Will Your Loved One’s Senior Care Community Perform CPR?

When our parents move to an independent, assisted living and dementia care community, we often assume we’re paying for their entire care.  I mean, we’ve done our homework, right?  We’ve checked that they have nurses on staff.  We’ve check that the med room is safe, and we made sure that the community has a good safety record and adequate staff.

But what actually happens when there is an emergency?  What happens in the event the staff needs to intervene to potentially save your loved one’s life?  The answers aren’t always clear. And there is no real way to see it in action.

Below is a sad and eye opening story from Bakersfield, California.  In this story, an elderly resident was denied CPR from the nurse on duty because it was not the policy of the community to engage in such activities.  Despite the pleas of the 911 operator, the nurse would not perform CPR and would not find anyone who would.

So this begs the question: do you know what the policies of your loved one’s community is? Would they step in during an emergency? If you don’t know the answer, you should find out and make sure you are comfortable with it.

People to Meet on Your First Community Tour

Meeting new people has never been a problem for me. But when I arrived in the parking lot of the first community, I found myself very nervous. I spent many hours on the Internet looking for the right questions to ask, the right people to meet, what safety metrics to ask about, etc. I met with the admissions director, took a tour and was back in my car 60 minutes later. I saw the entire community and even met a few of the staff members. I still had no idea of why that community was better or worse than any of the several I was planning to visit.

While I summarized our plan in the last blog, it makes sense to add more detail regarding the people you need to meet during each of your initial community visits. Your first community visit will be overwhelming. Assisted living is just like any other business. In the world of assisted living, beds are products and the goal of the admissions department is to sell that product.

Unless you arrive prepared, you’ll leave with nothing but a sense of completion and a shiny new brochure. What you won’t leave with is any useful information that will help you either eliminate that community from contention or move it on to the next round of consideration.

Try visiting during the week so you can get a feel for the full staff level. When you visit your short-list a second time, you can validate the weekend team.

Who You Need To Meet

When you set up your appointment, make it clear to the admissions representative that you’d like to meet with several members of the staff. I’ve listed below the ones I believe are crucial to meet on your first visit.

Admissions director: The admissions director will likely be your primary contact at the community. At many communities, this person is also responsible for sales and marketing. As such, you should expect an upbeat conversation with little or no negativity. The admission director’s primary role is to fill the beds (product) in the community, but they more than likely care a great deal for the people they place in the community. That being said, expect to get the pros, but not a complete picture of the cons during your discussion. I do recommend that you leverage this person’s knowledge of the staff to learn more about their backgrounds.

Activities director: The job of the activities director is to provide entertaining and stimulating activities for the residents. The demeanor and attitude of this person is tremendously important. Their patience, creativity and tenderness can make a world of difference in residents’ daily lives. Find a grumpy one, and your loved one could be looking at days of old movies and bus rides. The following chapter discusses the right way to implement an activities program.

Registered nurse: Assisted living communities are not required by law in all states to have a registered nurse (RN) on staff during some portion of the day. The RN will likely be the one to follow up with your doctor if your loved one is not feeling well, and they’ll also be the one to call an ambulance. Spend some time with the RN to clearly understand his/her hours. Get a feel for their philosophy. At all costs, avoid those who have that “tough it out” attitude.

Medication manager: The medication manager (also called a “med-tech”) is responsible for getting all medications to your family member on schedule. In assisted living, residents are usually not allowed to keep medications in their rooms – over-the-counter or prescription. Spend some time with the medication manager to understand their experience and communication skills. Make sure the night shift med-techs have the same training and language skills as the day shift.

Physical therapist: Depending on your family member’s ambulatory skills, the physical therapist may, or may not be, of value. Aside from my mom herself, the physical therapist had the most impact on her recovery and ongoing mobility.

Most communities have a therapy room, and you should visit it. If you time your visit in the morning or early afternoon, you’ll likely get to see the therapist with one of the residents. Speak to the therapist to get a feel for the experience they have working with seniors. If you family member has a specific condition, make sure they have successfully worked with that condition. In the case of my mom, it was important the therapist have experience helping stroke victims learn to walk.

Head chef: The head chef is responsible for planning the menu and managing the chefs who cook it. Look at the menu and ask how they plan for sodium, cholesterol and sugar-restricted diets. It always struck me as odd that with many older people suffering from heart disease and diabetes that chefs would serve food that I wouldn’t eat myself.

Executive director: The executive director has ultimate authority over all aspects of the community. They are also the one responsible for passing on and maintaining records for state health inspections. The executive director should have a deep and profound connection to helping the residents. You’ll run across executive directors that are all business. While it’s obviously important to take a business approach to the community, make sure this demeanor doesn’t come at the expense of the patience and compassion required to make the residents happy.

Don’t Forget the Residents

The biggest barometer of a community is the residents themselves. Pay close attention to the way residents interact with each other and with other residents. If you notice a group of residents in front of the TV with no real engagement in the show, ask questions. This could be a sign of a disengaged activities director.

It is also perfectly reasonable for you to speak to the residents. As I mentioned, you’re unlikely to get honest answers about the quality of the community. In fact my mom has told me on several occasions that residents feel pressure (perceived or not) to not speak negatively about the community. So, take their words to heart, but with that proverbial “grain of salt.”

Photo credit: Sahaja Meditation

3 More Signs of Functional Decline

elder careIn the last blog, I discussed some of the warning signs that your loved one could be experiencing functional decline, including difficulty communicating and the disturbance of everyday functions and tasks. These kinds of hardships may be symptoms of a more serious functional decline, in which your loved one is losing the skills needed to maintain basic independence.

In the previous blog, I gave a detailed account of physical, perceptual and cognitive changes that can indicate a functional decline. Now here are three more areas to monitor if you believe your loved one may be experiencing functional decline.

1. Hearing and Vision Loss

Hearing loss is hard to hide; it’s often one of the first indications your loved one is in need of assistance. Here’s a list of things to note:

  • Saying “What?” over and over again during conversations, or repeating what you just said, as if to confirm what they heard.
  • Turning the volume up on the television repeatedly, until the neighbors may be able to hear it – while your loved one still complains it’s ‘too low.’
  • An inability to distinguish certain sounds, such as f, t, and z, resulting in misunderstandings and miscommunication.
  • Nodding frequently during conversations, as if to confirm that they are participating fully in the dialogue.

And then there is eyesight – often the first of the senses to be noticeably affected by age. Focusing on small details becomes difficult; self-grooming becomes challenging – and who can write out the checks to pay bills when you can’t see the numbers?
As with hearing loss, compromised vision is also a safety issue. What are some of the signs of decreased visual acumen? Just ask yourself these questions:

  • Has your loved one lost interest in reading, playing cards, or other hobbies where clear vision is required (embroidery or television viewing, for example)?
  • Are their clothes, shoes or socks frequently mismatched?
  • If they still drive a car, are they getting lost more often (because they can’t see the street signs)?
  • Has your loved one started to fall, trip or bump into things more frequently?

Once again, a primary concern here is one of safety. How safe can your loved one be, if they can’t clearly hear or see the world around them? And if they’re driving, it can be catastrophic.

3. Frequent Falling

Certainly, frequent falling may not be related simply to poor eyesight; it could be the result of medical conditions related to poor physical health. Or repeated falling in the home environment could be the result of poor safety habits: loose throw rugs, a cluttered living space, exposed wiring, no handrails or poor lighting. There are also those elderly who refuse to use their assistive devices such as canes, walkers and wheelchairs – even refusing to wear their eyeglasses!

Whatever the causes, the consequences are serious – and should be addressed by your family or geriatric physician. Here are some things to watch out for:

  • Unexplained cuts and bruises, or explanations for these injuries that seem far-fetched or implausible.
  • Hesitancy when walking or climbing stairs.
  • Reticence to leave the familiarity and relative safety of their home.

4.  Psychological Changes

May Lamberton Becker – the journalist and literary critic once said, “We grow neither better nor worse as we get old, but more like ourselves.” What she’s describing is the process called disinhibition, where those personality traits that may have once been charming or quirky slowly become exaggerated as we age. Aunt Rosemary used to be rather bossy, but now she’s dictatorial; your father, who used to simply be self-reliant, is now completely resistive and argumentative.

It seems that the natural process of disinhibition is magnified when aging is coupled with fear and unhappiness. If it is complicated even further by depression or anxiety, your loved one will completely cling to those coping strategies that served them so well in their younger days – to the point they completely interfere with an independent life.

So, whatever you do, don’t delay in taking action. Start actively assessing all six areas of your loved one’s strengths and abilities as soon as possible. If there are signs of a serious functional decline, then you may want to consider a transition to assisted living.

Photo Credit: Flickr user One From RM.

3 Common Signs of Functional Decline

Everyone changes physically and mentally with age, but there are some changes that can really put a loved one’s safety at risk.  If you think that a loved one may require a transition to assisted living or elderly care, then you must first assess whether they are undergoing a true functional decline.

Functional decline is sometimes difficult to diagnose as individual symptoms often go unnoticed. Below is a list of symptoms of functional decline to be familiar with.

  • Misusing medication (over or under use and deviating from a schedule)
  • Reports of inexplicable behavior from friends, neighbors or family members
  • Poor personal hygiene
  • Unpaid bills
  • Changes in spending patterns
  • inappropriate clothing
  • Stains on clothing or upholstery from urine or feces
  • Forgetting how to use simple tools
  • Poorly cared-for pets
  • Repetitive questioning
  • Difficulty in communicating
  • Confusion
  • Unfinished tasks and chores
  • Spoiled or poorly-prepared food

Studies have documented that functional decline, i.e., the loss of either complex or basic ADL functions is due to changes in one or more of six areas: physical, perceptual, cognitive, visual and hearing, falling and psychological.  Below I will describe the first three areas in more detail and I will discuss the latter three areas in the next blog post.

1. Physical Changes

It’s obvious to anyone: as the human body ages it loses physical strength, stamina, muscle coordination, and balance. Those of us who had aging grandparents or aunts and uncles saw firsthand how the natural aging process affected their abilities to perform commonplace tasks.

2. Perceptual Changes

Here we’re considering all the senses: vision, hearing, sensitivity to touch, taste – even smell. After all, each is important to overall well-being. If you can’t smell smoke, you may lose your life to a house fire; if your sense of touch is diminished by poor circulation, you may be burned by scalding water.

Many medications are responsible for changes in taste perception. When this happens, it’s easier to eat spoiled food, or even choose not to eat at all, as food no longer tastes like it used to. I have noticed that after older people are less able to use the telephone with ease. Warning alarms and buzzers may go unnoticed.

3.  Cognitive Changes

While our thinking may remain clear, the speed at which a human can process information slows considerably as we age. It’s not just the speed at which we perform tasks. It’s also our ability to multitask. Our ability to divide our attention fades as we age.

Those changes are within the range of normal and expected changes; but what of the complications of dementia and Alzheimer’s disease? With dementia and Alzheimer’s loss of memory, language processing skills and inability to solve problems greatly affects your loved one’s level of independence.

Look for these warning signs:

  • Disorientation, fright or confusion when faced with a change of location, such as a doctor’s visit, visiting friends or family, or eating out at a local restaurant.
  • Giving incorrect or evasive answers when asked simple questions. For example, “What day is it?” gets the response, “What, don’t you know?”
  • Aggressive behavior or noticeable personality changes.
  • An inability to concentrate on television programs, tasks or conversations.
  • A gradual (or sudden) loss of memory.
  • Disinterest in routine tasks, such as cooking or housekeeping.
  • A decline in social skills, such as successfully engaging in conversation, or eating a meal with the correct utensil.
  • A decline in judgment skills, or inability to recognize consequences. This could manifest itself in leaving the water running, not shutting off the stove, or leaving the front door unlocked.

There are three more areas to monitor in order to determine whether a loved one is experiencing a real functional decline: hearing and vision loss, frequent falling and negative psychological changes. In the next blog post we’ll discuss symptoms within these three areas and how these problems can lead to a functional decline and loss of independence in aging individuals.

Photo Credit: Flickr user e-MagineArt.com.

Is it Time for Assisted Living?

elder careYou’ve come to this blog for a reason. More than likely, you’ve seen changes in your loved one that have you concerned. They are likely changes that worry you, but have not fully convinced you that your loved one may need additional care. Whether a spouse, or a parent – even an aging sibling, this person has come to an impasse in life’s journey. And it’s at that impasse that you wish to help them overcome.

The first step is getting clarity about what’s going on today, and to temper that clarity with loving compassion and an understanding of what the future may hold. This assessment process can be emotionally challenging. It’s something I’ve learned firsthand.

Take a deep breath, and let’s move on to step one: the assessment of your loved one’s current capabilities and needs.

How is Your Loved One Feeling Today?

Regardless of our age, our bodies are in a continuous state of decline. Whether it is reading glasses, arthritis or a doctor’s warning about your lifestyle, our bodies emit warnings about its decline.

It’s no different with our loved ones, except that while it can be an inconvenience for us, it is a matter of independence for them. Since you are concerned about your loved one, you’ll want to do an assessment.

An assessment looks at four areas where change may have taken a toll on your loved one’s independence: the physical, perceptual, cognitive and psychological manifestations of aging. We’re going to explore those areas with one overriding premise: ensuring their safety, and the safety of those around them.

Physical changes and loss of abilities (to some degree) are natural in the aging process. Your loved one is not the same as they were 10 years ago, or even 5 years ago – any more than you are the same as you were then. With that said, the essential key in the assessment process is to recognize symptoms and actions which fall outside the range of expected and acceptable changes. What defines “acceptable changes”? I would say they are those changes that don’t significantly interfere with the way they’ve lived their daily life.

Many changes are subtle and inconsistent; and many don’t put their lives, or the lives of others, at risk. Truly then, the focus should be on risk management. Continually ask yourself this question: Is my loved one a risk to themselves or others?

The criterion most often used by doctors, social workers, and geriatric care managers is a list of activities of daily living, or ADLs. These are those most common activities, divided into two categories: basic and complex.

The early warning signs are often losses in the realm of complex skills. Usually (but not always) loss of basic ADLs comes later on in the decline in the quality of your loved one’s life. As every person is an individual, so is his or her aging; assessment can only be done on a case-by-case basis.

Basic Skills

  • Ability to feed oneself
  • Ability to use the bathroom appropriately
  • Ability to maintain good personal hygiene
  • Ability to dress appropriately for the season

Complex Skills

  • Cooking
  • Shopping
  • Effective communication
  • Following directions
  • Taking medications appropriately
  • Money management

This list of activities appears rather brief; however you can see that each element listed, whether ‘basic’ or ‘complex’ is essential. Everyone should be able to use the bathroom appropriately, or follow directions.

If your loved one is having difficulties with one or more of these tasks, then they are in a state of functional decline and you should more thoroughly asses the state of their decline and possible solutions. In my next post I will discuss common signs of functional decline in greater detail.

Photo Credit: Flickr user Titoy.

My Experience with Elder Care and Assisted Living

elder careEighty-four percent of Americans over the age of 50 expect an immediate family member to move into a senior living community within the next 10 years, while 24 percent over the age of 65 expect the same for themselves, according to a new national survey of American attitudes on assisted living released today by the Coalition to Protect Choice in Senior Living (CPCSL). The poll found just more than half (51 percent) expect their parents to live in a senior living community within 10 years, with 15 percent expecting the same for their spouse and 10 percent for a sibling.

My Story

I’d like to briefly share the story of the event that started me on this path. I imagine it’s similar to your own in that it begins with an unexpected phone call.

My wife and I had just returned from celebrating our engagement in Greece, and we were sharing stories over bowling with some good friends.

I was the product of a second marriage, and my mom and I had become quite close since my father’s passing while I was in high school. We spoke often, so I wasn’t surprised when my cell phone rang and the caller ID showed it was her.
I was surprised when I answered and it was the paramedics.

Apparently, my mother called 411 asking for my name and phone number as she could not remember it. The operator called 911, and in a matter of minutes, they had arrived, kicked down the door and called me.

My mother had a stroke. I was only 33, and totally unprepared for the depth of emotions, or the complexity of the decisions I was about to face.

That a 73-year old woman had a stroke is not unusual. My mom’s case was unique because of the series of complications that nearly killed her. In the eighteen months following her stroke, she endured major back surgery to remove a staph infection from her spine, a perforated intestine that required stomach surgery, several MRSA infections1 requiring IV antibiotics and a broken hip. She spent several weeks in the surgical intensive care unit recovering from her back surgery. Many of these nights, I feared the worst. But my mom is a fighter.

The medical system these days isn’t designed for long-term recovery. Hospital personnel are highly trained at treating acute problems and dealing with specific injuries and conditions. In fact, we have some of the most skilled doctors in the world.

But when you’re older and recovering from a serious illness, your options are usually to go home, or go to a skilled nursing facility – where staff can provide physical or occupational therapy, administer IVs and perform other functions requiring a registered nurse.

During this time, she spent nearly six months moving back and forth between the hospital and skilled nursing. In January of 2006, I moved Mom from San Diego to Orange County. She graduated from skilled nursing and was on her way to assisted living.

Trust, Hope and Hard Work

When Mom arrived in assisted living, she could not stand or walk and required a 24-hour caregiver. She could not eat or drink on her own and was in a deep state of depression.

While I found much advice on medical conditions and treatment, I found virtually nothing on understanding assisted living. Sure, there were some Websites that taught you the basics, like “make sure a nurse is on duty” or “make sure the kitchen is clean.” But this is my mom and I wanted far better for her. I wasn’t putting her away; I was playing a key role in her recovery.

Because of the lessons I learned – and a lot of hard work on the part of my mother – she is doing very well. In fact, we’ve become very close friends. She walks with a walker; her memories are clear and vibrant. She has a circle of friends and a packed calendar.

She even made it to my wedding. And she looked beautiful. I cried. They say your wedding toast is one of the most important speaking opportunities you’ll ever have. And I consider myself to be a good public speaker, routinely speaking at tradeshows and other events. But when I looked into the crowd and saw my mother smiling, I fell apart.

The joy I felt at seeing her on that special day was overwhelming. So was my commitment to her continued well being. It was my clear intention that she be given every opportunity in her assisted living situation to thrive, to grow, and to be fulfilled.

Recall the statistics at the beginning of the chapter. While I was shocked these numbers were so high, I completely agree. I did some homework. In an informal study of about 40 people, I sensed an almost inevitability about needing assisted living. I also found that financial issues and quality of care topped the list of concerns for both Baby Boomers and their children.

I followed up my informal study with a formal study of nearly 200 families. The Assisted Living Family Attitude and Preparedness Report showed that 75% of respondents believed a friend or family member would soon require assisted living. The report is free to anyone who wants to read it and can be accessed at the link above.

My goal is to share with you some of what I learned through my journey. My hope is that these lessons can make it easier for you and your mom, dad, relative or loved one. I assume you’re reading this blog because you or a loved is considering assisted living. Since you likely haven’t gone through it before, the decisions can be overwhelming. I’ve written this blog to help you make more informed decisions, and to be calm in what is likely to be an emotional storm. I sincerely hope I can help you avoid some of the pitfalls of learning the assisted living ropes.

While a move to assisted living may initially be seen as negative, I know first- hand that with some careful and thoughtful planning, you can make it a huge positive for all concerned. Over the last several years, my relationship with my mother has strengthened. She has become one of my best friends and an integral part of my life.

I hope you enjoy reading this blog and that I’m able to somehow make your journey a bit easier.

Photo Credit: andrewmalone.

The Unpaid Family Caregiver

The Unpaid Family CaregiverIs this the picture you had of retirement?

I’m referring to the one on the left!

Are you checking in on your elderly parents living at home? Is one parent more mobile than the other and caring for their spouse? If so, how is this affecting the health of the caregiver? Regardless of who the caregiver is, the additional burden can easily drain all of their reserves. Then everyone’s safety and health may be at risk.

A lot of attention has been given to medical assistance for our frail seniors that is available at home, as well as assisted living facilities of all types. The public may not be aware of an entire industry of in-home, non-medical care that is available today.

If you are checking on elderly family members at home: Has the house and the refrigerator had a good cleaning lately? Are they eating healthy? Are the bills paid on time?  Is bathing a safety concern?  Are menial chores such as shopping, cooking, laundry, and housecleaning a challenge?

The caregiver may expend all their energy completing these tasks with no energy or time left for doing the things they enjoy. If money wasn’t an issue, would you hire help? Would there be more time for everyone to enjoy life together? I’ll bet this is the case. All these services are now available in the home.

Ryan Malone’s new book: “Saving Money on Senior Care: How to Make Aging Affordable” discusses many issues impacting families’ ability to pay for senior care and takes a no-nonsense approach to educate you on the six most impactful options: reverse mortgages, VA benefits, life settlements, Medicare planning, long-term care insurance and the unique senior line of credit.

The Unpaid Family CaregiverMoney is available to pay for in-home care, especially for those who are “house rich and cash poor.” In 1989, a government program was created to enable seniors to stay in their home by paying them for the equity in their home. The upside to this program is that there are no credit or income requirements and no mortgage payments. Yes, it’s a Home Equity Conversion Mortgage (HECM or Reverse Mortgage). It’s called a Reverse Mortgage because it pays you. This program has changed a lot over the years and I have seen it change people’s lives. It can ease financial strain and relieve concerns about losing the home. The loans are FHA insured, non-recourse loans. That means if the home is sold and sales proceeds are insufficient to pay the amount owed, FHA will pay the lender the amount of the shortfall.

Four important points about this safe, Government program:

1)      The bank does NOT keep the title to the home

2)      There are no mortgage payments

3)      Stay in the home as long as you want to and can

¨       It must be the primary residence

¨       Must pay homeowner’s insurance and property taxes; maintain the property

4)      The loan is paid off with proceeds from the home sale

¨       FHA insures the loan and pays the lender any shortfall

For more information and a calculator:


A free booklet from The National Council on Aging:
Use Your Home to Stay at Home: A Guide for Older Homeowners Who Need Help Now”

Now, what would you do with the extra time and the money you may have had to pay for care?

About the Author: Linda Lewis is a reverse mortgage specialist with FutureSafe Financial Corporation and lives in California.  You can follow Linda at her website at www.ReverseWithLinda.com.

Seven Ways to Talk to Your Parents About Getting Help at Home

It can be difficult to acknowledge the fact that your parent needs some help with day-to-day activities, let alone introducing to them the idea of hiring a professional caregiver for help. Your parent is likely to react to this decision with some resistance. Approaching the subject requires patience and tact. However, there are certain considerations to keep in mind that can help you approach this conversation with your parent with greater success.

Below are some ideas to consider, based on our years of experience with families facing these struggles:

1. List advantages. Make quality home care provided by a hired caregiver desirable to your loved one. Some benefits for hiring in-home care for your parent may be: rather than having to move to an assisted living facility or nursing home, they can remain at home; in-home care is often less costly; they will be given one-on-one attention when their caregiver is there.

2. Focus on independence. Explain why hiring a caregiver is a way for your parent to maintain their independence in their own home. Of course, this is easier said than done. Perhaps paint a visual picture for them. Have they already fallen once or twice? Explain what could happen if they fall again – how it could lead to broken bones, surgery and hospitalization, followed by a lengthy recovery period. The same method could be used if they frequently forget to take their medications, or often miss doctor appointments.

3. Try a different approach. If your parents are still living together, try suggesting that in-home care would benefit their spouse. They may be more willing to accept the care for the sake of their loved one, even if in reality, it is equally beneficial for both parents. If they live alone, focus on concerns or activities that are important to them.  For example, your parent may deny needing help, but may be amenable to someone helping with housekeeping and preparing some meals. They may acknowledge that they don’t like to drive at night but still want to attend their weekly bridge game.

4. Make it about you. Explain to your parent how much you worry about them. Or if you have been acting as primary caregiver explain that it has become too much on top of career or parenthood responsibilities. According to a recent study by Genworth, 55 percent of Americans say being a burden on their family is their biggest concern regarding long term care issues. Take this into consideration when approaching your parent about accepting in-home help. You might say, “Mom, I worry about you…and even if you tell me I shouldn’t, it keeps me up at night. Would you try having someone come in once a week for me?”

5. Mitigate fear. An elderly person can act hostile towards a hired caregiver at times, but this action is most likely out of fear. Prior to attempting to alleviate this fear, it is important to understand it. Common fears include loss of independence, losing control and dignity and financial worries. The presence of an outsider is likely to leave the elder feeling vulnerable. Take this into consideration when communicating with them, and respond with empathy rather than with frustration. Realize how your own emotions may be impacting the conversation and increasing resistance. It is important to choose an appropriate time and place for these discussions and set aside time for them.

6. Test it out on a trial-basis. Try hiring an outside caregiver for in-home help on a short-term basis for respite, or recovery care, after being discharged from the hospital or after a fall. This provides an opportunity to show your parent that having a caregiver is not something to fear and often leads to them being open to receiving ongoing care. If they currently rely on you, another family member or friend as their primary caregiver or source of help, try using vacation as an excuse to bring in a professional caregiver while gone. Explain that it is for your own peace of mind.

7. Get advice from a professional. Try discussing the situation with your parent’s primary care physician (this is most likely someone they have known for years and trust). If they share your concern for your parent, they are likely to help by talking to them, explaining why in-home care is the best option for them. Another option is to consult a geriatric care manager, a professional with special expertise in making these assessments. They will be able to provide you with further advice on how to prevent resistance when introducing the new living arrangements with your loved one.

Photo Credit:  Eggybird

About the authors: Alex Chamberlain is executive director at EasyLiving, Inc., a fully licensed, private duty home health care company serving individuals and families in Pinellas and Pasco counties in Florida.

Shannon Martin, M.S.W., CMC, serves as Director of Communications for EasyLiving, Inc. and Aging Wisely, LLC. Shannon has worked for Aging Wisely, a professional geriatric care management and consultation firm, for over 8 years.

Five Tips for Finding a Quality Home Care Provider

You and your family have decided that it is time to bring in outside help to assist with the care of a loved one in need. Because you want them to be able to remain safe, comfortable and independent in their own home for as long as possible, you have chosen to hire an in-home caregiver or home healthcare agency. The next step is choosing the best care provider for you and your loved one. But how do you know who the best is?

Here are five tips for finding a quality home care provider:

  1. Get recommendations. Talk to trusted professionals and community members. Your parent’s doctor, financial advisor, attorney, other medical providers, friends or family members may have familiarity and experience with local companies that do a good job. A list of providers is also available from your local Area Agency on Aging or hospital social work department. However, it is rare for these resources to make specific recommendations.
  2. Know your liability. Understand the possible liabilities and ramifications involved when hiring a caregiver privately. Consider issues such as taxes, insurance, liability and worker’s compensation, backup coverage, background checks/oversight and training.  If hiring through a nurse registry or employment agency, the family may end up being the official employer, responsible for pay, taxes and other obligations. On the other end of the spectrum, fully licensed private duty home health agencies offer more comprehensive services and protections as employers of the caregivers.  To learn more about state agency requirements and protections, contact your state licensing agency for healthcare organizations, or visit the National Private Duty Association at www.privatedutyhomecare.org.
  3. Consider innovation. Research how current their monitoring and communications technology is. How easy is it to monitor the care your loved one is receiving? Do they use technology like telephone clock in systems and scheduling software for quality assurance?  How quickly are they aware if a caregiver has not shown up to provide care?  What methods do they use to communicate with you?  Do they offer you conveniences such as online monitoring and paying bills online or via credit card?  Do they keep up to date with aging in place technology and can they provide you recommendations that may bolster care?
  1. Get to know who you’re hiring. When talking with an agency, get a feel for their process. Will they allow you and your loved one to interview potential caregivers? How do they handle replacing a caregiver that is not a good fit? What steps do they take to ensure coverage and accountability? How do they supervise, train and support staff? Do they strive for continuity or will your loved one have different staff each time?  How many caregivers will cover the shifts your loved one requires?  It is important to discuss your loved one’s specific diagnosis and needs, finding out the agency’s experience with similar situations and any special training and guidance they provide, for example training on working with clients with Alzheimer’s disease.  While regulations standardize licensed home care agencies to a degree, these are the things that will set one agency apart from another.
  2. Research involvement. Seek out providers who have a history in the community and the industry. Check if providers are involved with local and national associations such as the Alzheimer’s Association, the Area Agency on Aging and the National Private Duty Association. Their involvement demonstrates passion and dedication for their field. Management staff that has a history in the community and the profession demonstrates a commitment, stability and a positive reputation that they would want to protect.

Photo credit: familymwr

About the authors: Alex Chamberlain is executive director at EasyLiving, Inc. (http://www.easylivingfl.com), a fully licensed, private duty home health care company serving individuals and families in Pinellas and Pasco counties in Florida.

Shannon Martin, M.S.W., CMC, serves as Director of Communications for EasyLiving, Inc. and Aging Wisely, LLC (http://www.agingwisely.com). Shannon has worked for Aging Wisely, a professional geriatric care management and consultation firm, for over 8 years.