Is Home Care the Best Choice for Your Loved One?

Rather than moving into a nursing home or long-term care facility as they age, studies consistently show most older adults prefer to stay at home for as long as possible. This may be the right choice for your loved one if they only need assistance with daily activities to maintain their independence.

It’s perfectly natural for your aging loved one to want to stay at home as they grow older, where they are comfortable and independent. However, it’s important to take the time to look at the big picture before deciding whether staying at home for the long term truly is the right decision for your family. Too often, decisions to leave home are suddenly made after a sudden loss or emergency, making adjustments all the more painful and difficult. Examine all of the options, and remember to consider the costs as well, before choosing what’s best for your loved one’s specific situation.

What Should Be Considered?

Everyone’s home situation is unique, and several factors should be considered for your loved one, including:

• Location and accessibility. Where is your loved one’s home located? Are they in a rural or suburban area that requires a lot of driving? If they’re in an area with more public transit, is it safe and easily accessible? How much time does it take to get to services such as shopping or medical appointments?
• Home accessibility and maintenance. Is their home easily modified? Does it have a lot of steps or a steep hill to access? Is there a large yard that needs to be maintained?
• Support available. Are there family and friends nearby? How involved are they? Are they able to provide the support your loved one needs? Many older adults prefer to rely on family to provide help, but as needs increase, they might not be able to fill in all of the gaps. It’s important to consider proximity to community services and activities as well.
• Isolation. If it becomes difficult or impossible for your loved one to leave home without help, isolation can rapidly set in. They may not be able to participate in hobbies they once loved, stay involved in community service that kept them motivated, or visit with friends and family. Losing these connections and support is a recipe for depression.
• Medical conditions. No one can predict the future. However, if your loved one has a chronic medical condition that is expected to worsen over time, it’s especially important to think about how you will handle health and mobility problems. What are common complications of the condition, and how will they handle them?
• Finances. Making a budget with anticipated expenses can help you weigh the pros and cons of your loved one’s situation. Arrangements like assisted living can be expensive, but in-home help can be a cost-effective alternative, especially until higher levels of care and live-in or 24-hour coverage becomes necessary.

How Can Home Care Help Your Loved One?

You may be used to handling everything your aging loved one needs yourself, dividing up duties with your spouse, or relying on other family members for help. But as circumstances change, it’s good to be aware of the home care services that might be of help. What you may need depends on how much support you have, your loved one’s general health, and the financial situation.

• Household Maintenance.  Keeping a household running smoothly takes a lot of work. If your aging loved one is finding it hard to keep up, home care caregivers can help with laundry, shopping, housekeeping, and other services.
• Transportation. Transportation is a key issue for older adults. Maybe your loved one is finding it hard to drive or doesn’t like to drive at night. Home care can provide transportation services to help keep your loved one’s independence and maintain their social network.
• Home modifications. If your loved one’s mobility is becoming limited, home care agencies can arrange for modifications that go a long way towards making home more comfortable. This can include things such as grab bars in the shower, ramps to avoid or minimize the use of stairs, or even installing new bathrooms on the ground floor.
• Personal care. Help with activities of daily living, such as dressing, bathing, feeding, or meal preparation, is called personal care or custodial care. Home care provides help with personal care, ranging from a few hours a day to live-in care. Caregivers who provide this level of care include certified nursing assistants and home care aides. CNAs and HCAs all must be licensed by the state of Washington to provide care.

Involving Family In Caregiving

Everyone has different family structures and support. In deciding your own options, take a look at your own family structure, culture, and the expectations you and family members might have. Perhaps you and your family want to work out a system where caregiving by family is your primary support for staying in the home and home care services are used for respite or breaks for family caregivers. Or it could be that work, health issues or location of your family may not make this feasible. Your family could live far away from your loved one, which might mean a local family support system isn’t possible.

While this conversation may not be easy, it’s better to discuss these issues earlier than to wait for an emergency when options may be more limited. An independent opinion, such as a home assessment by a geriatric case manager or consulting with other professionals, can be helpful in defusing family tensions too.

Even if there is strong family support, be open to the idea of having help from a home care agency too. Many people have an initial feeling of “not wanting strangers in the house,” but caregiving can be physically and emotionally exhausting, especially if it is primarily on one person such as a spouse or grown child. Your relationship will be healthier with your loved one if all are open to the idea of getting help from more than one source.

Finding the Right Home Care Services for You

Once you’ve figured out your aging loved one’s needs, it’s time to evaluate what home care services are right for you.

As you search for home care services, especially personal care, how do you decide which is the best option between hiring a home care agency or an independent caregiver? Here are some issues to consider when considering an agency, registry, or independent provider:

• Full-service home care agencies like FirstLight Home Care — South Sound can come at a higher cost than hiring an independent caregiver. However, agencies also provide pre-screened applicants who have already had background checks. Since the caregiver works for our agency, tax issues and billing are simpler. You can also check the licensing history of agencies and find out if they are bonded for issues such as theft. If a caregiver quits or is not working out, a replacement can also be rapidly provided, and coverage will be uninterrupted if a caregiver calls in sick.
• Registries and independent providers come at a lower cost, but require careful legwork and financial paperwork on your part. You need to be aware of any tax and Social Security requirements since in most cases you will be hiring a home care helper as an employee. It’s also good to consider careful background checks and identity verification, since there is no independent verification. There also won’t be any backup coverage in case of illness or sudden termination.

Tips for Hiring a Home Care Provider

How you go about hiring home care providers will partially depend on what kind of help you are looking for, however, there are some basic tips to keep in mind:

• Interview several agencies before choosing. It’s important to speak with at least three so that you understand the differences between agencies. This will help you choose the best fit for you and your loved one.
• Be specific about the tasks that you need. Ask open-ended questions to assess the agency’s experience and competence with these tasks. Review the agreement closely to make sure it specifically outlines the tasks, payment procedures and termination procedures.
• Make sure you understand exactly what services will be provided. What exactly is covered in a contract? Are there additional fees that apply to specific services or add-ons? If needed, what are the procedures for termination or requesting a different caregiver?
• Check references carefully. Always check references carefully from more than one source. Listen carefully to the person’s tone and information. Are they enthusiastic about the agency, or are the answers vague and short?
• Confirm the agency conducts background checks and drug testing on caregivers. Background checks are often provided by agencies, but you’ll want to check exactly what is covered and how the check is done.
• Don’t be afraid to ask for a different caregiver if the one assigned is not the right fit. It’s especially important that your loved one feels comfortable with their caregiver, since this person is providing services in the privacy of their home. If the agency is not accommodating, don’t be afraid to find another provider and give your current provider notice.