What Service Is Appropriate?

By Dana Pavelock, Director of Home Care Operations

With the significant aging trend of the U.S. population, many of us soon will be grappling with serious decisions with care and assistance for our elderly parents, relatives or even ourselves. I welcome the opportunity to sort out and address the complexities of the home health care industry. I hope to provide valuable information to assist you in making informed decisions for accessing services for yourselves or a loved one.

As you may already be aware, home health care is the fastest growing industry nationally. The service is most appropriate for those individuals that require a variety of skilled nursing or therapy and/or paraprofessional support. For some, that may mean short term care if recuperating from a recent hospitalization, injury or illness. For others, it may mean making arrangements for long-term care needs or extended hours of care. In all cases, and especially when in doubt about what level of care is needed, it is important to consult with the treating physician. One of the greatest benefits of this industry growth for all of us is that there are many choices and more options for elder care that never existed before. The home care industry offers a great alternative to institutional placement and the opportunity to remain living safely in the privacy of our homes and function as independently as possible for as long as we may choose.

Given our own agency experience there has been a significant request for live-in caregivers. Up until the past few years a majority of home care needs have been delivered on an hourly basis. Hourly home health aide services certainly make sense when an individual might need some basic help with personal care (morning or evening care, assistance with bathing, dressing, grooming, meal preparation, medications etc.) and for the most part still are relatively independent. When an individual’s health needs become more complex or are at significant risk for falls, when memory impairments or increased frailness occur, more hours of care may be required so that they can live safely at home. Up until the past decade, many people requiring more significant care at home were either cared for by immediate family members or placed in nursing homes.

The decision of when or why to switch from hourly to live-in services is very individual in nature and often a decision made by family members and/or the patient. We recommend live-in care when a patient’s care needs exceed 8 to 10 hours of care daily and for those desiring to remain at home vs. placement in skilled nursing care or other institutional facilities.

The benefits of accessing live-in aide:
· Cost savings: more affordable than hourly care or skilled nursing facilities.
· Continuity: one aide to provide care vs. two or three staff.
· Consistency: reliability of consistent coverage without interruption.
· Quality: Live-in caregivers dedicate their lives to provide excellent patient care
· Living at home

How does one make arrangements in finding a live-in aide? Accessing this level of service may be easier than you think. In fact, in some cases it might be easier for an agency to place a live-in caregiver than arranging hourly coverage. Also, it is important to note that this service may be appropriate for short term or respite care as well. In choosing an agency consider the following. Is the agency licensed by the state Dept. of Health? Accredited by JCAHO? Insured?
· How long has the agency been providing live-in care service?
· Does the agency conduct thorough criminal background checks and drug screens?
· What type of nursing oversight is provided to the patient and the aide?
· The level of training, experience and skills of the aide.
· Can the agency accept long-term insurance (if applicable).
· Reputation of the agency? Ask around, check the Better Business Bureau.

One last thing to consider. Please remember that when making arrangements for the care of a loved one at home that the cost associated with the delivery of care should not be the primary reason for making your decision. Also remember that you are purchasing more than just the hours the aide provides, you are entering into a relationship with a service agency to provide the best care and oversight possible so that the person receiving the care can remain living at home with dignity and respect!