Question: My 88-year old mother needs a morning caregiver.  She requires help getting up in the morning, dressing, having breakfast, getting a little exercise and perhaps lunch.  We can’t afford a care facility and can’t bear the thought of her being in one again.  Where do we begin?       

Answer: Your mother is in the fastest growing segment of our society – the 85 plus group.  What a victory for longevity.  Yet this increased life expectancy is fraught with complexities.  One of those is staying at home in advancing years and needing care and support.

It sounds a though you have given thought to the important first step – what is needed.

Geriatrician Dr. Christine Himes and colleagues have published a comprehensive list of possible needs in their book Aging in Stride (Caresource 2004).  Consider the following needs in addition to the ones you have identified:

  • Transportation to and from the doctors’ offices, shopping, church or synagogue, etc.
  • Doing laundry and household chores.
  • Preparing nutritious meals.
  • Help with activities of daily living, such as dressing, bathing, grooming and mobility.
  • Yard work.
  • Minor home repairs, such as fixing a leaking faucet and changing light bulbs.
  • Organizing and paying bills.
  • A companion for company.

In reviewing the list, determine if a need is immediate or one that is anticipated.  Next, think about who can assist with that particular task.  Is it family, friends, senior service agencies, a paid helper or a volunteer?

The next usual question is “Where do I find a home helper?”   There are options.  You could hire someone directly or go through an agency.  Here are some advantages and disadvantages to both, as presented in Aging in Stride.

Going through an agency
•    Advantages: The agency takes responsibility to screen, train and supervise the caregivers.  If something goes wrong, such as the home helper is sick and cannot work, the agency provides a back up.  Also, the agency takes care of tax withholding and other responsibilities of being an employer.

•    Disadvantages: You likely will pay more, since the agency needs to cover its overhead. Turnover often occurs making it difficult for the older person to continually adjust to a new care provider.

Hiring someone directly
•    Advantages: The cost is likely to be less.  If the helper is good and you like the individual, a personal and consistent one-to-one relationship can be developed.

•    Disadvantages: You are responsible for screening and checking references.  You also are responsible for working out problems.  And, if the person you hire becomes your employee, you must meet the legal obligation of an employer, such as withholding and reporting income taxes and paying Social Security taxes.

Once you know what is needed, and you know the resources and budget, the next step is to make a selection. Himes suggests the following in evaluating candidates:

•    Ask good questions. Determine the person’s agency experience, their training, standards and pay expectations.

•    Check references.
Ask for names of other persons for whom the individual has worked.  Call the references and listen to them carefully.

Here are some questions to ask the reference: What is your relationship to the person I am seeking a reference for?  What services did that individual provide and over what period of time?  How would you describe the quality of his or her work?  Is the person reliable and on time, honest and respectful?  Would you hire that individual again?

Himes further suggests that once a caregiver is hired, it is time to manage the relationship.  Be clear about your mother’s needs and the scope and quality of work you expect.  As the home helper begins his or her work, provide clear and constructive feedback about how the individual is performing.  Also remember to tell the care provider what he or she is doing well and express appreciation.

We know that a significant proportion of older adults want to “age in place.” And 79 percent of boomers want the same, according to AARP.   The challenge you face will become an even greater one as boomers age.

Best wishes in finding the right person to assist your mother so she can live independently with the best support.

© Helen Dennis 2010, all rights reserved.

Question: My 88-year old mother needs a morning caregiver.  She requires help getting up in the morning, dressing, having breakfast, getting a little exercise and perhaps lunch.  We can’t afford a care facility and can’t bear the thought of her being in one again.  Where do we begin?       

Answer: Your mother is in the fastest growing segment of our society – the 85 plus group.  What a victory for longevity.  Yet this increased life expectancy is fraught with complexities.  One of those is staying at home in advancing years and needing care and support.

It sounds a though you have given thought to the important first step – what is needed.

Geriatrician Dr. Christine Himes and colleagues have published a comprehensive list of possible needs in their book Aging in Stride (Caresource 2004).  Consider the following needs in addition to the ones you have identified:

  • Transportation to and from the doctors’ offices, shopping, church or synagogue, etc.
  • Doing laundry and household chores.
  • Preparing nutritious meals.
  • Help with activities of daily living, such as dressing, bathing, grooming and mobility.
  • Yard work.
  • Minor home repairs, such as fixing a leaking faucet and changing light bulbs.
  • Organizing and paying bills.
  • A companion for company.

In reviewing the list, determine if a need is immediate or one that is anticipated.  Next, think about who can assist with that particular task.  Is it family, friends, senior service agencies, a paid helper or a volunteer?

The next usual question is “Where do I find a home helper?”   There are options.  You could hire someone directly or go through an agency.  Here are some advantages and disadvantages to both, as presented in Aging in Stride.

Going through an agency
•    Advantages: The agency takes responsibility to screen, train and supervise the caregivers.  If something goes wrong, such as the home helper is sick and cannot work, the agency provides a back up.  Also, the agency takes care of tax withholding and other responsibilities of being an employer.

•    Disadvantages: You likely will pay more, since the agency needs to cover its overhead. Turnover often occurs making it difficult for the older person to continually adjust to a new care provider.

Hiring someone directly
•    Advantages: The cost is likely to be less.  If the helper is good and you like the individual, a personal and consistent one-to-one relationship can be developed.

•    Disadvantages: You are responsible for screening and checking references.  You also are responsible for working out problems.  And, if the person you hire becomes your employee, you must meet the legal obligation of an employer, such as withholding and reporting income taxes and paying Social Security taxes.

Once you know what is needed, and you know the resources and budget, the next step is to make a selection. Himes suggests the following in evaluating candidates:

•    Ask good questions. Determine the person’s agency experience, their training, standards and pay expectations.

•    Check references.
Ask for names of other persons for whom the individual has worked.  Call the references and listen to them carefully.

Here are some questions to ask the reference: What is your relationship to the person I am seeking a reference for?  What services did that individual provide and over what period of time?  How would you describe the quality of his or her work?  Is the person reliable and on time, honest and respectful?  Would you hire that individual again?

Himes further suggests that once a caregiver is hired, it is time to manage the relationship.  Be clear about your mother’s needs and the scope and quality of work you expect.  As the home helper begins his or her work, provide clear and constructive feedback about how the individual is performing.  Also remember to tell the care provider what he or she is doing well and express appreciation.

We know that a significant proportion of older adults want to “age in place.” And 79 percent of boomers want the same, according to AARP.   The challenge you face will become an even greater one as boomers age.

Best wishes in finding the right person to assist your mother so she can live independently with the best support.

© Helen Dennis 2010, all rights reserved.