FAQs on Home Care

You Asked, We Answered

We asked the members of the CAHC team to discuss some of the top issues and concerns that families should address when choosing a home care agency. The following insights and advice are based on many decades of their collective experience in the home care field. You can scroll down as you read or CLICK on the questions

There are typically two scenarios when home care services
are needed. The first scenario is when someone has a stroke, accident, or other
type of acute medical episode and needs home care for a defined period of time
after a hospital stay.

The second scenario occurs when someone gradually becomes
ill or frail, and it becomes obvious they need help in the home.

In the first scenario, typically the family can speak to a
hospital discharge planner, nurse case manager, or social worker while the
patient is still in the hospital. These professionals can assist you in setting
up services for the short term through an appropriate source from a Medicare
certified provider. You should also talk to the physician about coordinating
care after the patient is discharged from the hospital.

Unfortunately, families sometimes get very short notice
about the patient’s discharge and are overwhelmed about the type of care that
may be needed at home. So, it is important to be proactive about getting the
discharge planning help you need. The hospital may suggest a few home care
providers, but they generally cannot suggest just one or “the best
one” if asked.

In the second scenario, our listing of CAHC accredited agencies in good standing is a good place to start. But before you call, you need to determine what your care needs are and any other considerations, like language, that are important. That way you can select an agency whose services are a good fit for your situation. You can make the arrangements for care directly with the agency.

We strongly recommend that you use the CAHC website to get a list of accredited agencies that service your county. Click Here for our listing of accredited agencies. These agencies are required to follow federal, state and local regulations.  Agencies or ‘freelance’ home aides that are not accredited do not meet the same standards of professionalism, safety, or quality of care.

In the second scenario, our listing of CAHC accredited agencies in good standing is a good place to start. But before you call, you need to determine what your care needs are and any other considerations, like language, that are important. That way you can select an agency whose services are a good fit for your situation. You can make the arrangements for care directly with the agency.

We strongly recommend that you use the CAHC website to get a list of accredited agencies that service your county. Click Here for our listing of accredited agencies. These agencies are required to follow federal, state and local regulations.  Agencies or ‘freelance’ home aides that are not accredited do not meet the same standards of professionalism, safety, or quality of care.

In the second scenario, our listing of CAHC accredited agencies in good standing is a good place to start. But before you call, you need to determine what your care needs are and any other considerations, like language, that are important. That way you can select an agency whose services are a good fit for your situation. You can make the arrangements for care directly with the agency.

We strongly recommend that you use the CAHC website to get a list of accredited agencies that service your county. Click Here for our listing of accredited agencies. These agencies are required to follow federal, state and local regulations.  Agencies or ‘freelance’ home aides that are not accredited do not meet the same standards of professionalism, safety, or quality of care.

You can begin by determining if the person needing home care is eligible for Medicaid or one of the special state assistance programs for home care.  If you have money saved to pay for care yourself, you will be able to privately pay for home care services.

If the person is not eligible for State assistance, contact your insurance company to see what they will or won’t pay for. If they will pay for home care, what agencies will they allow you to use?  Sometimes, insurance companies will restrict you to selected providers.  Other times, they will allow you to use any licensed, accredited provider in the State.

You can begin by determining if the person needing home care is eligible for Medicaid or one of the special state assistance programs for home care.  If you have money saved to pay for care yourself, you will be able to privately pay for home care services.

If the person is not eligible for State assistance, contact your insurance company to see what they will or won’t pay for. If they will pay for home care, what agencies will they allow you to use?  Sometimes, insurance companies will restrict you to selected providers.  Other times, they will allow you to use any licensed, accredited provider in the State.

You can begin by determining if the person needing home care is eligible for Medicaid or one of the special state assistance programs for home care.  If you have money saved to pay for care yourself, you will be able to privately pay for home care services.

If the person is not eligible for State assistance, contact your insurance company to see what they will or won’t pay for. If they will pay for home care, what agencies will they allow you to use?  Sometimes, insurance companies will restrict you to selected providers.  Other times, they will allow you to use any licensed, accredited provider in the State.

Supervision is the difference between working with an accredited agency and a freelancer, even if the freelancer was recommended to you by a friend or family member.

Home care is a very autonomous role for the professional and paraprofessional. Unlike a hospital or assisted living facility where many others work with them, nurses and aides work alone in the home with your loved one who may be quite vulnerable.

A key consideration is the amount of oversight or supervision that the caregiver receives. Is there an assurance that care is conducted the way it should concerning safety, infection control and similar issues? Is there someone who is monitoring the care? The advantage of using an accredited agency is that you know that the employees are screened, supervised and a registered professional nurse is monitoring the level of care.

Supervision is the difference between working with an accredited agency and a freelancer, even if the freelancer was recommended to you by a friend or family member.

Home care is a very autonomous role for the professional and paraprofessional. Unlike a hospital or assisted living facility where many others work with them, nurses and aides work alone in the home with your loved one who may be quite vulnerable.

A key consideration is the amount of oversight or supervision that the caregiver receives. Is there an assurance that care is conducted the way it should concerning safety, infection control and similar issues? Is there someone who is monitoring the care? The advantage of using an accredited agency is that you know that the employees are screened, supervised and a registered professional nurse is monitoring the level of care.

It is important to remember that the home care caregiver does not supplant a family member. A home care caregiver does not have the same bond you have developed during the years of your relationship with your loved one. While you are providing an oversight function while your loved one is receiving care, you can also continue to maintain your relationship.

An important part of taking care of someone who needs help is taking care of yourself. If you are overly stressed or exhausted, you need help. Home care services give caregivers a break or respite. By having home care, you can usually sustain the care needed for a longer period of time. Providing better quality care by getting home care can help increase your peace of mind

We also suggest considering a caregiver support group as an option – sharing your experience with others in the same circumstances as you can help you feel better.

It is also important to remember that the home care arrangement is a work arrangement and that the caregivers are not family members. Aides, nurses, and the elderly often develop close, personal relationships. There’s a level of intimacy in the relationship that can develop when the aide or nurse is taking care of very private needs.

Your loved one is grateful for the support he or she receives and often comes to feel that their aide or nurse is a member of the family. You have to draw the line and ensure that your senior does not give them money or other valuable items or share confidential information with their aides or nurses.

It is important to remember that the home care caregiver does not supplant a family member. A home care caregiver does not have the same bond you have developed during the years of your relationship with your loved one. While you are providing an oversight function while your loved one is receiving care, you can also continue to maintain your relationship.

An important part of taking care of someone who needs help is taking care of yourself. If you are overly stressed or exhausted, you need help. Home care services give caregivers a break or respite. By having home care, you can usually sustain the care needed for a longer period of time. Providing better quality care by getting home care can help increase your peace of mind

We also suggest considering a caregiver support group as an option – sharing your experience with others in the same circumstances as you can help you feel better.

If your nurse or homemaker-home health care aide is from an agency, you should start by reporting your concerns to the agency. One of the questions you should ask when choosing an agency is how they handle complaints or concerns. Accreditation standards require that consumers are given information about how to file a complaint. It should state clearly who to contact – whether it is the owner, director of nursing, or director of operations, etc. – and how to do so. So, your first step should be contacting the agency.

CAHC accredited agencies are required to have an internal process of investigating grievances. If you make a complaint and you are not satisfied with the internal process, you have your appropriate State agencies that license home health care agencies.

If you suspect theft or fraud, you should also contact the police. If you believe physical abuse has occurred, you should contact your local police department and your local Adult Protective Services unit which is usually located in the social services department of your county. In the event of child abuse, you can contact Child Protective Services.

One caveat to keep in mind is that people with dementia or Alzheimer’s Disease may imagine they are having items stolen or that someone is acting abusively. You need to assess the situation to determine how to respond. Does the person have bruises? Have you looked for “missing” items? When an agency has an internal process to investigate your concerns, it may prevent you from jeopardizing a good care-giving situation by making unfounded accusations. On the other hand, having a clear process to address your concerns allows you to act effectively if an abusive or fraudulent situation actually exists.

If your aide is a “freelancer,” you have fewer options. If someone is a freelancer, and you suspect criminal behavior, then contact the police. If you have a concern about the aide’s credentials or whether the aide is certified, contact your State’s licensing authority.

 

In the above situations, if the agency is CAHC accredited please contact us so we are aware of the problem.

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