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5 Common Questions About Hiring In-Home Care

Gillian Burdett
Oct. 30, 2014

If you're grappling with the decision of hiring in-home help, consider these questions.

When your adult or elderly loved one can no longer live independently, you're faced with a stressful decision for how to get them the best care moving forward.

"The majority of seniors prefer to live at home," says Mardy Chizek, a registered nurse and the president of Charism Eldercare Services in Westmont, Ill., "so before considering placement in an assisted-living facility or nursing home, family members should consider all available options."

These options can include family members acting as caregivers, in-home nursing support or in-home, non-medical attendants. If you're thinking of hiring in-home help, consider these common questions.

  1. How Will I Know if In-Home Help Is Right for My Loved One's Needs?
    "Your decision will largely be determined by the health conditions, financial resources, availability of family and the physical environment of the home," says Chizek.

    The health and safety of your loved one is the primary concern. Will your mom be happier continuing to live in her home, rather than moving to an assistant living facility? Will her life be improved if she has someone to help with taking medication and monitoring health care on a regular basis?

    And don't forget about the home itself. Is it still a safe environment for your mom to live in? Are there problematic areas like staircases and slippery floors that could make it difficult to get around? Use this checklist for aging in place.
  2. Where Can I Find Reliable In-Home Help?
    There are two routes to hiring caregivers. You can work with an established agency or hire someone on your own.

    Lynette Whiteman, executive director of Caregiver Volunteers of Central Jersey, recommends hiring through an agency because, "with an agency, if the aide gets ill or does not show up, there is backup and a system in place to respond to this."

    If you prefer to hire independent help, you'll have complete control over who cares for your loved one. And while a bit more time-consuming, this route can often be less expensive.

    Whether you go through an agency or hire an individual, it's important you check references and run background checks on any care providers.
  3. How Much Will In-Home Help Cost?
    Medicare does cover home health services in cases where a doctor has determined there is a need for skilled nursing care of a home-bound senior. It will also pay for the services of a Medicare-certified home health agency if the services are deemed necessary by a physician.

    If your family member only needs personal care services, rather than health care, it's generally not covered by insurance. Personal care providers help with daily tasks such as housework, dressing, bathing and running errands. Depending on where you live, you can expect to pay between $15 and $30 an hour.
  4. How Can I Monitor the In-Home Provider?
    Whiteman recommends you, a friend or neighbor drop by unexpectedly to check on your loved one and the activities of your in-home care help. "This is the best way to really monitor what is going on."

    If your loved one regularly appears agitated after a visit from his or her aide, Whiteman also recommends hiring a new aide. Although there may be no actual abuse, there is something causing your loved one discomfort.
  5. How Can I Get My Loved One to Accept Help?
    Have you spoken to your dad about hiring in-home care? He should be a part of the decision-making, rather than having it foisted on him.

    Chizek notes that you can expect some push-back or even anger from the person who needs help. They may think they are healthier than they really are, and may object to new surroundings or strangers in their home.

    "I would present it as 'giving it a try' for a short period of time," says Whiteman. "Most of the time, if they get along with the aide, the resistance is diminished and they better accept help."

If your loved one has reached the point when their independent living is no longer a reality, it's time to get help. "Making decisions about the care of aging parents is highly emotional and stressful, but don't do it alone," Chizek says. "Tap into the available resources and elder care experts in the community."

Gillian Burdett is a freelance writer in New York.

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