Finding the Right In-home Care
Sources and Resources
For more information on home care services or to find local providers contact:
211/First Call for Help
A Place for Mom
Choosing Home Care
Western Reserve Area Agency on Aging
Veterans Administration: Aide and Attendant Benefit
Does your mother have problems bathing or remembering to take her medications? Is your recently widowed uncle having problems taking care of the house? Are you wondering how you’ll manage on your own – taking care of the wound, getting to rehab, cooking – after knee replacement surgery?
For growing numbers of people, the solution to those problems is home care.
Not sure what home care is? You’re not alone. “Most people only learn about it because a parent or relative, or they themselves, need help at home,” says Anthony Togliatti, president of Living Well Home Care in Independence.
Even those who know what home care is often don’t realize that “the level of care that the person needs determines who will be delivering it,” explains Autumn Richmond, LSW, community liaison for Benjamin Rose Institute. The non-profit has been providing home care services to Cleveland-area residents for over 100 years.
Levels of Care
Along with providing companionship, home care aides (sometimes called homemaker aides) assist with meal preparation, house cleaning, laundry and shopping and errands. In many cases, especially where family members live far away, they are “eyes and ears” in the home, too, says Richmond.
The workhorses of homecare are home healthcare aides (sometimes called personal care assistants). Not only can they provide assistance with housekeeping and errands, they also provide personal care, including bathing and grooming, assisting with range-of-motion exercises, emptying colostomy bags, etc. Increasingly, they are “graduates” of rigorous training programs — offered through the Red Cross, community colleges and other organizations — and have passed a test to become a state tested nurse aide/assistant (STNA).
Home care nurses (most often RNs) work with the patient, the patient’s family and/or paid caregivers. Besides monitoring the patient’s condition, they help locate medical supplies and equipment and provide education in their use; perform medical procedures (injections, wound care, medication administration, etc.); monitor home healthcare aides; and coordinate services provided by other healthcare professionals (podiatrists, physical therapists, etc.). “The nurse,” explains Richmond, “is the case manager and the link between the patient and the doctor.”
How to Find Home Care Help
Ministers and rabbis often know someone in their congregation who would enjoy working as a companion and/or housekeeper. When a higher level of care is required, physicians, social service organizations and disease-specific organizations (see below) can often provide lists of agencies providing in-home care. But, says Togliatti, directors of community offices on aging and senior centers may be your best resource because “they know the local resources and agencies.”
But, getting a phone number is just the first step. You must vet providers, too. “Whether you are going with an individual or an agency, always make sure — for that person who’ll be coming into your home or your loved one’s — that a background check has been done and that they are bonded and insured,” says Richmond.
Only services that are deemed medically necessary by a physician are covered by insurance, including Medicare, Medicaid and the VA’s little-known Aide and Attendant’s Pension Benefit. Like Medicaid, the latter is available only for those who meet specific income and asset guidelines.
Many factors influence the cost of in-home care. There are many individuals and agencies providing services, so competition is fierce. The training and skills of those providing care, even through the same agency, varies widely, so hourly charges do too. Client’s needs also vary widely: some require an hour for bathing twice a week while others require 24/7 care.
Consequently, it’s impossible to give a blanket quote for home care costs. In general, however, home care aides, whether self-employed or working through an agency, bill $8-$18 an hour; STNA certified home health aides bill $14-$25 an hour; and home care nurses bill $60-and-up an hour. In all cases, however, when assignments are short — say an hour two times a week — or the care provider is hired through an agency, the hourly cost is higher. Those higher costs cover background checks, bonding, workers comp insurance, Social Security taxes and administrative fees, and also ensure that the client’s needs will always be met because agencies can call in substitutes when necessary.
Eileen Beal is a health care writer specializing in issues related to aging and caregiving. This Successful Aging column sponsored by the Benjamin Rose Institute was published in the Sun Newspapers in February 2010.