Senior In-Home Health Care Providers: Where Do I Begin?

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The biggest fear for most seniors is losing their independence. Moving out of their home and into a community senior-care setting can be devastating. Fortunately, most seniors will never have to leave their homes. There are options available that were not available just a few years ago. Seniors can now remain in their homes indefinitely.

Try to locate an agency that will give you a complete list of their services and different levels of care. Long-term, will they be able to meet your needs or that of your loved one? Early stages of care may only require meal preparation and light housekeeping. Later stages of care may require more hands-on care such as bathing, medication administration, and ambulatory assistance may be needed. What services does you senior home care provider offer?

Next, are all employees they have screened? First and foremost, background checks are essential which would include criminal background checks. If you choose a private-duty caregiver, this is would be especially important. Most professional agencies will check all employees. If you find out they don't do have this as part of their process, find another agency.

Nurses must follow stringent nursing practice regulations according to their State Board of Nursing. However, sometimes things slip by. Give yourself peace of mind and do a private check on your own.

There are 4 types of in-home care agencies: Employers, registries, referral companies and independent caregivers that you can choose from. Employers pay their employees directly. Most employers offer benefits to their employees and are required to pay federal taxes, Social Security, and Medicare withholding. They also pay state and local taxes.

Registries are also companies. They coordinate caregiver schedules. They pay their caregivers as independent contractors. The caregivers are responsible to pay their own taxes. You will receive a bill from the registry and then they pay the caregiver.

There are some companies who offer referrals and background screenings. They will find a suitable caregiver for your particular situation for a fee. There is more paperwork for you with this type of service such as paying taxes and fees. This type of service is not for everyone.

Independent caregivers can be found in local newspaper listings. This is probably the least expensive but can also be the riskiest in terms of liability as you would be officially "the employer." Questions? Check with an attorney who specializes in senior care.

Agencies may require a dress code or uniform that you may not be concerned with, but it is always a good idea to stress appropriate attire. Caring for an elderly person who may be confused at times will recognize a uniform but not a different outfit every day.

Excessive jewelry can be unsanitary and distracting to an elderly person. Small stud earrings and a wedding band is more appropriate than big jewelry. Ask your caregiver to keep the jewelry they wear to a minimum. Fragrances should not be allowed.

Will your loved one need transportation to doctor's appointments, PT, or other functions? Find out if the caregiver is covered for transportation in their personal vehicle or will the agency provide transportation?

Does your senior need companion care, personal care, or skilled care? Is light housekeeping, assistance with ADLs, and miscellaneous activities needed? At the companion level of care, the caregiver does not usually touch the client. Personal care may include assistance with eating, bathing, dressing, toileting, transferring, and continence. This requires a higher level of skill and training. Often, a license is required. CNA's and LPN's can offer this type of care.

Skilled care is always provided by a professional who is licensed in your state. This includes RNs, LPNs, physical therapists and occupational therapists. These services can be private pay or through an agency. A basic in-home care provider cannot give meds. Most seniors take some form of medication.

Is funding available? What is the cancellation policy? Is there a 24/7 number to call in case of emergency? There must always be a way to contact the agency and this should be in writing.

What are the rates? No surprises! You need to know billing procedures, late fees, up-front costs, etc. right from the start.

From time to time, there are problems. Elderly folks sometimes "fire" their caregiver. The family needs to understand that this happens frequently. Listen to your loved one and investigate complaints. But, listen to the caregiver as well. A simple change in medication or a urinary tract infection can cause problems for seniors. If there is a clash in personalities, this should be remedied immediately. Your loved one should enjoy their companion.

It's also important to find a person at the agency that you can trust, understands you and cares about your situation - someone who doesn't mind you calling with your concerns.

Making the best decisions for your loved one is important. Once everything is in place and running smoothly, make sure you're available. Stop by for unannounced visits. You are their true care giver in that you watch over them even when you're not there 24/7.

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