Nurse_in_geriatry

Does Mom or Dad Need Care at Home?

 

Chris is concerned about Terri, his mom. Terri seems to have been eating cereal for all her meals and whose refrigerator is nearly empty. And Terri seems to be mixing up her medications.

Marcia is worried about Sal, her dad. Sal’s apartment is a mess, he isn’t showering and he never seems to go out.

What can Chris or Marcia do to help their parents? Of course, they need to make sure that neither Terri nor Sal has a medical problem that isn’t being attended to – so a visit to the doctor may be needed. Beyond that, they need to figure out whether Terri or Sal would benefit from having some help at home.

There are two basic categories of care at home

  • Home health care, which refers to medical care provided at home by a skilled professional (registered nurse/licensed vocational nurse or skilled therapist).
  • Home care, refers to assistance in the home by a caregiver (also called a home/personal care aide, or homemaker/choreworker), who provides assistance in the home and attends to the elder’s personal needs.

Focusing on Home Care

Most elders require home care rather than home health care, so obtaining home care will be the focus of this article. Obtaining home care can be tricky. Obtaining the best possible results requires attention to:

  • Determining needs
  • Interviewing and selecting caregivers
  • Creating a written contract
  • Creating and following a care plan
  • Creating and following an activity log
  • Spelling out important contact and other information
  • Spelling out procedures for handling money
  • Creating an inventory of belongings
  • Supervision, communication and problem-solving
  • Employment law and Social Security
  • Insurance coverage

In this article, we’ll focus on two of the topics, determining needs and insurance coverage.

Determining Needs

How much care does your family member need? What kinds of care? By taking a needs inventory, you can assess how well the person functions in daily activities. You’ll evaluate how well the person does in bathing, dressing, grooming, using the toilet, eating, shopping, preparing meals, taking medication, managing money and doing housework. And assess memory and cognitive functioning.

How is an assessment done?

You can do one yourself with a tool like the Needs Inventory available from H.E.L.P., or a professional from a care agency or social services agency can do it for you. Be sure to get copies of any completed assessments.

What it can tell you

It can help show you what kind of assistance (and caregiver skill) is needed – by tabulating how well the person functions in each area. Home/personal care aides can assist with care such as bathing, dressing. A homemaker/chore-worker can help with shopping, meal preparation and housework. If your loved one has medical needs, such as injections or oxygen, a home health-care worker is needed. Or needs might be met through other services such as home-delivered meals and money management programs.

Insurance Coverage

Be sure to speak with your insurance professional. Include the following in your discussion:

Injury Insurance: Is the caregiver covered by Worker’s Compensation Insurance? If not, then the elder or family member may be liable for the caregiver’s job-related injuries. The elder or family member should not rely on Homeowner’s Insurance coverage, unless the insurance carrier has confirmed coverage for this risk. Many insurance companies have specific riders that can be added, to cover in-home caregivers.

Liability Insurance: Does the caregiver have adequate insurance coverage? If not, and the caregiver gets in a car accident in the course of running errands for the elder, then the elder may be held liable for the damages caused by the caregiver. Does the elder have sufficient liability coverage in case the caregiver is injured in the home due to non work related causes such as a broken step or faulty plumbing? Extra coverage beyond a homeowners policy can help to cover any liability.

Theft Insurance/Bonding: Is there adequate theft insurance (bond, professional or general liability)? If not, then the elder or family member should consider obtaining such coverage. In the unfortunate case of theft by a caregiver, adequate insurance coverage can help the elder recover financially.

Hiring a Care Manager

If you are not located near your family member, or you don’t have the time or the training to take on needs assessment, caregiver hiring and supervision, etc. – and you have the financial resources – consider hiring a professional geriatric care manager to help you. Call us at 310-533-1996 for a copy of our latest information sheet on hiring a care manager.