Angie's List member Donna Butcher of Castleton says she did her best to care for her now-departed mother and aunt, but the task became overwhelming. The two women, both relatively healthy widows in their 90s, lived next door to each other.

"They didn't drive and couldn't do things like read their bills," Butcher says. "Taking care of their needs was more than I could do."

Since neither woman wanted to leave their homes, she decided to hire a personal care service, highly rated Senior Home Companions of Indiana. The Indianapolis-based company, which charges about $20 per hour, assisted with transportation, errands and housework. She says the caregivers came four hours per day, three days a week. "Otherwise, it would have been my full-time job," Butcher says.

Personal care services can fill an important gap for seniors who need assistance but don't require full-time care facilities or skilled medical services. Rachel Bunting, owner of highly rated Companion Care Connection in Fishers, says situations such as Butcher's are common. "The majority of people want to remain in their homes, but need assistance," she says.

Since consumers pay for in-home personal services on an as-needed hourly basis, they offer an affordable alternative to full-time facility care settings. "Because you're only spending for the help they need, it's more cost effective," Bunting says.

According to a 2010 long-term care cost survey from insurer MetLife in Indianapolis, the average daily cost of nursing homes ranges from $176 to $223, while assisted living facilities cost $2,652 per month or about $88 per day. Personal care services range from $19 to $23 per hour. Medicare may cover the costs of medically necessary skilled nursing facilities or home health care, but most clients pay for personal care out of pocket or via long-term care insurance.

Chris Irons, president of the highly rated Home Instead Senior Care franchise on East 86th Street, says the benefits of remaining at home outweigh the cost. "The outcomes are definitely better when you stay at home, especially for clients who have been in their homes for 30 to 50 years," he says.

For Courtney Carrillo of Indianapolis, hiring Senior Home Companions while her mother-in-law lived with her and her husband following stroke rehabilitation meant she could continue to work full time. "She stayed with us because her doctors told us she shouldn't be on her own," Carrillo says. The caregivers' assistance helped speed her mother-in-law's recovery, allowing her to successfully transition back to living independently in her own home.

Bunting says family members who want to hire a personal care service should interview at least three companies before hiring. Personal care services must be licensed by the Indiana State Department of Health.

She also suggests consulting with a geriatric care specialist who can objectively evaluate a client's needs and make recommendations.