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Shopping for the Right In-home Help

By Eileen Beal, MA

(Page 1 of 3)

When Mom and Dad are struggling to keep up with the chores, activities or medications that help them maintain their independence and health, the solution to their situation (and your concerns) could be as simple as bringing in someone to provide in-home care for a couple of hours a day.

But not before you and they have had a frank discussion about the kind of help, support and services they need – and will accept.  “You want them to feel they are a part of the decision-making process, that their wishes and wants are honored and respected,” says Mary Ellen “Mel” Roberts, LCSW, a certified care coordinator at Oklahoma City-based Elder Care Solutions.

Start by asking your loved ones (and yourself) the following questions: 

  • What days and times, and in what situations, might you need help?

  • How much money is available to pay for outside resources, and will your insurance – including Medicare or Medicaid – cover any costs?

Home care vs. home health aide

Home care aides provide assistance with housekeeping and chores (meal preparation, shopping, errands, etc); socialization and companionship; and may also provide some personal care (bathing and grooming).  In some areas, they are called personal care assistants.

Home health aides – increasingly certified nursing assistants (CNAs) and/or state tested nursing assistants (STNA) – provide medically-related care (check blood pressure and glucose levels, dress dry wounds, empty colostomy bags, etc.); assist with therapeutic treatments prescribed by a physician; supervise medication administration; etc.

 “The client’s needs and the aide’s skill-level determine what the aide’s [hourly] fee will be.  The more skills the aide has, the higher the cost,” says Debbie Adams, RN, the Director of  the Cleveland, Ohio-based Western Reserve Area Agency on Aging’s Community Services and Support Program. 

Write a job description

Using the information you’ve gathered from discussing and assessing your loved ones’ needs, write a detailed job description.  “Care expectations vary from client to client, so having everything in writing means everyone knows, and meets, expectations,” says Lucy Andrews, the nurse/CEO at Santa Rosa, California-based At Your Service Home Care.

 A detailed job description doesn’t just “clarify expectations;” it should also influence whether to hire on your own or through an agency. 

With an agency, the aide has been trained, screened and checked  – for everything from DUIs to TB –and bonded.  And they are supervised.  “That,” says Adams, “includes surprise home visits.”

But there are other benefits, too.  “Clients have back-up if the scheduled caregiver can’t be there.  And an agency handles all the paperwork:  reimbursement forms, payroll, taxes, workers compensation, insurance,” says Andrews.


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