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When Caregiving is  Not Enough -
Finding Good Homecare

By Leah M. Pavela, LCSW

(Page 2 of 3)

Kathy R. found communication a problem with one home health agency while caring for her stepmother cross- country.  She faxed a durable power of attorney right to the home health agency but “they still wouldn’t tell me anything!”  She states that “especially when you are working from a distance, your hands are tied when there is no communication.” 


For most people, it is a far better choice to choose a “full service” agency which provides for all their needs (nursing, home health aide, physical therapy) than to pick and choose services from different agencies.  This ensures that caregivers are free to communicate amongst themselves on a patient’s progress and work collaboratively to resolve any issues, rather than if they are all from different agencies and forced to stab blindly at problems as they arise.


Most patients fare better when they see one or two familiar faces rather than a steady stream of strangers passing through their lives.  Find out if the same person will be caring for your loved one, or if they will see a new person on a continual basis.  Having one or two familiar caregivers is particularly helpful in the case of people who are confused or frail, as this helps both the patient and caregiver get used to a routine.  It also helps the caregiver know what is “normal” for a patient and what is not normal and warrants a call to the doctor.  Also important to find out is what will happen should the regular worker call in sick.  Will the person be forced to wait for assistance until the next day?  Will a substitute come out at the same time?  Will the person have to wait for hours until another worker has time in their schedule? 


Find out what the procedure is if there is an emergency.  Is there always someone on call?  Will a patient need to wait until the next business day to speak with someone should an emergency happen after the regularly scheduled service is performed?  A good agency should have someone on call 24 hours a day, seven days a week, so urgent matters need not wait until the next scheduled visit.

FINANCIAL RESPONSIBILITY – A reputable agency will not hesitate to address the patient’s financial considerations and should provide the patient/caregiver with a written statement explaining what is/is not covered by insurance/Medicare, and what services the patient will be responsible for out of pocket, if any. 


Check with friends, your physician, ask people at your place of worship, or attend a support group and ask which home care agencies others are using.  One of the best ways to assess how an agency performs in the home is to look past the glossy brochure and ask people how they feel about the service that has been given to their loved ones.  Chances are that good or bad, people will be happy to share their experiences. 


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