Finding at-home help for aging parents

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When an older relative starts to need help to get through the day, many families want to avoid institutions. To keep their loved one at home, they need to either hire a home-care aide or become one.

There are two main kinds of in-home care. Personal or home-care aides provide companionship and support a person’s activities of daily living such as dressing, bathing, preparing meals and doing laundry. Home health aides may do all those things plus tasks such as administering medication or recording changes in a client’s condition. They also may work under a nurse’s supervision.

Here are questions to ask when thinking of hiring or becoming a caregiver.

What kind of care do you need and can you afford?
Before looking for a home-care worker, families need to make sure they can afford to hire one. Families typically pay for these services out of pocket unless the older person meets Medicare’s coverage conditions or has a private long-term care insurance policy that covers such needs.

If you don’t know what kind of care is needed, a specially trained geriatric care manager can help. Assessments cost about $500 to $800 depending where you live. The Alzheimer’s Association offers assistance with an always-open phone line at (800) 272-3900 and at www.Alz.org/carefinder. Medicare’s website has a Home Health Compare tool.

Rates from $14 to $22 an hour for non-medical in-home care are typical, but keep in mind that assisted-living facilities can run $2,800 to $4,400 a month. Agencies’ rates often are toward the top of the scale. Caregivers who work independently tend to be less expensive.

Should you hire an independent worker directly or go to an agency?
The advantage of using an agency is that it takes responsibility for paying wages, taxes and insurance. Agencies also run criminal background and driving-record checks, and provide back-up aides should the main caregiver get sick or go on vacation.

Families who decide to hire someone on their own should make sure they follow all state and federal employment laws, including any provisions for overtime pay. You don’t want someone going after your estate or the family member’s estate because something wasn’t handled correctly.

How do you find the right home-care aide for your needs?
Experts recommend interviewing at least six candidates. Families should interview applicants in the home so the aides know in what kind of environment they would be working. For example, having a smoker or pets in the home may be an issue. And don’t forget to include the elder’s input. Finally, don’t balk if someone who stands out is a little more expensive. Paying a little more for someone you really like is worth the extra cost.

Do you have a plan to take care of yourself?
If you’re caring for a loved one yourself, you need to plan time away to tend to your own physical, social and emotional needs. If you don’t, you risk health-draining burnout. Churches, synagogues and volunteer groups may offer short-term relief. Adult day-care centers may be another option. The Alzheimer’s Association and Agency on Aging groups also provide respite-care resources. For overnight breaks, check with assisted-living facilities, which may offer furnished rooms, meals and nursing staff on a temporary basis.

Family caregivers can find more resources at www.familycaregiving101.org, a website run by two non-profit organizations.

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