Find the Best Home Care Services

Service availability

Home health aide schedules vary between agencies. This can impact affordability and convenience when hiring a service.

• Home for the holidays: Does the agency offer holiday service? Many elderly people celebrate in their own homes, making it crucial for an assistant to be available during these days.
• Part-time option: Not all seniors need round-the-clock care, so a part-time option helps keep costs low.
• Overtime service: Family members responsible for primary care may face a late day at the office, bad traffic or any number of factors that could leave them running late. Be sure that a caregiver can remain on site when a complication arises.
• Respite care: Family caregivers need breaks from time-to-time to tend to their own needs. Home health aides can fill in so that the care recipient remains safe while the family caregiver is away.

Clear communication

Communication between the family of the senior receiving care and the provider organization is critical to creating a comprehensive schedule of services. Slow response times could leave a senior alone, or put them in danger by delaying reports on issues that could impact their health.

• Health reporting: How often does the service provider give a comprehensive report about the senior’s continued ability to live alone?
• Schedule changes: For many people, caring for an elderly parent does not reduce other demands on their time, leaving them to schedule around school plays, nights out with friends and work functions. Flexible and emergency scheduling is a must.
• Live operators: As effective as voice mail can be, waiting for a call back can be nerve-wracking. Make sure your service provider routinely answers the phone, rather than responding to messages.

Provider screening

Any time you let someone into your home, you take a risk. The elderly are particularly at risk, so before inviting someone in, it is important that they pass screening and a background check which should be provided by the agency.

• Background checks: A credit check and scan of criminal history could provide a sense of security.
• Reference checks: Reference checks are a quick and easy way to find out whether someone has a history of quality performance, and they are also something that many employers neglect to do.
• Caregiver interview: Instead of simply assigning someone to a case, it is important to allow the caregiver, senior and their family to meet in an informal environment. Compatibility is a foundation for building trust.

Absentee policies

Everyone needs a day off occasionally, so what happens when a caregiver calls out?

• Immediate notification: Before sending a replacement, the agency should notify you of the conflict. You might prefer to take some time off rather than have a stranger take on the job.
• Available replacement: If they have a call out, can the agency send out someone else without missing the service window?
• Permanent replacement option: While occasional call outs are inevitable, repetitive issues with missed work can be a major issue. It is important to know how many you might deal with from a single provider.

Cost

When trying to provide care on a limited budget, the cost can be a major issue. Medicare rarely covers in-home care costs, leaving much of it to be out-of-pocket. You can see what benefits you or your loved one are eligible for by visiting benefits.gov. Long-term care insurance and Medicare supplemental insurance might be viable options to help cover costs.

• Daily charges: Is there a daily maximum on charges?
• Hourly charges: Hourly charges can rack up fast, particularly for those that need round-the-clock care.
• Extra therapy charge: If the primary aide only helps around the house, but is supplemented with a physical therapist or nurse, is there an additional charge for these occasional services? There almost always is.

Home health aides

Home health aides are professionals who can help with self-care, housework, cooking and more. They might also perform some basic medical tasks. Home health aides sometimes have medical training, so they might be certified nursing assistants (CNAs) or licensed practical nurses (LPNs). However, there aren’t any specific standards requiring a home health aide to have particular training or certification. If you’re looking for someone to help with any medical-related tasks, ask about certifications when choosing your provider. Medicare or Medicaid might pay for help from a home health aide.

Nurses

Home care nurses often handle the basic medical needs of those aging in place, like tracking their vitals, giving them IV medications and changing bandages. These professionals could either be licensed practical nurses (LPNs) or registered nurses (RNs). The higher level of care a person needs, the more likely their nurse will be an RN. Sometimes, a nurse will visit a patient less frequently but will manage a team of home health aides that visits the person every day. Medicare or Medicaid might pay for help from a home care nurse.

Geriatric care managers

Geriatric care managers are professionals that help caregivers figure out how much care their loved one needs and what living situation might be best for them. They also help caregivers and families navigate the medical system and figure out how to pay for care and hire appropriate home care professionals. Geriatric care managers often have backgrounds in gerontology, social work, nursing, psychology or another related field. You’ll often have to pay out-of-pocket to hire a care manager, but it could be worth the investment if they help you save money in other ways.

Companion services

Companion services vary a lot. Companions might just be someone who keeps your loved one company, or they might also offer transportation and housekeeping services. Companions don’t handle any medical tasks, and they don’t usually help with bathing, grooming or other activities of daily living (ADLs). Because these individuals don’t provide medical care, Medicaid and Medicare won’t pay for them. You may be able to find a community service organization, like Volunteers of America, that provides these services for free.

Meals on Wheels

Meals on Wheels is a national organization that operates in most communities in the United States. It works with local businesses and volunteers to serve meals to people over 60. The organization delivers meals to people in their homes, and the volunteers who drop meals off provide some companionship to seniors. The group also serves meals in local community centers, so people who can drive can get out of the house to socialize. These services are free or low-cost, depending on where you live.

Community villages

Villages are non-profit organizations designed to help people age in place. Villages coordinate volunteers and paid workers to organize social and educational activities. Villages typically offer transportation services and limited in-home assistance as well as discounted services from health professionals. Each village is independently operated, so the services offered in your area will vary. To find out about a village near you and learn more about these organizations, visit the Village to Village Network’s website.

PACE programs

Programs of All-Inclusive Care for the Elderly, or PACE, is a part of Medicare and Medicaid. The programs provide as much care as feasibly possible to people in their own homes. For example, someone in a state with PACE might be eligible for in-home care, social work counseling and many other services.

Programs in different parts of the country have slightly different offerings, but the overall goal is to keep people in their own homes as long as possible. These programs currently exist in just over 30 states, but they don’t necessarily cover the entire state. To find out about PACE programs in your area, visit the PACE page on the Medicare website.

1. Write down all the care services needed

Start by making a complete list of all the tasks you or your loved one needs help with. Once you have this list, you can decide whether you need one provider or a few with different specialties.

2. Screen over the phone first

Next, call the companies that advertise the services you need and confirm that their employees can do everything needed. Use the list of questions from Eldercare.gov to ensure your loved one will receive quality care.

3. Interview in the resident’s home

If a provider meets your standards after talking to them on the phone, have an in-home interview with the people who will work with your loved one. Make sure you and the care recipient feel comfortable and confident.

4. Call the provider’s references

Anyone who will be working in your loved one’s home should be willing to give you a list of references, including current clients. Call these people to learn more about the provider and ensure they’re someone you want to hire.

5. Run a background check

Run a background check on each individual who will be helping your loved one in their home.

How to find the best hospice care. What to look for when you're deciding on hospice care