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Making Home Care Work for Your Aging Loved One, Part 5

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This is the final, fifth installment in our Making Home Care Work for Your Aging Loved One series. The transition of introducing care into your aging loved one’s home can feel very overwhelming! We started by compiling five of the main concerns our customers have expressed to us. Each installment focuses on one specific obstacle and how to tackle it, based on our 30 years of home care experience. So far we’ve shared:

#1 Help! My Loved One is Refusing Help at Home

#2 I Don’t Know What to Expect from Home Care

#3 How Do I Pay for Home Care

#4 How Do I Choose a Home Care Company

We’ll finish with, Home Care or Hire My Own Caregiver? When you know that your loved one is going to need home care, you will want to understand your options. Should you hire a home care company, or go it alone and try to employ your own caregiver(s) for your loved one? Or, maybe you are new to home care, are surprised by what home care costs, and are seeking the most cost-effective option for your family. Either way, we encourage this conversation because we want you to make an informed decision.

Concern #5: Home Care or Hire My Own Caregiver?

To clarify when you may need a caregiver, let’s review two main types of home care. Medicare, skilled home health care is prescribed by your doctor, for a time-limited period. This care is funded by Medicare or a Medicare Advantage plan (when you qualify, and are 65 or older). Care is provided by licensed nurses, therapists, social workers, and occasionally a certified nurse aide who helps with bathing. Medicare home health care is not provided by caregivers, and the services are not meant to provide non-medical help with daily activities.

Private Duty, or Private Home Care Services, include non-medical care like help with daily activities. It is provided mainly by caregivers, and it is funded through self-pay, or sometimes through a long-term care insurance policy. Private Services are designed for your loved one who needs non-medical help to be safe at home. Their needs may range from occasional supervision and companionship, to moderate help when they are moving around their home, and/or to get up and down from sitting/standing, from the toilet, and from their bed. They may even need maximum assistance if they have dementia and/or Alzheimer’s, causing confusion that may lead to agitation. Every aging loved one’s needs are going to differ; their daily needs may be physical, cognitive, or both.

Another variable is that your loved one’s need for help at home may have developed gradually, or it may have come up suddenly following a fall, other injury, or illness. You may wonder how they are going to be safe at home when you cannot be there 24/7. Or, you may be frustrated if your loved one only needs help occasionally and you feel like you are going to have to pay for more home care than you need. You may have assumed that Medicare would pay for all of your aging loved one’s needs, when it doesn’t. So, what can you do?

We want you to feel good about your home care decision, and there are several factors that will drive your satisfaction level. These factors include cost effectiveness (paying a fair price and only paying for what you need), and caregiver performance (do they arrive as scheduled and do they what you ask them to do). Which is more affordable and has better results?

When you choose a home care company like Cooperative Home Care, here is what you can and should expect: our Intake Nurse will take your call directly and can qualify your loved one for every home care service, before you pay out-of-pocket. She can work with your doctor if you qualify for Medicare home health care, and she can also identify other funding sources including VA, Reduced Fee through the United Way, and Medicaid. If your loved one also needs Private Services for daily assistance, she can schedule your free, no obligation assessment. All of this can be completed conveniently over the phone.

During your free assessment, our Case Manager can help you design a schedule that compliments any other home care services your loved one is receiving. This helps ensure you are only using Private Services when you need them. Private Services can flex from day to day if you and other family and friends want to help provide care some of the time, which also helps to defray the cost. Cooperative Home Care also offers Value Packages (hyperlink to Value packages page), which are flexible home care packages that are discounted to further decrease your out-of-pocket cost. Finally, your Private Services can decrease if your loved one regains their independence. Overall, you can expect to pay about $21 to $23 per hour of Private Services.

The other key piece of your free assessment is that you can share all of the information you have about caring for your aging loved one. Our Case Manager will design a care plan that is shared with all of the caregivers assigned to you, so that you can feel confident that each one has a good understanding of your expectations and of your loved one’s needs. You can also ask any remaining questions you have.

Once home care services begin, your Case Manager will work with you to identify the best caregiver, or caregivers, for your aging loved one. If there is a problem with a caregiver, you can communicate that with your Case Manager (and we urge you to do so) so that we can resolve it quickly. If your caregiver cannot fill her scheduled shift, your Case Manager will replace her with another caregiver. If our caregiver is injured while caring for your aging loved one, we have workers compensation insurance to help her recover and return to work. As a responsible employer, we are licensed, insured, and bonded if the unexpected happens.

Cooperative Home Care also completes extensive pre-hire reference checks, background checks, and drug testing. We provide a two-day orientation training including CPR and First Aid, as well as ongoing training for our caregivers as well as our nurses, therapists, and other clinicians. Our training meets and exceeds Missouri training requirements; we are licensed and accredited and we work with these oversight organizations to ensure the quality of our care.

If you have determined that you want to try to hire your own caregiver, the hourly wage you pay will be less than $21 to $23, but there are hidden costs you’ll want to manage if your goal is to save money. If you don’t know a potential caregiver, you will be investing your time to search for, and interview, potential caregivers. Some caregivers post ads seeking job opportunities in local papers or online, or maybe you have a trusted family member or friend who can refer someone to you.

For your protection, you will want to complete at least some minimum reference checks and background screenings, and you’ll need to research how to legally proceed.

Depending on how much help your aging loved one needs, you may want to hire more than one caregiver to share open shifts. This is helpful because you have a back-up if one caregiver is sick or otherwise not able to work. In time, your caregivers may be able to communicate directly to cover the care for your loved one with less intervention from you. Overall, you can expect to spend considerable time at the start of home care, to train your new caregivers and to make the transition for your aging loved one as smooth as possible. If your caregiver is falling short, be prepared to have direct and potentially awkward conversations with them about their performance. It can be tricky to balance having a positive relationship with your loved one’s caregivers as well as supervising them.

When you privately hire caregivers you are also assuming great and complete risk if something goes wrong. If they become injured, they are going to expect you to cover their healthcare costs, their lost wages, and you will need to find a replacement. If they suddenly quit, you will have to quickly find and train a replacement. You are at risk if a dishonest person tries to capitalize on your arrangement for financial gains. Older adults who need help at home are targeted because they are perceived as vulnerable; as an uninsured employer you are also very vulnerable.

From what we have observed, there are limited instances when privately hiring your caregiver is more successful than working with a home care company. If you’re still unsure, we welcome you to contact our Intake Nurse at 1-800-HOMECARE (in MO), which is 1-800-466-3227. Schedule a free assessment and give us the opportunity to honestly and openly answer your home care questions.

Thank you for following us through our journey to answer five major concerns people have when they need home care. What was helpful? What did we miss? We hope we have helped you make home care work for your aging loved one. Share your thoughts and suggestions on our Facebook page!