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By Eileen Beal, MA
When Mom and Dad are struggling to keep up
with the chores, activities or medications that
help them maintain their independence and
health, the solution to their situation (and
your concerns) could be as simple as bringing in
someone to provide in-home care for a couple of
hours a day.
But not before you and they have had a frank
discussion about the kind of help, support and
services they need – and will accept. “You
want them to feel they are a part of the
decision-making process, that their wishes and wants
are honored and respected,” says Mary Ellen “Mel”
Roberts, LCSW, a certified care coordinator at
Oklahoma City-based Elder Care Solutions.
Start by asking your loved ones (and yourself)
the following questions:
What days and times, and in what situations,
might you need help?
How much money is available to pay for
outside resources, and will your insurance –
including Medicare or Medicaid – cover any
costs?
Home care vs. home health aide
Home care aides provide assistance with housekeeping
and chores (meal preparation, shopping, errands,
etc); socialization and companionship; and may also
provide some personal care (bathing and grooming).
In some areas, they are called personal care
assistants.
Home health aides – increasingly certified nursing
assistants (CNAs) and/or state tested nursing
assistants (STNA) – provide medically-related care
(check blood pressure and glucose levels, dress dry
wounds, empty colostomy bags, etc.); assist with
therapeutic treatments prescribed by a physician;
supervise medication administration; etc.
“The client’s needs and the aide’s skill-level
determine what the aide’s [hourly] fee will be.
The more skills the aide has, the higher the cost,”
says Debbie Adams, RN, the Director of the
Cleveland, Ohio-based Western Reserve Area Agency on
Aging’s Community Services and Support Program.
Write a job description
Using the information you’ve gathered from
discussing and assessing your loved ones’ needs,
write a detailed job description. “Care
expectations vary from client to client, so having
everything in writing means everyone knows, and
meets, expectations,” says Lucy Andrews, the
nurse/CEO at Santa Rosa, California-based At Your
Service Home Care.
A detailed job description doesn’t just
“clarify expectations;” it should also influence
whether to hire on your own or through an agency.
With an agency, the aide has been trained, screened
and checked – for everything from DUIs to TB
–and bonded. And they are supervised.
“That,” says Adams, “includes surprise home visits.”
But there are other benefits, too. “Clients
have back-up if the scheduled caregiver can’t be
there. And an agency handles all the
paperwork: reimbursement forms, payroll, taxes,
workers compensation, insurance,” says Andrews.