Denise ran into the
house... "Hi Mom, gonna quick throw a load in the washer and
get the dishwasher started. Have you eaten yet? If not
I brought over a plate with some chicken and potatoes on it.
I know I am late, I'm sorry. Only have a couple minutes
until I have to pick up the boys from school. I'll try to
stop by later to switch over the laundry otherwise tomorrow.
Did you take your pills? (pause) Mom... you're not dressed
yet. Are you okay? Ya Sure?"
"OK... Anyway... Jerry says his
meeting ran long and he won't be out early tonight so he can't do
the lawn but I will try to get Randy or Justin over here to at
least get the mowing part done. Yeah, if I do it that way, I
can run and get your meds refilled and pick up a few groceries for
you while that is going on... looks like a pizza night
tonight! Gotta run, see ya in a bit!"
If you can relate to
the above scene, you are not alone. More than 1 in 5 people
who live in the same town as their parents are current caregivers
for at least one aging parent. Another 1 in 5 has been a
senior caregiver in the past
In a recent survey,
over 97% of people over the age of 50 said that they would prefer
to always remain at home receiving homecare services, rather than move into an institutional
setting. This is still true even though there has been quite a transition in the look
and feel of assisted living centers.
is not always possible and we must then turn to outside sources
for assistance. The first line of assistance is generally
local family members as caregivers.
Family caregivers often help senior
parents with various home tasks, if and when they are
around. Unfortunately, it isn't always possible to be there
or be there with enough consistency. Trying to run two
households can become virtually impossible and being a caregiver
is a demanding task.
Most aging parents
also have at least one adult child that doesn't live close enough
to supply personal services. Even 15 miles across a busy
city can make it difficult to be an active caregiver. Such a distance after work
in many cities can take an hour or longer. Add that to the
trip home and do that every day and you have quite a time
investment in the traveling much less the typical caregiver tasks.
The Case for Homecare
When self-care at
home has become difficult or family caregivers are not immediately
available to do the volume of work that is necessary, many people
are now choosing Homecare over institutional care. Doing so
often relieves family members of basic caregiving functions and makes it
possible to spend quality time, rather than the functional
Aside from being
easier and faster to implement than moving to a institutional care
setting, Homecare allows the senior to stay at home in familiar
and comfortable surroundings. The time that adult children do
have can the be spent on quality time... visiting, having fun with
the parent, instead of just being a caregiver.
should not be confused with home
health care. While some home care workers may take and
record vital signs or record other measurements and some companies
provide both services, most homecare companies are not licensed to go far beyond
recording basic vital measurements. If you need more
than home and personal care, you should talk with a home
healthcare company. To reduce costs, consider mixing the two
services. Some homecare providers offer both home healthcare
and personal non-health care at lower costs. Others only
provide one service.
If you need someone
to administer and adjust medication levels, wounds that need to be
monitored and dressed, or anything similar, you will have to talk
about home healthcare, not homecare. Home healthcare is
provided by trained medical personnel and is therefore more
expensive. Be sure that you understand what it is that you
need or utilize the services of a Geriatric
Care Manager to determine the level of services that you need.
Homecare companies provide
a wide variety of personal services that are non-medical such as:
- Bathing, dressing,
and personal hygiene
- Taking and recording vital
- Assistance in the bathroom
- Light housekeeping
- Meal preparation
- General observations of health
- Grocery shopping and pharmacy
- Home safety supervision
- Medication reminders
Bringing an unknown
person into your home is a very hard process the first time.
Adult children seldom realize that parents may initially feel a
bit abandoned... like you don't care. The elder parent may
also feel like they are a tremendous burden to you and that you
wish to shove them off on someone else.
It is important to
take things slow when transitioning to homecare, if possible. Providing home care services
can be a great relief to you but may be a bit disconcerting at
first for the senior parent. They are used to having you
around, but are not used to having a stranger in the house.
Consider the use of a geriatric care manager to help facilitate
the transition. Geriatric Care Managers (GCM) are not only
great organizers, they typically understand the emotional aspects
of what you and your senior parent will be going through in the
transition phase. A good GCM can help both you and your
senior parent work through this.
Over time, you will
likely find that the senior parent will not only become very used
to having home care staff around, but enjoy it. Things that
they didn't feel like they could ask you to do are easily asked of
the home care worker and they find that they have time to spend
with you when you do come over instead of having you rush in and
out or feel like they are a burden to you.
It is often said
that in senior years, the parent becomes the child and vice
versa. This is probably largely due to the necessity to
provide basic physical help. Bringing in homecare can help put you
back in that adult/adult relationship.
Talk About Homecare
It's always best to
sit and discuss hiring homecare with the parent before doing
so. Explain that while you enjoy being able to help, there
aren't enough hours in the day to be able to do it right and still
have the quality time visiting.
Everyone will react
differently to the idea. Some will be very accepting of the
idea, others will argue, some will do the guilt trip thing, and
others will probably just say no!
If the reaction that
you get isn't positive, explain again why it is that you want to
bring in a home care company, explain your problem again, and then
ask your parent to come up with other alternatives... to help
you! It can be frustrating and it may take some time, but
eventually most still come around. Bottom line, it's best
not to force the issue, but to be persistent.
One alternative is
to bargain for bringing Home Care come in for something that is
non-personal. Light housekeeping is a great place to start
so that the elder parent will get used to the idea and even enjoy
the company of the Home Care worker. At the same time, this
can take quite a burden off the family caregivers.
There is an
understandable dislike for the idea of someone coming in to help
in the bathing process or even doing laundry. Such feelings
are rarely expressed about someone who prepares dinner, does the
dusting, and transports them to the doctor. Those things are
not as personal
Over time, you can
begin to gradually add services, if and as you need them.
Again, it is a very
personal decision to bring a homecare caregiver your home. You and
your parent should determine that the company and the person that
will be supplying services is the right one for you.
Take your time in an
initial telephone interview. Don't hesitate to ask any
questions that come up, including hypothetical ones. Homecare companies are there to serve you and you will be billed for
services that you agree on. You are not taking up their time
and it only makes sense to want to know what it is that you get
and don't get for your money.
There are no dumb
questions. Homecare companies seldom work with people that
have been through this before and they know you don't fully
understand their services. People that are in homecare have
to be very approachable.
You may have other questions,
but be sure to ask:
How long the
company has been in business?
Do they have any
complaints against them with the BBB, or with any licensing
Do they check
their workers' police records?
Do they do drug
Do they check
their workers' driving records? (Where transportation is a
Have they every
had any charges of elder abuse?
Do they pay
their workers as employees or contract agents?
What kinds of
duties can they perform?
Can you add
schedule according to your needs or must you fit around their
Can you meet the
person who would be doing the work before signing an
Can you change
workers later if there is a problem?
What if your
worker is sick or quits?
What kind of
feedback will you get from the Home Care worker?
What kind of
evaluation services are available for determining the extent
of need and changes to those needs?
What are the
How are bills
calculated (by job or hour)?
How are payments
call services available?
Be sure to check
with your local BBB and any licensing agency that might be
available or appropriate. While the vast majority of
are careful about who they hire, you don't want to hire the one
company that has had problems with hiring good or honest people.
Set up a home
interview time with your elder parent and the person from the
homecare company to meet. It won't be a long one but will help
to break the ice a bit on the first day, especially if you are not
there to get them started.
Show the homecare
aide around the house where cleaning and other supplies may be
located. Talk over any questions that the homecare aide has as well as those of the elder parent. It is important
that all feel comfortable in this setting.
Be sure to leave the
homecare aide with your contact information during the day so
that questions may be answered. This is the time for
everyone to come to a complete understanding of what is to be
accomplished and get off on a great footing.
Respect, and Professionalism
There are occasionally
some strange dynamics in homecare situations. While most
are easily remedied, every once in awhile, someone will contract
for minimal services and then expect that the homecare aide will be only too happy to do more, without notice and without
This is not a big
problem for most people, but it should be pointed out that while
your homecare company aide is there to help you, mutual
courtesy and respect are a must. Doing so will help all
parties understand where the boundaries are and a terrific
You should have a
list of what service can be performed and you will have agreed to
the performance of certain duties. Don't expect that you
will be able to add to these duties without notice and when you
do, be prepared to pay for them. You would want to be
compensated, even if you were working for a friend.
Be aware of why it
is that you want a homecare worker to come in. Homecare
companies exist to take care of your family member, not to clean
the house. While most consider that some basic homecare is
part of that process, it is not their primary duty.
Don't expect to leave the job of cleaning under the refrigerator
to the homecare aide.