In-home Care is becoming increasingly popular due to the fact that it allows older adults to remain independent in the place where they are most comfortable --- their homes. To find the best in-home care worker, for your situation, will require some research and need assessment. This is simply because a large number of people don’t ever take notice of this service until it is needed. So where do you begin?           

You will need to know exactly what the needs are of your loved one. In some instances, it is a matter of the doctor’s instructions. Sometimes the need has been identified as the health situation gradually changes. Other times, the need arises out of a sudden event such as a stroke or the death of a spouse. Someone who knows your loved one very well or is willing to spend some time around them in order to find out should be responsible for identifying exactly what activities or tasks they need assistance with. Of course, in some situations, your loved one can tell you themselves. It is important, if at all possible, that they have input in this process of selection.

Questions to consider:

• Are both personal care and household assistance needed?
• Are medical procedures required (i.e. physical therapy, injection of insulin)?
• What specific household assistance is needed within a typical day? Make a
   list.

Is care needed for a specific time of day or all day?

This need assessment is important due to the difference between non-medical home care and home health care. In-home non-medical care generally pertains to service such as light housekeeping, transporting to appointments and errands, light meal preparation, and medication reminders. In-home health care includes services of nurses, physical therapists, and respiratory therapists. Providers are trained medical, health care and psychiatric professionals, or certified nurse aides. In-home health services are usually ordered by a doctor.

Families may consider hiring private in-home care without going through an agency. The cost may appear to be less than going through an agency but great consideration should be given to the total cost and responsibilities of hiring private in-home care. As a private employer, the family or individual is required to pay Social Security, unemployment and payroll taxes.  It is strongly urged that families consult with a labor attorney to insure that all laws are being followed relative to federal tax laws. In addition, the family or individual can be held liable for any work-related injury that occurs to the worker while on the job. Contrarily, if you go through an agency, the agency is responsible for paying appropriate payroll taxes, liability, and worker’s compensation. The agency is also responsible for monitoring the quality of care being provided to your loved one.  Agencies perform background checks as well. 

Questions to ask an Agency:

• How do you select your employees?
• Are your employees insured and bonded?
• Does your agency carry professional liability and worker’s compensation?
• Do you provide information explaining available services, eligibility
   requirements, and fees?
• What are procedures for billing?
• Do you accept any insurances, Medicaid, Medicare?
• How are emergencies handled?
• What kind of supervision policies are in place for your employees in the
   field?
• Can you provide references?
• Can we meet and interview the caregiver before an actual assignment is
   made?

Question to ask an individual:

• Why are you interested in providing home care?
• Tell me about your past home care experiences?
• Do you currently provide care for others?
• How flexible is your schedule?  What is your availability?
• Are you willing to do household chores such as cooking or housekeeping?
• Do you like pets (if this applicable)?
• Are there any tasks that you are unwilling to do?
• What kind of training have you had?
• Can you provide references?

If your loved one is being discharged from a nursing home, rehabilitation center or hospital, the doctor and/or discharge personnel can usually recommend contacts for in-home care.  You can contact the regional Area Agency on Aging, religious affiliations, newspaper ads, yellow pages and friends or co-workers who may have previously been involved in this type of process and may have already found an agency who provides quality service.  In the Triangle area, an additional resource is the non-profit agency, Resources For Seniors.  As with any potential service provider, it is best to research several before a decision is made.

Submitted by Genel Webb, owner of CenterPeace Companion care in Fuquay-Varina. The number is 919.567.8200.