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A Practical Guide to Selecting the Right Home Care Services

Aging in your own home is a popular and growing lifestyle choice for many of today’s seniors, and one that has advantages when it comes to physical, emotional, social, and spiritual well-being. However, the decision to remain in one’s home may often include having some assistance with activities that become more challenging as one ages. For those that do find that they require assistance with the Activities of Daily Living, hiring a home care agency or private caregiver is often a viable option.

Activities of Daily Living (ADLs) is a way to describe the functional status of a person. Some of those activities include:

  • Mobility
  • Communication
  • Bowel and bladder management
  • Eating and drinking
  • Personal cleansing and grooming
  • Personal device care – Includes items like hearing aids, glasses, prosthetics, adaptive equipment, etc.
  • Controlling body temperature
  • Sleeping

If activities such as those mentioned above have become difficult for you and/or a loved one, then changes in your lifestyle and living situation may need to take place. At that time, it is advisable to consult with a trusted healthcare professional that can assess your functional status. Many times they will concentrate on the following specific activities of daily living when assessing seniors: ambulating, toileting, hygiene, dressing, medicating and eating.

If you and/or your family physician or other trusted advisor believes that some level of assistance would be of benefit, there are many choices to consider. First, determine what type of needs you have currently and how those needs may progress. Some questions that may help you determine these factors are:

  • Do you need any skilled medical assistance for things such as blood pressure checks, blood sugar testing, medication administration, wound care, or other?
  • Is a memory loss diagnosis (Alzheimer’s, dementia) a factor or is the patient confused and/or forgetful?
  • Do you need a Caregiver that is specially trained in hospice care, Alzheimer’s, transfer / ambulation or other special needs?
  • Do you need any other special needs, such as a Caregiver that speaks a particular language?

The next step is to understand the different types of companies that are available to provide such assistance, and what the differences between those companies may mean to you. They are:

Nursing Registry: A Nurse Registry is a company that maintains a list of RN, LPN, CNA and other credentialed healthcare professionals, and will refer clients to those qualified caregivers. Registries do not employ their caregivers, and as such the client is usually responsible for payroll taxes and insurance.

Home Care Agency: A company that utilizes company-employed professional caregivers to provide home care services. The agency is responsible for conducting background and credential checks, as well as paying the payroll taxes and insurance.

Home Healthcare Agency: A company that provides home care services, either non-medical and/or medical in nature. HHA utilize company-employed caregivers, and they generally provide care for clients under Medicare and/or Medicaid. Service hours may be limited as determined by medical necessity.

So, now you know that you want to get some assistance, you know what types of service would be the best for you, and you know what kind of company you would like to hire. How do you go about finding the right one for you that will be trusted, reliable, affordable, and available? First, call a trusted professional advisor, such as your Primary Care Physician, local hospital, Elder Law Attorney, or Clergy at your church. You may also want to ask friends, neighbors or relatives that have had experience with local home care agencies. Also, your county will have an Area Agency on Aging that can be of great assistance with finding the proper care.

Once you have a list of agencies, call the agencies and ask to speak with the owner or the Office Manager. You should be looking for an owner and staff that know the area, are well connected to the healthcare and social community in which you live, and are willing to invest time (without expense to you) to understand your needs and how they can best help.

Some tips to consider:

  • Local is better when it comes to home care. Look for an agency that has an operating office in or around your town. Your case should be staffed with a local caregiver, and you should discuss contingency plans in case you and or your caregiver has an emergency.
  • Look for an agency that has a Registered Nurse on staff that will conduct a thorough intake and Plan of Care for your case. Be sure to get their name and phone number in case you have any emergencies or concerns with the service you are receiving.
  • Read their service agreement carefully without pressure to sign anything on the spot. Make sure you understand all of the fees, any minimums imposed by the agency, and exactly what types of services are covered under the agreement.
  • Once you have selected your home care agency, work with the RN on developing your Plan of Care that will include all of the services that you would like to have done by the agency. These may include transportation, medication reminders, shopping, personal care, exercise, light housekeeping, and other activities.

Remember, you are the customer and you should not hesitate to express your needs and give feedback to the agency. When an agency assigns a caregiver to your case you should look forward to seeing that caregiver and the benefits that go along with having their help. You should never feel that you are stuck with a Caregiver that does not make you feel comfortable, safe, and secure. A little bit of planning, research, and screening can result in finding that perfect level of assistance that can keep you safe and comfortable in your very own home. After all, there is no place like home!

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