Those of us who are fortunate that our parents are still with us face the issue of having to provide care for them as their ability to manage for themselves slowly fades. Despite their slow but steady loss of their abilities of independent living many are, understandably, determined to stay in their own homes. That’s when the discussion of alternatives, including homecare, becomes unavoidable for even the most independent minded folks.
Homecare provides people the advantage of staying in their homes and maintaining independence, while providing required medical care. Elderly homecare may be necessary for a variety of persons, such as those with acute injuries (hip replacement), and chronic ones (stroke). The skills required of homecare providers vary as well.
Types of Homecare Personnel
Homecare aids: Certified Nurse Assistants, or CNAs, provide assistance in bathing, feeding, hygiene, and toileting needs. They are generally useful for chronic, long-term care persons.
Registered Nurse: RNs are able to provide medications, wound dressing changes, and obtain vital signs. RNs are useful when skilled, acute care is needed.
Therapists: Physical and Occupational Therapists provide skills for speech and motor rehabilitation when acute care is needed.
The National Family Caregivers Association provides information on homecare. The first step “is to make sure you and your loved one are comfortable with the idea of someone else taking on some of the tasks that you’ve been doing by yourself.” After that, the specific tasks needed should be determined. This will help to define the type of homecare personnel needed.
Federally funded programs, insurance, and health maintenance organizations (HMOs) may or may not cover the services you require. Personal care tasks are usually not covered by private insurance or Medicare. Long-term-care insurance usually covers services required, but not all Americans have it. Unfortunately, “more often than not the costs of homecare services will have to come out of your own pocket” (NFCA).
Accreditation of Care Agencies
Some agencies may be accredited, which is a step beyond certification. Accreditation signifies conformity to national industry standards. Some well-known homecare agencies that provide accreditation are: the National League for Nursing, the Joint Committee for Accreditation of Healthcare Organizations, and the National Foundation of Hospice and Home Care.
Cost of In Home Care
Agencies vary in their costs. Visits by RNs and therapists are more valuable and costly than those by CNAs. Some agencies charge a flat fee for each visit (about $100). Some have a minimum two or four-hour fee. Rates may be from $13 to $35 an hour.
Questions to Ask the Eldercare Agency (from NFCA)
- Is the agency certified in Medicare and/or Medicaid programs? (if needed)
- How long has the agency been in business?
- Is the agency accredited by a recognized body?
- Is an initial assessment provided to determine if homecare is appropriate?
- Are the services you need provided by the agency?
- How are employees chosen and trained? Are background checks mandatory? Are caregivers given written personnel policies, benefit packages, and mal-practice insurance?
- Are emergency procedures in place?
- Are any references available from clients?