Examining the ins and outs of private home care

Before jumping in with two feet, it's important to ask, 'What assistance is needed and how much?'

In the past month, I’ve had numerous calls from individuals asking about various private home-care agencies and the ins and outs of private care.

It seems like a good time to reprint this column, with a few updates.

Mrs. Robson is a 92-year-old widow with Alzheimer’s disease. In her younger years, she was a schoolteacher and raised three children. She and her husband married at 20 years old and enjoyed a 60-year marriage.

She was an avid hiker, gardener and enjoyed reading. She loves her home, which overlooks a nearby park, and she has lived in the same neighbourhood for the past 40 years.

Although very independent, Mrs. Robson needs some care and supervision; she can no longer make meals, drive and is a little unsteady to shower by herself. Some of her children’s concerns include Mom getting lost on one of her walks or having a fall in her home.

Before her diagnosis, Mrs. Robson and her children discussed her future and she expressed her desire to stay in her home for as long as possible.

Although Mrs. Robson is eligible for home support services through the local health authority, her current income level provides the option for hiring privately.  The family decides to use private care to complement what Mrs. Robson uses through publicly funded services.

There are several important decisions seniors and their families face when more help is needed to allow an aging loved one to stay in their home. Hiring a private caregiver to provide home support services and other household management tasks is often at the forefront.

There are a few options for hiring private caregivers depending on the needs of your aging loved one including through a home care agency, privately on your own and the Live-In Caregiver program.

Before jumping in with two feet, it’s important to ask, “What assistance is needed and how much?”

In Mrs. Robson’s case, the family decides that their Mom needs a care provider every afternoon Monday to Friday for two hours to help with meal preparation, housekeeping/laundry, transportation to appointments and some companionship. The family will rotate and assist in the evenings and weekends.

Using a local home health-care agency or an independent private caregiver is often a first choice for families and seniors. Screening and other background checks are already in place and licensed care providers are available, usually 24 hours, seven days a week. Here are some questions families and seniors can ask when researching different home health care agencies:

How many years has the agency/individual been serving in the community?

What are the services and costs, and do they have the information in print? Be sure to ask if  if travel time is included in the service and if so, how much time is allocated for travel time.

What is the minimum amount of service?

If you live in a more rural area, ask about travel time and/or mileage costs for staff’s travel.

Is the agency accredited? This means that their quality of care has been surveyed and approved by an outside accrediting organization.

Double check insurance coverage – general liability and WorkSafe BC, especially for independent private caregivers

Can you get a service agreement which outlines the services to be provided and the cost, in writing?

How does the agency/individual handle billing?

Will the agency/individual provide a reference?

Are the agency’s caregivers available 24 hours per day, seven days a week?

Does the agency have a nursing supervisor on call and available 24 hours per day? For individual private caregivers, ask about backup plans

What are the qualifications of the staff? How are they trained?

Does the agency/individual do a in-home assessment and what’s included? Is this free of charge?

How does the agency/individual ensure client confidentiality?

Does the agency require criminal record background checks and communicable disease screens for its employees?

What is the process for resolving issues that may arise between the client/family and home health-care staff?

What happens if the care provider fails to make a scheduled visit?

What is the cancellation policy?

Will the same care provider visit regularly?

Wendy Johnstone is a gerontologist and is the founder of Keystone Eldercare Solutions. Her column runs in the Comox Valley Record every second Thursday.

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