Day 17: Home Care (Part 1)

Raising 'Rents (as in paRents) a show about caring for an aging parent or adult

Host Zack Demopoulos launches his 30 day preparation plan to care for an aging adult. In Day 17, Zack talks about hiring a professional caregiver. Specifically how to choose a home care agency, how, what to look out for, what to ask, and how to protect your family.

You finally have come to the realization that you need to hire some outside help to care for mom or dad.

As a home care provider myself, and having hired over 500 aides in 10 years, I will tell you the good news—most of the horror stories you have heard are not true or can be avoided. The bad news—-you still have to manage the aides no different if you let a plumber into your house. But we’re going to talk about how to do all of this the easiest way possible, how to find a good agency, what to ask and look for, and how to protect your family on this episode of Raising ‘Rents Podcast.

This show is sponsored by ComForCare, a national home care provider that will help you live your best life possible. https://comforcare.com/

This is Day 17 of the 30 Day Preparation Plan to care for an aging parent. The Prep Plan is all about helping you the family caregiver provide your loved one with the best comfortable safest and efficient caring environment in which they can grow old in.

The topic today is one option for long term care which is home care.

If you have not had a chance to listen to Days 1 through 15, please go back to Season 1 and check out these episodes. Also in Season 1 we introduce the 9 beginner steps in raising your parents. http://raisingparentspodcast.com/page/5/

Back on the episode that was Day 14 of the 30 Day Preparation Plan To Care For An Aging Parent we talked about how your parents can age in place—what to consider so that they can live at home independently as they get older in a safe environment and with dignity. http://raisingparentspodcast.com/episode-023-day-14-what-is-aging-in-place-for-mom-dad/

It really is what most people prefer— to remain living at home as they get older.

In the beginning the family caregiver steps in. It could be the spouse. It could be an adult kid who lives nearby or even a long distance adult kid. After a while though, that is just not enough or practical.

When we plan for long term care as someone ages, the first goal should be that they stay home or if the situation calls for it, in someone’s home. Anywhere but a facility if it can be helped is usually the most effective option to begin with. But to make that happen, besides being the family caregiver, you need help. It is time to hire a caregiver, a professional aide from a reputable home care agency.

There are two types of services that come to the home—typically referred to as home care and home health. Home care is considered non medical and home health is considered medical, that is, it is prescribed by a medical provider like a doctor...services like physical or occupational therapy, skilled nursing, administration of medicines, wound care and monitoring of health status. Usually these services are part of a care plan following a hospitalization. By the way, these services are usually paid for by medical insurance, including Medicare and Medicaid, because they are prescribed by a doctor and typically associated with a hospital discharge.

In this episode we are only talking about home care the is non medical. Services like Helping with adult daily activities or referred to as ADL’s in the industry, things like grooming, dressing bathing and using the toilet. There are others services as well such as assistance with safely managing tasks around the house like preparing meals, shopping, medication reminders, assistance with walking or transferring from a bed to a wheelchair, assistance with chores like light housekeeping and then there is safety supervision such as fall prevention and monitoring someone with dementia. There is also Companionship which include things like engaging in conversation and helping them with their hobbies—gardening, reading a book, listening to music. Some agencies will even allow their aides to drive a client’s vehicle or their own vehicle to run errands, do some shopping, and transport to doctor appointments.

Different terms for a caregiver: aide, companion, home maker, home care aide, certified nursing assistant or CNA, Home health aide, or Certified Home Health Aide CHHA. It varies depending on which state you live in and how they are regulated. For example in New Jersey a CNA is an aide that works in a hospital or facility like skilled nursing and a CHHA is the aide that works in a private residence. New Jersey leans heavily towards protecting the consumer by regulating home care agencies and their employees—that is good news for a family that needs to hire an aide.

The agency has to be licensed and regulated under the Division of Consumer Affairs, renew on an annual basis, comply with strict requirements like having a RN on staff who supervises the aides and carrying the right insurance, and starting in 2019 agencies in New Jersey must be accredited which is an extra step in meeting the highest quality standards in the home care industry.

The CHHA is regulated under the Board of Nursing, must renew their certification every two years, has to successfully finish a course and gets fingerprinted and background checked. The state also monitors CHHA’s and agencies for any criminal activity and reports it on their site

Best way to search an agency is plugging in your state with terms like home care agency, home care aide, caregiver as a start. Some of the state government departments offer information about how to pick an agency and what a home care aide is. You can check out the one New Jersey provides as good reading—just remember that it is specifically for New Jersey but a lot of it is applicable to general home care knowledge. https://www.njconsumeraffairs.gov/hhh/Documents/A-Consumers-Guide-to-Homemaker-Home-Health-Aides.pdf

We get calls to our own home care agency from stressed adult kids all the time who were told by a discharging personnel like a social worker from a hospital or rehab center that their parent is being released tomorrow and they will need home care.

Zack’s personal experience: After calling the Employee Assistance Program at my job years ago it was suggested to me to hire an agency for my father who was in North Carolina and I am in New Jersey. I went about it blindly hiring the first agency I spoke to without doing any research, not knowing what they do, what they require, what they cost. It was stupid when I think back on it.

It really pays to do your research. I would recommend no less than speaking with three agencies and if possible having a face to face meeting with them.

Speaking about associations, if your state has one, which most states do, that is a great resource to check in with and ask questions or ask for their membership list. Typically associations like these only have members that are very reputable and credible but do not assume that—you still need to do your research. Go to their websites, check out their list of members, read some of their resources, and even reach out and ask questions. https://www.hhsanj.org/ and https://www.homecarenj.org/

Each county also typically has some type of resources for elder care, usually called the area agency on aging. They also can provide lists of home care agencies they have worked that are reputable. They are also a great resource to answer questions you may have about how to pay for some of these services such as the Veterans Administration https://www.benefits.va.gov/pension/aid_attendance_housebound.asp and Medicaid https://www.medicaid.gov/medicaid/hcbs/index.html

There are plenty of other places to find lists of home care agencies. There are publications that you can find in hospitals, libraries, senior centers or online. Just keep in mind just because they are listed somewhere doesn’t mean they are endorsed by anyone or anything in particular. It usually means they paid for an ad to be on that list. One professional publication that is nationwide that I have had a great experience here in New Jersey is the Senior Blue Book https://www.seniorsbluebook.com/. https://www.seniorsbluebook.com/local/newjersey/. The book lists many reputable home care agencies that the publisher of the book personally vouches for. By the way, the book also has multiple resources of other areas of need such as medical home care services, housing, and moving services just to mention a few.

The internet has plenty of information too. As you plug in “Home care” into your browser and the geographical area you are searching for, you will get a long list of options. Some referral sites will pop up too.

Another great source are Social workers. They usually have a list of reputable home care agencies, or at least ones they have had their discharged patient or resident use and there have not been any issues they know of.

And don’t forget your EAP —-Employee Assistance Program. Most companies now offer that to their employees. They usually can also provide you some guidance as to where to look and perhaps offer a few recommendations.

There are major franchise home care chains. Typically these are considered reputable because they not only follow their own states regulations but have to follow their franchise system requirements that usually are more strict than what the state requires.

I recommend you have at least two if not three or four to evaluate and now you should call them. Because most of you work, you will probably have to do this after hours. Not to worry. Most agencies tout they are 24/7 and this is the first test to see how 24/7 they are.

Once on the phone, you should be prepared to ask questions. They will go into their pitch I am sure but a very good agency will listen to you first, ask clarifying questions, then proceed to share with you what they can do. And this is very very important to me...I hope it is to you. I would at the very least ask them to meet you, preferably in your parent’s home or where the care will take place. And if you can’t meet them because you are long distance, get another family member or responsible decision maker to be there.

The face to face meet and greet is important for a few reasons. It will give you a good impression of who you are dealing with, it will equally give them the same impression and put them in a better position to help your family. Are they professional? Are they the owners? Are they more educators or are they trying to just make a sale. It will also help start a relationship for your parent or parents—remember this is their home and they probably did not ask for someone to be sending someone into it. As the owner of a home care agency and with many years of experience, I also like to give safety suggestions by inspecting the home for fall prevention—regardless if they pick me or not. Home care providers are usually very knowledgeable with this and should offer.

This was Day 17 part 1 of the 30 Day Preparation Plan to care for an aging parent. Tune in for the next episode when we continue to talk about Home Care. In this episode I will share with you questions that you should ask a home care agency before you hire them. We will also discuss what the next steps are after you have identified the right home agency for your parent or parents, the different type of options for shifts including 24/7 or live in’s, how to protect your family when aides visit their home, what home care costs, and the pro’s and con’s of hiring a caregiver privately.

Thank you for listening to the Raising ‘Rents podcast. If you have any questions or feedback, please go to our website http://raisingparentspodcast.com/ and click on the “Contact” tab. Let us know about any topics you want covered. You can also find the show notes and references to anything we talked about. Until we talk again, remember that our parents raised us, the least we can do is help raise them. Talk to you later. ?

Sources used in this series: Intro/outro music: Arthaiz

Other music: Philipp_Weigl_-_01_-_Subdivision_of_the_Masses, Blue_Dot_Sessions_-_06_-_Wahre Daughter Anastasia Demopoulos does the opening voice over Website created and managed by Philip Golden