Advantages of Hiring a Senior Home Care Agency

When the need for additional care presents itself for a senior, many decisions must be made.

Does the senior wish to remain in the home they currently live in?

Is that home able to accommodate their current medical conditions?

What are the financial capabilities to pay for care services?

What are the long-term plans for the senior’s care needs based on their physical and mental capabilities and socialization needs?

Caregiverlist provides information on ways to pay for care, quality standards and Checklists for planning your care options.

Once the decision to stay home has been made, for the short-term or long-term, the next task is to find an appropriate care provider.

Caregiverlist provides information on care services provided by quality licensed senior home care agencies. As there are no national licensure standards for senior home care, Caregiverlist has created a set of standards participating senior home care agencies must meet, along with a client survey to maintain high-quality providers.

Caregiverlist does not connect seniors with independent contractor caregivers (direct-hire). There are plenty of other websites that try to do this. We choose to only provide information on professional senior home care services and would like to tell you why.

Caregiverlist’s owners and advisors have years of experience in senior care. While in some rare occasions, an independent contractor caregiver can adequately provide for care needs, in far too many instances a direct-hire caregiver does not present quality care and a safe environment for the senior or the caregiver. Seniors have spent a lifetime to acquire assets and a certain lifestyle and all this can be risked if proper care is not in place. A senior home care agency provides the necessary protections and quality of care for each individual situation. Senior home care agencies hire trustworthy individuals with personal and professional experience in caregiving and provide training and active management.

What does this mean for you as a client?

Employment Law: Senior Home Care Agencies are professionally licensed businesses and will abide by the business license requirements in their state and follow all the U.S. employment law guidelines.

1. I-9 Form: the caregiver will be required to present the necessary identification documents to satisfy the I-9 form requirements and be legally hired in the U.S.
2. Taxes: all payroll taxes will be deducted from the caregivers pay (and the agency will make the matching employer contribution).
3. Insurance: worker’s compensation insurance, fidelity bond insurance and professional liability insurance will be provided.
4. Language Capabilities: the caregiver will be required to communicate well in English and if requested, another foreign language to accommodate the senior client’s needs.
5. Timesheets: the caregiver will have a system to follow to insure they start the assignment on time and leave on time (telephone systems called telephony, logging in and out of a computer payroll system with a telephone call are common).
6. Training: customized training for age-related diseases are provided and Certified Nursing Aide and Home Health Aide skills are verified.
7. Care Plans: a Plan of Care is created to outline the daily routine and tasks for the caregiver to complete.
8. Active Management: the caregiver will enjoy a team environment with ongoing training, incentives, social activities, performance reviews and community programs to assist them to provide quality care.
9. Initial Assessment: a Case Manager or Supervisor will conduct an initial client assessment to make sure all the necessary care services and safety items are in place for the senior and the caregiver.

Seniors deserve quality care, which can best be provided by a professional senior home care agency offering both the senior and the caregiver support and guidance.

I am completely convinced of this after owning and operating a senior home care agency which successfully serviced more than 400 clients over 6 years (both hourly and live-in care), becoming the leading senior home care agency in its area which led to an acquisition by a national company.

Here are some of the situations I walked into when beginning care services for new clients (names have been changed for privacy) who had previously had hire-direct care services.

Aunt Mary with no family nearby: I received a call one day from a nice man living in Canada who had found a direct-hire caregiver to assist his Aunt in Chicago. He was in a wheelchair from an accident he had suffered a few years ago and had not been able to visit his Aunt since the accident.

His Aunt (we’ll call her Aunt Mary) was a widow with no children. While she had worked her entire life and owned her home, her nephew was trying to conserve her assets as best as possible. He did want her to have good care and the caregiver he found was set-up to move in and live with his Aunt to be there around the clock. She had a variety of ailments, including diabetes, high blood pressure and some mobility issues. She also was about 100 pounds overweight which added additional challenges for walking. She often had knee pain and was unable to walk up and down her front stairs.

Recently, it seemed that Aunt Mary was more and more distant and sometimes did not know who he was when the nephew called. Then a neighbor called him, concerned that she was not eating enough and that the caregiver was gone most of the time.

I arrived at the house to conduct a Client Assessment interview. It was apparent Aunt Mary had not had a bath or a haircut in a very long time. She did not have healthy food in her refrigerator and there was no sign of the caregiver. After speaking with the neighbor, I learned that the caregiver was working another job during the day and actually did not spend the night with the senior. The caregiver also did not speak very good English, which complicated issues since Aunt Mary was already suffering from memory loss and communication was a challenge for her. In addition, Aunt Mary’s medications did not match the medication list the nephew had sent to me. The doctor confirmed that if she were not taking her medications as scheduled, this would cause additional confusion and appetite issues.

I immediately found a caregiver to come and assist me in giving her a shower and I called the pharmacy to organize her medications. I then made a list of needed repairs (there was no light in the kitchen and the bathroom shower needed a grab bar and the vacuum cleaner did not work). We began staffing a live-in caregiver to assist Aunt Mary to begin a daily routine and we set-up doctor’s appointments for her and arranged for her household repairs. We also had the locks changed on the doors. Aunt Mary did improve and eventually her nephew arranged for her long-term care in a nursing home because of safety concerns due to Aunt Mary’s weight and mobility issues.

Aunt Mary was sometimes resistant to care and sometimes would become angry and speak in her native language. She was not always an easy client. I do sympathize with her hire-direct caregiver as she did not have support and training for a challenging care situation. However, she should have notified the nephew that she was not able to meet Aunt Mary’s care needs.

Mr. and Mrs. Thompson whose caregivers kept quitting: this couple had been married for more than 50 years and still lived in the first home they had purchased. The wife had suffered a stroke and was in a wheelchair and the husband had memory loss.

One Caregiver had been hired to live with Mr. and Mrs. Thompson and a friend who was a former neighbor was managing the care services and paying the bills. However, she no longer lived in the neighborhood and had small children and was not able to visit daily. Mr. and Mrs. Thompson were not getting along with their caregiver and were continuing to have caregivers quit or walk out. This was causing their former neighbor her own family problems due to the continued need to rush over to provide care at the last minute and then to spend the time to find another replacement.

During the initial visit for the Client Assessment, it became apparent that parts of the challenges were due to the fact that there was too much work for one caregiver. The caregiver was expected to do the care management (manage doctor visits, medication refills, bill payment) and caregiving for two people who needed hands-on assistance for bathroom visits and bathing, along with meal preparation and eating assistance. The caregiver had no down-time to rest. There was also no bathroom door (it had been removed to allow for wheelchair access) and this was the bathroom the caregiver was expected to use (you could, and should, add a curtain for privacy in such instances).

This situation needed Care Management services to manage the groceries (you can set-up delivery in most cities through Peapod or a local grocery store), doctor’s visits and bill payment. A caregiver experienced in stroke rehabilitation was required, along with proper training for transfers. It was also necessary to provide for additional caregiver pay for this assignment and to shorten the length of shifts to eliminate burn-out. Caring for two people requires much more effort than caring for one and the care plan, schedule and pay must be adjusted accordingly.

Mrs. Allen, outliving everyone: This client’s care was managed by the law firm where her husband had been a partner. Before he died, he had arranged for one of the attorneys to be the trust officer for Mrs. Allen.

However, Mrs. Allen outlived the attorney who was assigned to be her trust officer. At age 96, her only surviving family members lived more than 600 miles away. She also spent all of the money in her trust. The law firm decided they would continue to pay for her care and they assigned a new attorney to be her trust officer. However, this attorney did not personally know her and because of this was not aware of all of her care needs.

In an effort to make her care as economical as possible, the attorney hired a direct-hire caregiver.

This caregiver was to be in charge of everything, from managing her household needs, to grocery shopping to providing care. The caregiver was given access to Mrs. Allen’s credit cards to pay for everything.

This caregiver decided a few more credit cards might be nice and opened more credit card accounts in the client’s name. The credit card bills went to the large law firm and their accounting department paid them.

Finally, the accounting department notified the trust officer that perhaps the bills were a little excessive. This is when the trust officer decided to call a senior home care agency to manage care services. It turned out the caregiver had opened up credit cards with Home Depot and a few department stores and was enjoying their own nice wardrobe and new appliances while Mrs. Allen was not enjoying a quality lifestyle nor receiving quality care. We started care services and immediately changed all of her bills to the law firm address. We set-up grocery delivery services, meal plans, a daily routine, exercises, activities (Mrs. Allen had enjoyed going to the theatre and participating in the activities of the senior center near her house but the caregiver had also neglected to assist her in this area). And, most of all, she said, she missed her daily afternoon martini, and with her doctor’s approval, we allowed her to enjoy this little luxury again.

Mr. Rogers, $20 to walk a block to the grocery store: this client’s daughter called me after hiring a direct-hire caregiver to assist her father who was already living in an assisted living community. The caregiver was hired to be an additional companion for her father. The care duties included checking in daily to visit with him, escorting him to the grocery store one block away, and attending the community activities as he was unlikely to participate on his own. Her father had some balance issues which made him prone to falling if he did not use his walker. He also had some memory loss.

The daughter began to discover that her father would mention his caregiver was running errands without him. She also noticed that he was running out of his pocket change faster. He really only walked to the grocery store to purchase milkyway candy bars and crème soda, his two favorite snacks. He definitely should not have been running out of money so quickly as the assisted living community provided him with meals.

It turned out the caregiver was charging her father $20 every time they walked to the store in addition to making him pay for whatever snacks she desired. Her father’s memory loss was at a point where the caregiver could easily make him feel confused about his purchases and her pay.

We began caregiving services and each week required the caregiver to present Mr. Rogers with the assisted living community’s schedule of activities and we implemented a petty cash box which required receipts for each purchase made.

I have many more stories and some of them are heart-breaking. There was the adult child who successfully was able to take all of his parent’s assets, including a loan against their house, to pay for his drug purchases (his father had Alzheimer’s Disease and his mother simply trusted him and believed what he told her when she signed over financial documents). Fortunately, we discovered the father was a veteran and he was able to be accepted for admittance to a veteran’s retirement home which allowed his wife to stay, too (many veteran’s homes are only for male residents). If he had not been a veteran, their only choice would have been to go into a Medicaid nursing home.

Financial abuse is the leading form of elder abuse. As many seniors may be lonely with family living far away, they can become too trusting. This can lead to sharing too much information which can lead to financial harm. As seniors are also at risk for developing memory loss or an age-related disease, professional care services by caregivers trained to provide for seniors are best. This is why senior care offers different challenges from child care and pet care and why Caregiverlist only connects consumers with professional senior home care agencies meeting our quality standards.

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