When your parents start having difficulty with every day tasks, most families feel the solution is to bring in someone to assist in caring for your parent in the home. This may not always be the best course of action as there are numerous medical, environmental, psychosocial and financial issues that have to be considered to assure in-home care is the best option. Options For Elder Care has the expertise to complete this evaluation to assure the best long term decision is made www.optionsforeldercare.com.
A qualified caregiver overseen by a RN who has the clinical knowledge to establishing a professional plan of care and offer direction to the caretaker would be in the best interest of the older adult.
CARETAKER QUALIFICATIONS:
You will see several terms utilized to describe In Home care providers and you may see the job descriptions overlap. Caretakers of all types do not have the education to function independently without over-site by a qualified professional.
1. Certified Nursing Aides (CNA): Have medical training and must pass an exam to get certified. CNA's can check vital signs, care for wounds, transfer techniques, and help with activities of daily living (ADL's) like bathing and dressing. CNA's typically received training under a registered nurse. When working in the home most are agreeable to assisting with household tasks and meal preparation.
2. Home Health Aides: May have some formal training provided by aemployer or can be "self taught" with experience. Typically Home Health Aides can assist with ADL's but did not receive formal training on medical issues. They can also assist with household chores and meal preparation.
3. Personal Care Attendants/Companions: Usually will not provide direct patient care but rather companionship. They can assist with cooking, cleaning, and shopping.
OPTIONS IN CARETAKER FINANCIAL ARRANGEMENTS:
- Hiring a Caregiver directly: Hiring a home care aide through word of mouth or through the classified is usually the least expensive option and the one families think will solve all their problems. This arrangement can creates legal liabilities for the family which becomes the employer. For instance, you can be held liable for any injury that happens on the job including medical and disability. If you choose to hire them as a contractor you will need to file a 1099 on any wages you pay over $600. You will need to conduct a background check, check prior employment history, complete drug testing, and most importantly, arrangements of this nature may not be the long term solution you are looking for. If you treat them as an employee you will be responsible for paying taxes and benefits such as Social Security and Medicare, income tax withholding, and unemployment tax.This industry has a high turnover rate and there is not a back up should this person leave unexpectedly or become ill. There are always bad apples who will take advantage of vulnerable clients - so make sure you do not unwittingly hire one! It is a good idea to make sure the individual you are hiring is a CNA so you know a registered nurse has trained the person in the basics of care. With that said, hiring someone on your own can be a good idea if you have the time to be the employer, medical education to over see the caretaker, and strong endorsement from someone you know who has used their service.
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Agency Caretakers: The rate an agency charges for staff tends to be higher but agencies will pay for the FICA taxes, cover worker's compensation insurance and screen potential employees backgrounds. You want to make sure the agency bonds and insures their caretakers and that their caretakers have received training on CPR and first aid skills. Most agencies have a large number of caretakers so you may be able to "try out" a few to find a good match. Additionally, the agency should offer you a guarantee of a substitute caregiver if your primary one is sick or on vacation. A quality agency will have a RN who follows up on the care plan, oversees and offers advice to the caregiver.
SETTING CLEAR EXPECTATIONS:
Caretakers are employees, do not try to make them your friends - keep it professional. If your employee thinks of herself as your pal, she may likely take liberties of a friend, not an employee of vulnerable adults.
Set clear expectations as to what she should be doing every moment she is working for you.
- Use a notebook all can write in regarding the care provided for a client
- Have a RN develop a plan of care and assure there is a method for the caretaker to record that she is following the plan of care.
- Should the caretaker bring their own lunch, should they remain 100% awake when working the night shift, run errands, shop, clean, cook?
- What personal care should they provide and using what methods.
As RN Geriatric Care Manager the most common call I receive is from adult children who have concerns about their parent's safety and are looking for in home care to solve this concern. The adult children want to know how much care their parents need and how they can get their parent to accept it. Most of these calls are precipitated following a crisis such as a fall or hospitalization.
In most instances, a parent will not acknowledge they need nor accept the idea of a "stranger in their home." Adult children frequently try to convince their parents they need in home care, resulting in a frustrating experience. In many cases Geriatric Care managers must mediate between the older adults desire to remain independent and their adult children concern for their safety. Through my 35 years of experience I have learned how to work with older adults in ways that respect their need to feel in control of their lives along with helping them recognize that accepting help actually allows them to maintain independence.
To find out more about how Options For Elder Care can assist you with the in home care of your parent please refer to our web site: www.OptionsForElderCare.com or Phone: 412-443-1365
