Are you struggling with the challenges of elderly in-home care? Follow “The Rule Of 4”.

Elderly in-home care

"The Rule Of 4" can help direct elderly in-home care.

Do you struggle with directing the in-home care of a loved one?  Those overwhelmed with the care of an elderly family member may not know where to turn.

The day-to-day tasks required for elderly in-home care may bring unexpected surprises that can throw a daily routine into a tailspin. If you find yourself asking, “What am I going to do all day?” when providing elderly in-home care, then read on to learn about the “Rule of 4”.

Using “The Rule Of 4” is just one tool to help manage elderly in-home care. AARP has an excellent article on helping loved one’s age in place

What is "The Rule Of 4"?

The rule of 4 is a method of breaking up the day of a caregiver and a patient into manageable blocks and tasks. Family caregivers can use this method to not only help manage their time, but also to delegate the time a private in-home caregiver is assisting their loved one. The rule of 4 establishes realistic expectations and patterns in a predictable and easy-to-follow format.

Why use "The Rule Of 4"?

Abby Services has been helping families and seniors in Fort Myers and Cape Coral find the elderly in-home care they need since 1997. We have seen family caregivers burnt out and overwhelmed with the daily challenges of 

Those overwhelmed with caregiving responsibilities are often challenged with meeting all of the care their elderly family member requires. In an attempt to meet all of an individual’s needs the caregiver’s needs may be neglected, leading to an even worse situation.

By using the rule of 4 caregivers can work to make sure their needs are met, as well as meeting the needs of their loved ones. Ok, enough with the what and why, let’s discuss the how.


Using "The Rule Of 4" to plan elderly in-home care.

My name is Scott Strachan. I am an RN and have been a caregiver with Abby Services. I have extensive in-home care experience as well as varied real-world hospital and senior care experience.

However, The rule of 4 actually came about through my experience as a father. As many are aware child care can be demanding and exhausting (much like elderly care). As a new father, I followed the EASY method. EASY stands for Eat, Activity, Sleep, You. By following this simple method I was able to ensure my children’s needs were met as well as my own. 

While some of the EASY method can be adopted into senior care, it requires a bit more flexibility due to the varying needs elderly patients have.

As a caregiver, nurse, and administrator of an In-Home service, I have learned to adapt some of the simplicity of the easy method into the rule of 4.

Step 1: Identify elder care needs.

 The first step of the rule of 4 is to identify priorities or things that need to be accomplished. This can be done if a family member is a caregiver or if a family member is directing the care of a professional in-home caregiver. Families together with the elderly family member are typically the ones best suited to identify the care needs of an elderly patient.

If you are struggling to identify what you hope to accomplish when providing elderly care a good place to start is through our commonly requested elderly caregiver services.


These cover common day-to-day tasks that need to be accomplished. You want to be sure first and foremost that ADL (Activity of Daily Living) needs are met. 

Step 2: Break down your elderly in-home care day into blocks of 4

Instead of considering what needs to be accomplished for an entire day (this can be overwhelming) consider what needs to be accomplished in 4-hour blocks. Typically there will be four, four-hour blocks during an individuals waking hours.


Often the 4-hour blocks follow a natural rhythm:

  • Morning Care

  • Afternoon Routine

  • Evening activities

  • Bedtime activities

While everyone’s needs and time frames will be different, this grouping can help in planning when and what activities need to be accomplished. This provides structure for the elder receiving care as well as the elder caregiver.

Step 3: Consider 4 elderly in-home care activities that will occur during this 4-hour block.

Using your list of required activities break down these activities based on the daily schedule you are developing. Many activities will fall into a natural time frame. For example, personal hygiene is typically accomplished in the morning, and before bed. 


In general, allot 1 hour for each chosen task. Some activities may take more or less than the time frame allotted. That’s ok, the intent is to provide a predictable structure for a caregiver and the elder care recipient that is not rushed or forced.


Following the rule of 4 often allows flexibility and important downtime for both caregiver and their elderly loved ones.

Step 4: Adaptation is key.

Initially, the “Rule Of 4” scheduling may need to be adapted and that’s ok. The intent of “The rule of 4” is not only adaptability but also the structure “The rule of 4” provides. It is important to remember that as an elderly patient’s needs change, their care may change as well. 

Did your loved one need to sleep in? That’s ok, adapt. “The rule of 4” is flexible. As you see predictable patterns you can adjust one or all of the 4-hour blocks you have scheduled. 

Using the rule of 4 to direct a private in-home caregiver.

Are you providing direction to a private caregiver? With “The rule of 4” simplicity is key. It is important to establish reasonable expectations both for the individual receiving elderly care, and their caregiver. Sometimes a rushed list of expectations in a 4-hour period creates undue stress and unrealistic expectations. 

Many in-home care services have a 4-hour minimum which makes “The Rule Of 4” a perfect tool for identifying priorities and expectations. It is recommended that when directing your elderly in-home care you have a written clear and concise plan of care

This establishes expectations that your private caregiver can understand and live up to. When developing your plan of care, you may want to develop essential tasks to be accomplished using the “Rule Of 4” format, as well as a list of secondary goals, should your caregiver require further direction or suggestions.

An Example of "The Rule Of 4."

It may help to see “The Rule of 4” in action. In this example, we will be developing a plan of care for AM Care. The main priorities in the am care are:

  • Waking up and preparing for the day

    • Personal hygiene, dressing.

  • Breakfast

  • Activity

  • Rest

When discussing “The Rule of 4” as we said, it is important to allow adequate time to complete the tasks. In this example, while breakfast may not take a full hour, the morning hygiene and routine may take longer than an hour. Essentially just remember that these are goals, not requirements, as such they are flexible.

As you may see rest is one of the goals in the 4-hour block. This is where the secondary goals can be utilized. These secondary tasks may include, light housekeeping, dishes, or laundry as time permits. Secondary goals may also include personal activities such as: reading the newspaper, watching a favorite show, or discussing current events.

Often by using 4-hour blocks there is a natural rhythm that is good for the elderly patient receiving care as well as the caregiver.

For many, there is stability in routine. Knowing what to expect brings a sense of structure.  Our days are often naturally broken up into 4-hour blocks. Consider Breakfast, Lunch, Dinner, And Bedtime.


These are key events that can and should serve as anchors when considering “The Rule of 4”. In addition to meals and essential tasks such as personal hygiene, caretakers should consider an activity within each block. 


Depending on an individual’s circumstances an activity could include a walk, range of motion exercises, or assisting with laundry or even meal preparation.

Do you need more information on elderly in-home care?

If you have further questions about managing your elderly in-home care be sure to call Abby Services at 239-590-0861. Our team of experts can help be sure you have the input and direction to help your loved one stay safe and independent.

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