Quality of Life

While medical care is essential for treating illnesses and injuries, custodial care plays a crucial role in maintaining quality of life for nursing home residents. Without this type of care, many residents would struggle to perform basic daily tasks and may experience a decline in their physical and mental health.

Custodial care helps residents maintain their independence and dignity by providing the assistance they need to complete tasks that have become difficult due to age or disability. This can include everything from getting dressed in the morning to attending social events within the nursing home community.

In addition to assisting with daily activities, custodial care providers also offer emotional support and companionship. For many residents, moving into a nursing home can be a difficult transition that leaves them feeling isolated and lonely. Custodial care providers work to build relationships with residents and provide them with the social interaction they need to thrive.

Overall, custodial care is an essential component of long-term care in nursing homes. It not only helps residents maintain their physical health but also improves their overall well-being by providing them with the support, assistance, and companionship they need to live fulfilling lives.

Types of Professionals Providing Custodial Care

As mentioned earlier, custodial care is provided by nursing home staff. The professionals who provide this care include personal care aides and certified nursing assistants (CNAs). These individuals are trained to assist residents with their daily living activities and provide emotional support.

Personal care aides typically provide non-medical assistance with tasks like bathing, grooming, and dressing. They may also help with housekeeping and meal preparation.

CNAs, on the other hand, have additional training in medical care and are responsible for providing basic medical services such as checking vital signs, administering medication, and assisting with medical procedures.

Both personal care aides and CNAs play an important role in providing custodial care to nursing home residents. They work closely with residents to understand their individual needs and preferences, providing compassionate and personalized care that enhances their quality of life.

Challenges Faced by Custodial Care Providers

While custodial care is essential for maintaining the quality of life for nursing home residents, those who provide this type of care often face significant challenges.

One of the biggest challenges is burnout. Custodial care providers work long hours and are responsible for meeting the needs of multiple residents throughout their shift. This can be physically and emotionally exhausting, leading to high levels of stress and burnout.

In addition to burnout, many custodial care providers also struggle with low pay. These individuals are often paid hourly wages that are barely above minimum wage, despite the demanding and important nature of their work.

Low pay can make it difficult for custodial care providers to make ends meet, leading to financial stress that can further exacerbate burnout and other job-related challenges.

Despite these challenges, many custodial care providers remain committed to their work and continue to provide compassionate and personalized care to nursing home residents. It is important that we recognize the vital role these individuals play in our healthcare system and take steps to support them in their work.

How to Choose a Nursing Home that Provides High-Quality Custodial Care?

Choosing a nursing home for yourself or a loved one can be a daunting task, especially when you're looking for one that provides high-quality custodial care. Here are some tips to help you make an informed decision:

Research the Nursing Home's Reputation

One of the first things you should do is research the nursing home's reputation. Look for online reviews and ratings from current and former residents and their families. You can also check with your state's long-term care ombudsman program to see if there have been any complaints or violations against the nursing home.

Visit the Nursing Home in Person

Before making a final decision, it's important to visit the nursing home in person. Take a tour of the facility and observe how staff interact with residents. Pay attention to how clean and well-maintained the facility is.

During your visit, ask questions about the nursing home's custodial care services. Find out what types of assistance they provide with daily living activities and how they ensure that residents receive personalized care.

Check Staffing Levels

One of the most important factors in determining whether a nursing home provides high-quality custodial care is staffing levels. Ask about staffing ratios and how many staff members are on duty during each shift.

Adequate staffing levels are essential for ensuring that residents receive timely assistance with their daily living activities and that their emotional needs are met.

Review Medicare.gov Ratings

Medicare.gov provides ratings for nursing homes based on factors such as health inspections, staffing levels, and quality measures. Reviewing these ratings can give you an idea of how well a nursing home performs in providing high-quality custodial care.

Consider Location and Amenities

While custodial care is an essential factor in choosing a nursing home, location and amenities may also be important considerations. Look for a nursing home that is conveniently located near family and friends and that offers amenities that are important to you or your loved one, such as outdoor spaces or social activities.

By taking the time to research and visit nursing homes before making a decision, you can ensure that you choose one that provides high-quality custodial care and meets all of your needs.

Strategies for Supporting Loved Ones in Custodial Care

If you have a loved one who is receiving custodial care in a nursing home, it can be difficult to see them struggling with daily activities. However, there are several strategies that family members can use to provide emotional support and enhance their loved one's quality of life.

Visit Frequently

One of the most important ways to support a loved one in custodial care is by visiting them frequently. Regular visits can help your loved one feel connected to the outside world and provide an opportunity for social interaction.

During your visits, make sure to engage your loved one in conversation and listen actively to their concerns. You can also bring along items that they enjoy, such as books, puzzles or photographs.

Participate in Activities

Many nursing homes offer a variety of social activities for residents. By participating in these activities with your loved one, you can help them stay engaged and maintain a sense of purpose.

Activities such as crafts, games or music can be enjoyable for both you and your loved one. They may also provide an opportunity for you to meet other residents and their families.

Advocate for Your Loved One

It's important to advocate for your loved one's needs while they are receiving custodial care. This may involve communicating with staff members about any concerns or issues that arise.

If your loved one has specific preferences or needs related to their care, make sure that this information is communicated clearly to staff members. You may also want to attend care plan meetings with staff members to ensure that your loved one's needs are being met.

Stay Involved in Medical Care

While custodial care is non-medical in nature, it's still important to stay involved in your loved one's medical care. This may involve attending doctor appointments or communicating with medical professionals about any concerns related to medication management or other health issues.

By staying informed about your loved one's health status, you can ensure that they receive the best possible care and treatment.

Practice Self-Care

Providing support to a loved one in custodial care can be emotionally and physically demanding. It's important to practice self-care to avoid burnout and maintain your own well-being.

Make sure to take breaks when needed and engage in activities that you enjoy. You may also want to seek support from other family members or a therapist who can help you cope with the stress of caregiving.

By using these strategies, family members can provide valuable support to their loved ones receiving custodial care in a nursing home. With emotional support and engagement in daily activities, nursing home residents can continue to maintain their quality of life and independence.

Ways to Improve Access to Custodial Care for Low-Income Individuals

Low-income individuals often struggle to afford custodial care, which can lead to a decline in their quality of life. Here are some ways that advocates can work to improve access to custodial care for low-income individuals:

  • Lobby for increased Medicaid funding: As mentioned earlier, Medicaid may cover custodial care in some cases. Advocates can lobby for increased funding for Medicaid programs that provide this type of coverage.
  • Advocate for expanded Medicare coverage: Currently, Medicare does not typically cover custodial care. Advocates can work to expand Medicare coverage to include this essential service.
  • Push for higher wages for custodial care providers: Low pay is a significant challenge faced by those who provide custodial care. Advocates can push for higher wages and better benefits for these individuals, which may help attract more qualified workers to the field.
  • Educate the public about the importance of custodial care: Many people do not understand the vital role that custodial care plays in maintaining quality of life for nursing home residents. Advocates can work to educate the public about this important issue and build support for policies that improve access to custodial care.
  • Support nonprofit organizations that provide assistance with long-term care costs: There are several nonprofit organizations that offer financial assistance or other resources to low-income individuals who need long-term care services. Advocates can support these organizations through donations or volunteer work.

By advocating for improved access to custodial care, we can help ensure that all individuals have access to the support and assistance they need to maintain their quality of life as they age or experience disabilities.


How is custodial care different from skilled nursing care?

Skilled nursing care is focused on providing medical treatment and rehabilitation services to patients who require more advanced care. Custodial care, on the other hand, is non-medical in nature and focuses on helping residents with their daily living activities.

Can family members provide custodial care at home instead of placing their loved one in a nursing home?

In some cases, family members may be able to provide custodial care at home if they have the time, resources, and ability to do so. However, it's important to consider the level of support that your loved one needs and whether you're able to provide it safely and effectively.

Are there any alternatives to custodial care for seniors who need assistance with daily living activities?

Yes, there are several alternatives to custodial care that seniors can consider. These include:

  • Assisted living facilities
  • In-home caregiving services
  • Adult day centers
  • Continuing care retirement communities

How much does custodial care cost?

The cost of custodial care can vary widely depending on factors such as location, level of support needed, and the type of facility or provider you choose. On average, nursing home costs range from $5,000 to $7,000 per month for a semi-private room and $6,000 to $8,000 per month for a private room.


Custodial care is an important aspect of long-term care in nursing homes. It provides residents with the support and assistance they need to maintain their independence and quality of life. If you or a loved one are considering moving into a nursing home, it is important to understand what custodial care is and how it is paid for.


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