It can be stressful and time-consuming to find a trustworthy, responsible, and compassionate caregiver to keep your loved one safe, independent, and comfortable in their own home. Lucky for you, we've rounded up seven pro tips on finding the best in-home health care for your loved one.
In-home care services can be skilled (medical), custodial (personal, household, emotional), or both. For the purposes of this article, we will focus on skilled care for seniors with an illness or disability that requires medical attention, although usually this level of care also includes help with Activities of Daily Living (ADLs) such as bathing, dressing, grooming, and ambulation.
AARP suggests starting off by getting together with your loved one and writing down their "needs and limitations, likes and dislikes, expectations, and doctor recommendations." This will help you decide whether you need a Home Health Aide (HHA) or a medical caregiver. According to Caregiver.org, there are three general certifications for home care attendants:
A Home Health Care Aid is the next step up from custodial care. These professionals provide the most basic level of medical care like checking blood pressure. They can remind the client to take their meds, but they aren't allowed to administer or dispense them.
In addition to providing personal care, CNAs and LNAs are trained to provide the next level of medical care, including observing and reporting changes in the patient, taking vital signs, setting up medical equipment, changing dressings, cleaning catheters, monitoring infections, conducting range-of-motion exercises, offering walking assistance and administering some treatments, according to AARP.
Licensed Vocational Nurses (LVNs) and Licensed Practical Nurses (LPNs) are the next level up. These licensed professionals "evaluate, manage and observe your family member's care and provide direct care that nonmedical and home health aides cannot." as described by AARP. They're allowed to administer IV drugs, tube feedings and shots; change wound dressings; provide diabetes care; and educate caregivers and patients. Some LPNs/LVNs are specialized in occupational, physical, or speech therapy.
LPNs and CNAs work under the supervision of RNs or Nurse Practitioners (NPs), who have a degree in nursing. Providing the highest level of in-home medical care, RNs can do everything from administering meds to operate medical monitoring equipment.
Staffing agencies make finding in-home care a breeze. They do all the heavy lifting for you, from providing trained candidates who have already been screened to handling payroll and taxes. Going through an agency can be expensive since they take a percentage for their services, but this way you won't have to worry if the caregiver is sick, as the agency will just send in a sub. Also, they can upgrade care as needs increase. The downside is, you may not have much say in who the agency chooses, and while individuals may be flexible with hours, an agency may require a full-time schedule.
Use an agency if you require help immediately, as it takes much less time and effort. To find an agency in your area, you can use your local Area Agency on Aging's free home-care locator service, The National Association for Home Care & Hospice database, and/or Medicare's Home Health Compare. Arrange a consultation with the best-suited agencies.
Often referred to as registries, these eldercare matching services are similar to staffing agencies, except the home health workers work for themselves, not an agency. Direct-hire firms like Care.com, ElderCare.com, and CareLinx will take the info you provide and give you options from their care community. This requires a little more legwork on your part, but you also get to see the caregiver's profile and have more of a choice.
Keep in mind, these websites typically don't run their own background checks unless you pay for that service as well. These companies will usually only charge a one time fee for a successful match, making it cheaper than agency fees. However, you are the employer in this scenario, not an agency.
"Word-of-mouth" is such an odd phrase. As opposed to what? Word of toenail? Jokes aside, in addition to online research, ask around your community for personal referrals. Reach out to friends, relatives, neighbors, doctors, senior centers, and organizations you trust to see if they recommend any local home healthcare companies or individual caregivers. You could even write a "looking for recommendations" post on Facebook. Some employers offer elder-care referral services, too.
Agencies and online eldercare matching services take a lot of this guesswork out for you, but be sure to write down your expectations so everyone is on the same page, especially if you're hiring someone privately. Be clear and specific--for example, if you need help with housekeeping too, list which tasks specifically. Some caregivers are willing to change a diaper but draw the line at washing windows. If your loved one has a pet, it helps to mention that to ward off those with allergies. If you are hiring someone privately, all of this will need to be drawn up in an employment contract. AARP has a checklist of important questions to ask before signing a home health contract.
If you are hiring a home health caregiver outside of an agency, you'll be reading resumes and performing the interviews. You can weed out the weirdos via phone, then ask the final candidates to meet for an in-person interview with you and your loved one (if possible). If the potential caregiver will be providing transportation, make sure they have a reliable car, insurance, and a current driver's license. Also, make sure to ask them for references (and then actually check them).
If you're checking out an agency instead of an individual, sometimes they will send someone over to interview you to find out what kind of care is needed, etc. However, there are some important questions you need to ask them as well. For instance, will you be able to interview their candidates? What happens if your loved one doesn't get along with the caregiver they've chosen? Is it just one person, or do they have a team who will rotate? Will they send someone else if your assigned caregiver can't come in for some reason? A Place for Mom has a bunch of great questions to ask, including requesting a "detailed 'Patient Bill of Rights' that outlines the rights and responsibilities of the providers, care recipients, and caregivers alike."
If you're going through an agency, you'll want to check their reviews and reputation on the Better Business Bureau website. You'll also want to ask the agency for references from doctors, clients, etc. When you call the agency's references, ask about how often they use this agency, if they have a contract, and how long they've used them. If you're hiring a person directly, it's on you to make sure they have the necessary credentials and experience.