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Senior Living

2003-10-01 09:00:00

Finding quality care for parents

:  My father fell and broke his hip. He is recovering in a nursing home and we expect him to return home in a few weeks.  He will require a lot of assistance when he returns home. None of us kids live in the area and we worry about how we will find the right people to provide the needed services. Even if we do find people to help him, we will not be there to ensure the quality of the services. What are our options?

ANSWER:  Caring for a parent is difficult when we are nearby, but when relatives are separated by distance, caring becomes even more complicated.  More than seven million Americans are long distance caregivers. They face feelings of guilt and helplessness that they aren’t able to give their parents the help that they need. However, this situation is not hopeless and options are available.   You can begin by asking your father’s primary care physician to refer you to reputable agencies or individuals that may be of assistance. The local Department on Aging is a good starting point as well. Generally nursing homes have case managers, social workers, or discharge planners on staff who are involved in the patient’s care plan at the time of discharge. They may recommend a Home Health Agency for continued therapy and have names and numbers of those available in the area.  Also, there are companies or individuals who specialize in assistance with activities of daily living, such as: meal preparation, light housekeeping, laundry, medication reminders, bathing and grooming assistance and even transportation. Sometimes the use of both types of service providers is the best way to meet all of a person’s needs during recovery.   Your primary concern of ensuring the quality of care your father will be receiving is a valid one.  There are independent elder care consultants who will work with families that are in your position. They act as a client/family advocate and will monitor the care of the client. Or, you may want to discuss your needs with a concerned neighbor, church member or family friend who can provide valuable input.   The most critical decision is whether or not to go with an agency or an independent caregiver. Often finances must be taken into consideration and it is true that independents can be hired at a lesser rate. But, it should not be the sole determining factor when making this decision.     There are many unknown issues involved when selecting an independent person to provide care. There is no way for you to conduct a background check or have any real knowledge of the Caregiver’s skills and training. If the family directly hires an individual, an employer/employee relationship has been established and leaves your father most vulnerable.  Many people do not understand that they are required to with hold federal and state payroll taxes, Social Security, unemployment taxes and Medicare from the independent’s paycheck.    Worker’s Compensation must be provided for the independent as well. It is a common misconception that Homeowner’s Insurance would cover expenses in the event of an accident or injury involving the direct employee.  In fact, most policies specify that employees are excluded from coverage. When the independent needs time off, calls in sick, or just doesn’t show up for work, the consumer is left in a vulnerable situation. A contingency plan should be in place to cover your father’s care if this is your choice.    Selecting a professional service provider has definite benefits. Agencies that recruit, hire and train their caregivers are an excellent solution to your problem.  Choose an agency that conducts thorough background checks on their employees which includes a credit report and driving history. Ask if the company carries workman’s compensation and fidelity bonds on their employees. An agency may appear to be more costly, but they assume the responsibility of all taxes and liability for insurance and Worker’s Comp on behalf of the consumer. Utilizing a service agency eliminates the hassle for you and your father.   Don’t be afraid to ask for references from present and former clients.  Find out what process the company has for monitoring the performance and quality of care provided by their caregivers.  Good ones will have a Client Care Coordinator or supervisor who conducts unannounced drop-in visits. Another bonus is that agencies will automatically have additional staff to provide continuity of care, in the event the regular caregiver calls in.    Look for a company that is willing to contact you on a regular basis to provide status reports on your father’s recovery and condition. Your peace of mind should be as important to them as your father’s care.