Tips for Choosing a Caregiver for an Elder

For seniors, staying at home and living independently, for as long as possible, enhances their quality of life. Providing home health care, can often delay or minimize the need for long term nursing home care. Home health care may include, speech or physical therapy, or skilled nursing care. Also, it may include help with activities of daily living, such as, bathing, dressing, cooking, monitoring prescription medication, and housekeeping jobs. Most people who need help with their daily activities rely on unpaid care provided by family members and friends. However, many seniors and their families are recognizing the benefits of hiring caregivers, to help keep their loved ones in their homes longer, providing for their comfort and safety, and thus give everyone peace of mind. Here are some tips for choosing an in-home caregiver.

It is not always clear when someone needs home health care or nursing home care, it is usually best to consult with a medical professional.

• Evaluate the needs for health, personal, and household care:
  • home health care – physical therapy or medication management
  • non-medical personal care – bathing, dressing, toileting, meal preparation, companion
  • house cleaning, shopping, home maintenance, running errands, or managing money
• Write out a plan of care, with input from senior, family and doctor:
  • Course of treatment
  • Specific tasks to be performed
  • When services are required
• For a health care agency review:
  • How long operating in the local community
  • Are they a Medicare provider?
  • License to practice
  • Patient’s Bill of Rights
  • Plan of Care for the Senior
  • Supervision, Communication with family, Scheduling concerns
  • Caregivers Hiring and Training Procedures
  • Procedures for resolving problems, questions or complaints
  • References
  • Sliding Fee Schedule, Financial Assistance
• If using an individual provider, make sure that he/she is qualified for the job. Neighbors, friends etc may be prospective caregivers. Remember that this is a business relationship. Can they commit to the care, time and attention that’s required?
• Hire a professional caregiver if you can afford it.
• Prepare a list of questions to ask. Have a list for any applicant, caregiver agency, referral source, or reference you may call during your search.
• After screening telephone applicants, interview in person those who sound acceptable. All decision family members, and independent friends, interview to provide opinions. Always observe interactions between the health care provider and your loved one.
• If interviewing a caregiver agency, interview the in-home caregivers. Many employees look good on paper, but may not be a good fit for you, for many reasons, cultural, religious, social, or any others.
• Check references carefully. Talk to all references. Remember, your loved one has to be cared for by someone who is dependable, reliable and qualified to do the work.
• Caregivers must have experience in the specific areas in which you require help. There is a difference between home health care and home care services. Home care typically includes chore and housekeeping activities, home health usually involves helping seniors with an illness or injury.
• Costs will fluctuate depending on home care services provided. Sources for payment include Medicare, Medicaid, Veteran’s Administration, private insurance. Medicare will pay for home health care if senior is homebound, under doctor’s supervision and requires skilled nursing care or certain types of therapy.
• Spend time with health care provider, before job begins, to discuss routines, seniors likes/dislikes, medications, potential behavior or any other problems.
• Prepare a monitor schedule to review the caregiver care/services. Personal contact, regular home visits, and periodic reports from the caregiver/agency are important.
• Anticipate changing needs, and have a back up plan for special situations i.e. health care provider may require time off or may be not on call. Therefore, have part-time or on-call person available if primary caregiver cannot be there.
• Watch for signs of abuse, neglect, and exploitation and report any suspicious activity to the State authorities.

David Wingate is an elder law attorney at the Elder Law Office of David Wingate, LLC. The elder law office services clients with powers of attorneys, living wills, Wills, Trusts, Medicaid and asset protection. The Elder Law office has locations in Frederick and Montgomery Counties, Maryland.