Elder Care Insights: Choosing an In-Home Health Care Provider

by Laura Gillson

As America’s “baby boomer” generation enters the second half of their lives, we face some heartbreaking choices as to how best to care for our aging parents. Many families are already struggling to cope with these issues, as they are caring for their elderly parents while raising their own children who are still living at home. Stretched to the limit of their physical and personal resources, these families must face the realization that it is time to hire an in-home health care provider. If you are at a loss as to where to begin, below are some tips that will help you to evaluate your needs, as well as those of your loved ones, and to make decisions that will give everyone peace of mind.

First, decide whether you want to hire a caregiver from a state agency or private agency. Usually, a state agency is funded by the state in which it operates, and is considered to be a state subcontractor. A private agency is just as it sounds. It is independently owned and operated, and its clients are called private pay clients. There are advantages and disadvantages to each. A caregiver from a government agency is subject to hiring practices that are standardized. Accountability and administrative procedures are taken care of at the agency. Private pay companies are often staffed by a small group of hourly workers. They have their own accountability standards, as with any sole proprietorship. The option you choose may depend upon your financial situation. Private pay service is usually much more expensive.

Get it in writing: Assess the needs of both the family caregiver and the person for whom care will be provided. Use a worksheet to create a “contract for services,” so that it is clear exactly what is expected of the care provider.

Generally, caregivers provide four categories of services (think of the acronym H.E.L.P.): Health Care Services, Emotional Care, Living Independently, and Personal Care Services. Health care services can include managing medical appointments, medications, and physical therapy. Emotional care consists of meaningful social activities, hobbies, a creative outlet or simply companionship. Living independently can require that the caregiver run errands, fulfill transportation needs, go shopping, cook, clean and performs other household chores. Personal care services can include bathing, dressing, and using the toilet.

Both you and your parent should actively participate in the hiring process. Your loved one may have strong preferences about the type of person he or she wants to hire. Make sure that these preferences are clearly expressed in writing. For example, your parent may prefer one gender over the other, cultural similarities, a non-smoker, and so on. You may also want to make note of what type of cooking, shopping and housekeeping routines you prefer.

Get all the info: Most agencies and private pay companies run background checks on their care workers; however, get all the information that is available about the person who will have full access to your loved ones and their home. Be as thorough as you would be for child care.

Check in on occasion. By checking in on your loved ones, you are letting the care providers know they are being supervised. While you may adore the young lady or gentleman who is caring for your elderly mother, you may not know who or what is being brought into the house during your absence.

Recognize the signs of abuse: Isolation from family and friends is one of the first signs of abuse. If you are not allowed unfettered access to your family member, or you believe excuses are being made for your parent’s absence or lack of availability via phone or in person, be sure to look closely at the situation.

Call for backup: Know what options are available for last-minute services should a care provider become unavailable. Have backup options ready. Even caregivers need to call in sick on occasion.

Reevaluate regularly: As health requirements and personal preferences change, so must the services provided. Establish a pre-set date for periodic review of the personal services contract. This allows for maximum flexibility and will give you the breathing room you need to modify or amend the contract, if changes are warranted.

Finally, be sure to express your gratitude. You are hiring a care provider because you either cannot or will not take up this immense task. The person taking care of your parent’s needs is giving the greatest gift they could give. Theirs is a noble profession, one that requires compassion and infinite patience. Be certain that you acknowledge their efforts and show your appreciation for a job well done.

Copyright 2005. All rights reserved.

Laura Gillson is a speaker, author and educator specializing in disability awareness, advocacy, accessibility and assistive technology. For corporate, community or caregiver training, visit Eloquent Insights at http://www.eloquentinsights.com If you need help with in-home care, you’ll find it at In-Home Insights at http://www.inhomeinsights.com Finally, you’ll discover a site for sore eyes at Accessible Insights at http://www.accessibleinsights.com The author's email address is .

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