Should You Get the Fall Flu Shot? What Caregivers Need to Understand
What sets the flu vaccine apart from all the other vaccines is that it must be updated each year; this has created a number of questions. Why can’t there be a single vaccine that will offer us long-lasting protection as so many of our other vaccines do? Is receiving an annual flu vaccine somehow weakening my immune system? Since I received the flu vaccine last year and still contracted the flu, what’s the purpose?
While these are valid questions, they are also important questions that need to receive good answers, and not dismissive responses, nor scare tactics from both sides of the argument. The truth of the matter is far more complicated than “all people must be vaccinated” or “vaccines are unnecessary.”
How the Flu Vaccine Really Works
Understanding how the vaccine works – and doesn’t work — helps explain why yearly vaccinations are encouraged.
Each influenza virus is always changing. We monitor the global circulation of various strains and predict which strains will be most prominent in the coming season. Then we create a vaccine that protects against those specific strains (typically three to four variations).
This is the critical point: the vaccine doesn’t guarantee that you will not contract the flu. However, the vaccine:
- Decreases the chance of contracting the flu by a significant amount
- Reduces the severity of symptoms, if you do contract the flu
- Decreases the risk of serious flu-related complications
- Decreases the risk of being hospitalized
- Increases the protection of those around you through herd immunity
The flu shot is similar to wearing a seatbelt. A seatbelt will not prevent a car accident from occurring, but it greatly increases your chances of surviving such an event without serious injuries. The flu vaccine works using the same principle; it is about reducing risks and not eliminating them.
The Timing Issue: When Should You Get Your Flu Vaccine?
It generally takes about two weeks to achieve maximum protection after receiving the flu vaccine. The flu season is typically from October to May, with peak flu season occurring between December and February. If you receive the vaccine in September or October, you will be protected before the flu season begins to circulate. Additionally, receiving the flu vaccine later in the flu season (e.g., January) will still provide some level of protection.
However, if you are caring for an elderly individual or have a compromised immune system, early vaccination would be beneficial. This is because their immune systems may take longer to develop protection, and they cannot afford to be exposed to the flu at its onset.
Who Really Needs the Flu Shot?
The Centers for Disease Control and Prevention (CDC) recommend that all people aged 6 months and above receive the flu vaccine, except in a few limited circumstances. While this is the recommendation, it is imperative to consider the individual’s health status. Some people have more to lose by not receiving the flu vaccine than others.
- High Priority Groups Include:
- Adults aged 65 and above
- People with chronic health issues (e.g., heart disease, diabetes, asthma, lung disease)
- Those with weakened immune systems
- Pregnant women
- Healthcare workers and caregivers
- Those that live with or routinely care for high-risk individuals
- Residents of nursing homes or long term care facilities
If you are caring for anyone in any of the above listed categories, the real question is not “should they be vaccinated?” but rather “can we schedule their vaccination?”
Something often overlooked is that if you are a caregiver, you too should receive the flu vaccine regardless of your age or health status. You are not only protecting yourself, but you are also protecting the vulnerable individual who depends on you. Bringing the flu home to someone with a compromised immune system can lead to devastating results.
What to Anticipate Following Vaccination
Anticipating the side effects of the flu vaccine can help alleviate undue anxiety. The typical timeline of possible side effects includes:
24 Hours Post-Vaccine:
- Possible localized pain and swelling at the site of the injection
- Possible slight fatigue
- Low grade fever (very rare)
Days 2-14 Post-Vaccine:
- Your immune system is developing protection against the flu
- Side effects are resolved, if present, by 48 hours
- You are not yet fully protected against the flu
2 Weeks Post-Vaccine:
- Peak protection levels are reached
- Immunity to the flu is maintained for the duration of the flu season
- Annual revaccination is required
You are free to resume regular activities unless you feel unwell. There is no medical reason to limit your daily routine after receiving the flu vaccine. However, it is always wise to listen to your body.
When Vaccination May Not be Appropriate
- Previous severe allergic reaction to a flu vaccine
- Egg allergy (although newer vaccines do not use eggs)
- Guillain-Barré syndrome within 6 weeks of previous flu vaccination
- Moderate to Severe Illness (wait until recovered)
Again, note that none of the following are included in the above list: being elderly, having diabetes, taking most medications, having mild allergies, or “having a weakened immune system.” People with weakened immune systems are actually a group of individuals who are most in need of vaccination.
If you are unsure whether the individual you are caring for should receive the flu vaccine, contact their doctor for guidance. Do not seek medical advice based on online forums or your friend’s opinion.
At Angel Care Agency Inc., we support caregivers in making educated health decisions regarding their loved ones. Our knowledgeable staff understand the unique needs of elderly or vulnerable populations during the flu season and beyond. Contact us today for guidance, support, or expert-level caregiving services.
A few winters ago my next-door neighbor panicked because her elderly mother was running a fever and coughing nonstop and didn’t know whether this was the flu, covid, or just a cold — or should she take her mother to the ER? This is a common occurrence across many families each winter when colds and other upper-respiratory infections appear to converge. Even doctors may require testing to determine what is causing the suffering of a family member who is sick. The Angel Care Inc. team explains the differences between these upper-respiratory infections, which can help you decide how to treat them and when to see a doctor. The Common Cold: The Inconvenience of Being Sick You’ve likely experienced the same thing. A scratchy throat that begins on a Monday morning, sniffles by Tuesday, and by Wednesday you’re going through boxes of tissues faster than you ever thought possible. The common cold is brought on by several types of viruses (the primary culprits are rhinovirus) and while it’s frustrating, most people aren’t at risk of serious harm. Cold symptoms typically include: Developed over the course of one or two days Stuffy/runny nose Slightly sore throat Some sneezing Very light cough Mild body aches and/or exhaustion Low-grade fever (more typical of children) As stated, “mild” is the operative term here. While the discomfort associated with colds is definitely noticeable, it is manageable. You’ll likely still attend to your job responsibilities while feeling unwell; you won’t be bedridden. Most colds will clear up on their own in 7-10 days although the cough may continue for a little longer. One of the unique aspects of colds is their progression. You’ll find that the symptoms build upon each other gradually – that tickly sensation in your throat develops into a stuffier nose on day 2, and reach their peak in terms of misery sometime between days 3 and 4, before beginning to subside again. This is a familiar pattern for many of us, having gone through this multiple times. Influenza: When "The Flu" is More Than Just a Bad Cold Many people are confusing. People will say they have the flu when they simply have a terrible cold. True influenza is significantly worse than that. I vividly remember getting true influenza years ago. I was fine at lunchtime, a little off by midafternoon, and by nightfall I was shaking under three blankets and had a fever of 103°F. This rapid escalation is a hallmark of flu. True flu symptoms typically include: Sudden, dramatic onset in hours Extreme fever (100-104° F or higher) Severe body aches and muscle pain Exhaustion and weakness Dry cough Headache Chills and sweats Infrequently, nausea, vomiting, or diarrhea (commoner in children) Flu generally lasts five to seven days for the acute phase, although fatigue can last for weeks. The main concern with influenza isn't the flu virus itself, but rather the potential for complications such as pneumonia, bronchitis, and sinus infections, as well as exacerbating underlying chronic conditions. COVID-19: The Unknown Variable More than three years after the pandemic started, COVID-19 is still difficult to predict. Some people don’t even realize they have it, while others become severely ill. These unpredictable symptoms make it difficult for caregivers to determine what ailing family members are experiencing. While current COVID-19 variants have produced some variations in symptomatology, common symptoms include: Chills/Fever Dry cough (can also produce phlegm) Fatigue (can range from slight to extremely debilitating) Shortness of breath Loss of taste/smell (although less common with newer variants) Sore throat Headache Muscle aches Runny/stuffy nose Nausea/Vomiting/Diarrhea Unlike colds, flu and other upper-respiratory infections, COVID-19 presents with a high degree of unpredictability. Family members who begin with a minor sore throat and congestive issues similar to a cold could develop breathing problems within days. Other family members can experience debilitating fatigue that persists for months -- known as "long COVID." The onset of symptoms can vary as well. Like flu, some people may develop symptoms quickly, while others develop symptoms gradually like a cold. This is another reason why testing became so critical. RSV: It’s Not Just for Babies & Toddlers Anymore Until recently, the majority of people were only aware of Respiratory Syncytial Virus (RSV) when they had young children or worked with pediatricians. However, we are now recognizing RSV as a major threat to the elderly and anyone whose immune system is weakened. Adults with RSV typically present with: Runny/congested nose Cough (which can be very severe) Difficulty breathing/wheezing Fever Less interest in food Fatigue Older adults with RSV can be at particular risk of developing serious complications, such as pneumonia or exacerbation of heart and lung disease. Older adults’ symptoms can initially be mild – simply feeling a little off – but can escalate rapidly in susceptible individuals. Comparative Chart: The Key Differences Below is a side-by-side chart comparing the differences in these illnesses: Feature Common Cold Influenza COVID-19 RSV Onset Speed Gradual (1-2 days) Sudden (hours) Variable Gradual Fever Rare (low-grade) High (100-104°F+) Common Common Body Aches Mild Severe Moderate to severe Mild to moderate Fatigue Mild Severe Variable (mild to severe) Moderate Cough Mild Can be severe Variable Often severe Shortness of Breath Rare Sometimes Common warning sign Common in severe cases Loss of Taste/Smell Temporary with congestion Rare Distinctive symptom Rare Typical Duration 7-10 days 5-7 days (fatigue longer) Variable (weeks to months) 1-2 weeks When to Seek Immediate Medical Attention Knowing when to escalate the level of care is vital, especially for caregivers caring for vulnerable individuals. While most respiratory infections are treated at home, there are specific warning signs that indicate a visit to the emergency department is necessary: Seek immediate emergency care if you notice: Difficulty breathing or shortness of breath when resting Prolonged chest pain or tightness Confusion or being unable to remain awake Blue lips or face Persistent vomiting Fever greater than 103°F that does not abate with medication Symptoms that begin to improve and then worsen Significant dehydration (reduced urine output, extreme thirst, dizziness) For older adults and/or those with ongoing health challenges, even mild symptoms warrant close monitoring. A seemingly minor cold can rapidly progress to a potentially life-threatening condition in someone with a compromised health status. Practical Care Ideas That Really Work Regardless of which viral infection you are experiencing, some care ideas provide legitimate relief: Rest is not optional. Your body is working to fight off the infection and that takes a tremendous amount of energy. Pushing through the illness will result in extended recovery time and an increased risk of complications. Fluid intake is more critical than you would believe. Fever, sweat, and respiratory symptoms can cause you to lose fluids. Drinking plenty of water, warm beverages, warm broths, and electrolyte-containing liquids can help keep you hydrated. As a general guideline: if your urine is darker than normal, you are dehydrated. Humidity can provide unexpected relief. Dry air irritates your already inflamed respiratory tract. Humidifying the air with a cool-mist humidifier, taking steamy showers, or even placing a bowl of boiling water on the table can help alleviate symptoms. Proper nutrition aids in recovery. Although your appetite may disappear, your body still requires nutrients. Easy-to-digest foods, such as soups, toast, bananas, and applesauce, provide calories without overwhelming your stomach. Monitoring your symptoms systematically is helpful. Keeping a basic record of temperature, symptom intensity, and any changes in symptoms will allow you to identify patterns and provide useful information to your healthcare provider. At Angel Care Agency Inc., we understand the challenges of managing health concerns for loved ones. Our experienced caregivers are trained to recognize concerning symptoms and provide compassionate support during illness. If you need assistance caring for a family member dealing with respiratory illness or any health concern, we're here to help.
The home care industry in New York is at a turning point. On the one hand, the demand for home care is at an all time high. New York's aging population continues to grow and an increasing number of people prefer to get their care at home rather than in institutional settings. On the other hand, agencies in the home care industry are facing greater financial pressures than ever before, along with regulatory changes and a shrinking workforce that affects families' ability to secure services. In New York City, Long Island and Westchester, home care aides working for licensed home care services agencies were paid a minimum wage of $19.10 per hour, effective January 2025; in the rest of the state, minimum wages for these aides were $18.10 per hour. Minimum wage for these aides in NYC, LI and Westchester will rise to $20.00 per hour in January 2026, while minimum wages for home care aides in the rest of the state will be $18.50 per hour. These wage increases are part of the wage parity initiative to increase wages for this vital workforce. Identifying the Different Types of Home Care in NY Prior to discussing costs and rules related to home care in NY, let's clarify what we mean by "home care", since the nomenclature for home care can be very confusing. Licensed Home Care Services Agencies (LHCSAs) provide personal care services such as assistance with Activities of Daily Living (ADLs) such as bathing, dressing, meal preparation, and light housekeeping. LHCSAs employ home health aides and personal care aides that work under the direction of an employee of the agency. Certified Home Health Agencies (CHHAs) provide skilled nursing care and therapeutic services ordered by a physician. This includes registered nurses, physical therapists, occupational therapists, and speech therapists providing medical services at home. Consumer Directed Personal Assistance Program (CDPAP) allows eligible individuals to hire, train, and direct their own personal assistants, including family members. CDPAP has experienced explosive growth over the past several years, although it has also faced great scrutiny and regulatory changes. The type of care your loved one requires will determine which services are suitable. A person recovering from surgery may require a Certified Home Health Agency (CHHA) for wound care and physical therapy. A person with dementia requiring assistance with ADLs may be able to obtain services from a Licensed Home Care Services Agency (LHCSA). A person preferring to use a family member as their caregiver may wish to pursue a Consumer Directed Personal Assistance Program (CDPAP). How Much Does Home Care Cost? We'll start talking about costs, since this is usually the first thing families ask — and the answer can be quite surprising if you are not prepared. As of November 2025, the average hourly rate for home care in New York City was approximately $25.76. Based on a 40-hour workweek, this represents a weekly cost of $1,030.30. A monthly cost for full-time care would be approximately $3,349 for 130 hours of service. However, the reality is that those rates represent just the beginning for the basic personal care. Skilled nursing care will cost significantly more. A live-in care arrangement, 24-hour care, or a specialized service for a condition such as Alzheimer's can easily cost between $8,000 to $15,000 or more each month. Estimated Cost Ranges for 2026: Type of Service Range of Hourly Rate Estimated Monthly Cost (130 Hours) Personal Care Aide $23-28/hour $2,990-$3,640 Home Health Aide $25-32/hour $3,250-$4,160 Skilled Nursing (RN) $75-120/hour Variable (typically fewer hours) Live-in Care $350-500/day $10,500-$15,000 Costs will vary based upon where in New York State you reside, the level of care required, the reputation of the agency, and whether the care is provided on weekends, at night, or on holidays (all of which generally cost more). Navigating the Medicare and Medicaid System Families need to understand the payment systems because many families believe that Medicare will pay for home care, which is generally not true in the way families think. Medicare will pay for skilled home health care if the individual meets the following requirements: You are confined to your home You require skilled nursing care or therapy A doctor orders the services The agency providing the services is certified by Medicare Medicare DOES NOT pay for personal care services (the help with bathing, dressing, etc. that most people need the most); nor does Medicare pay for 24-hour care or long-term assistance. Medicaid pays for personal care for eligible individuals through programs such as Managed Long Term Care (MLTC). However, Medicaid eligibility requires the individual to meet both medical necessity standards AND financial standards. Application to Medicaid can take months and requires a significant amount of documentation. Approximately 250,000 Medicaid enrolled New Yorkers currently receive services from home care programs at a total annual cost of approximately $6 Billion. Programs such as CDPAP have seen enormous growth over the past couple of years, with more than double the number of participants as compared to a couple of years ago, while traditional agency-based care has seen declines in participation. Many families find themselves in what I refer to as the "middle gap," meaning that their loved one needs a great deal of help but does not qualify for Medicaid, while Medicare does not pay for the kind of services they really need. In this situation, the family will generally have to pay for the care privately at least initially. The Growing Workforce Shortage No One Is Talking About There is a harsh truth: Finding quality home care aides is becoming increasingly difficult, and it appears that things are only going to get worse. This problem stems from the fact that despite increases in wages, home care is a challenging job with a high turnover rate. The consequences for families are real. When you contact an agency to inquire about services, they may tell you that they cannot accept any new clients. Alternatively, you may experience a high degree of staff turnover as aides leave for better-paying jobs. Lastly, you may find it difficult to obtain weekend or overnight coverage due to a lack of available staff. Demand for home care is growing much faster than the supply of home care staff. Between 2019 and 2023, the number of skilled home health agencies serving Medicare patients declined or remained stable in over 94% of U.S. counties. That is an astonishing statistic -- and it means that fewer people will have access to care at a time when more people than ever before need it. This creates the following realities for families: Find home care earlier than later -- ideally before you desperately need to do so. Be flexible in terms of the hours you can accept -- particularly during peak times. Treat your home care aide with respect -- they have choices. Contact multiple agencies -- you may find that one agency has the availability of another. If possible, consider using CDPAP and employing your own family members as your home care aides. Protecting Your Family from Unscrupulous Providers Not all home care providers conduct business ethically. There have been numerous cases of provider fraud, wage theft, and quality issues in recent years. To protect your family, you should ask the right questions and look out for red flags. Before contracting with a home care provider, verify: That the agency is currently licensed with the New York State Department of Health How long the agency has been operating References from current clients Training and supervisory practices of the agency for its caregivers Agency response to missing caregivers or emergency situations Billing practices and payment policies of the agency Red flags to watch for: Pressure to enter into contract quickly Unclear responses regarding the agency's licensure or certification status Low rates for services (possible indication of wage theft or inadequate training for employees) Reluctance to provide references Communication difficulties or unavailability of supervisory personnel High employee turnover Keep in mind, the person you are allowing into your home to provide care for someone in a vulnerable position is a trusted individual. Therefore, it is not unreasonable to ask detailed questions about how the agency operates — it is prudent. Angel Care Agency, Inc. understands the overwhelming nature of making home care decisions for your family. We assist families in navigating the complex home care environment in New York and match you with quality, caring caregivers. We assist you in determining the best course of action for your family, regardless of your need for a few hours of assistance or comprehensive around-the-clock care. Contact us today to review your family's needs.
