What does the term “Aging in Place” mean?
The CDC (Center for Disease Control) defines aging in place as “the ability to live in one’s own home and community safely, comfortably, regardless of age or income.
Most seniors would prefer to age in place, that is, to remain in their home as long as possible. It has been reported that 90% of adults over the age of 65 say that they would prefer to stay in their current residence as they age. To take it one step further, one-third of American households are home to residents 60 years of age and older. With people living longer, which is a good thing, this will surely grow.
The over-65 population will nearly triple by 2030 as a result of the aging Baby Boomers. The first Boomers will have turned 65 in 2011. This is good news, as more people will have the opportunity to be active and enjoy their later years.
- Statistics show that the over-65 population will unfortunately be managing more than one chronic condition.
- Diabetes will affect 1 out of every 4 people
- Arthritis will afflict over half this population
- Obesity will afflict one third of this population
- Heart Disease,Cancer,and Hypertension are also on the rise
Based on the preferences of seniors to age in place, coupled by increasing medical needs, the Home Health Agency model is the go-to place to insure your loved ones will receive the proper care to remain comfortably and safely in their own homes.
If you are recovering from an injury, have a chronic illness or just need companionship care, home health care is the way to go.
The demand for home healthcare workers is soaring due to the fact that people’s preference is to remain in their home.
There are many questions regarding home health care,and for individuals and families, it is an overwhelming and daunting process to secure the proper information and most importantly, know the proper questions to ask.
To help you get these answers and to gather the information so that you can make an educated decision, the below will give you some insight.
Picking the right Home Health Care Agency is critical in providing your loved ones the proper care and receive quality assistance.
Home health Care Agencies can provide the following services:
- Bathing/Showering assistance
- Assistance with ambulation/walking
- Toileting assistance
- Dressing and personal hygiene
- Meal planning and preparation
- Medication reminders and management
- Safety and Fall prevention
- Incontinence care
- Transportation services
- Scheduling Doctor’s appointments
as well as other additional services
Requirements for home health care agencies differ by state so it is important to ask the following questions of the agency:
- Is the agency licensed, bonded and insured? Most states require agencies to be licensed and are reviewed regularly
- Does the agency have a Director of Nursing on staff to supervise the clients care plan as well as the caregiver(s) assigned to a specific client?
- What type of employee screening is done?
- How does the agency train, supervise and monitor it’s caregivers?
- Can the agency provide references (either from clients or other healthcare professionals who have dealt with this agency)?
- How involved are the owners? Do they go above and beyond in helping their clients?
- How does the agency handle expenses and billing? Get detailed explanations of all costs and fees associated with home care.
- Does the agency take LTC ( long term care insurance) or Workingman’s Compensation?
- Does the agency work with partners that may be able to provide some financial assistance?
- Does the agency partner with other healthcare referral partners to help offer complete care?
Will the agency’s RN come out to do a clinical assessment?
An assessment is the personal, medical,family, physician information that the RN will gather to understand the client’s situation and specific needs.
Will the agency provide a POC (Plan of Care) before services begin and can family members be involved in putting it together?
The POC is the document that all the caregivers must follow on a daily basis for the ADL’s (activities of daily living) that they must follow so the client will be taken care of in a safe and healthy manner.
How often will the RN do follow up visits?
Each state varies but the RN’s are required to do regular follow ups to make sure both the client as well as the caregiver are safe/happy. Also, the clients needs will change over time and the follow up visits allows the RN to note these changes and to amend the POC if necessary.
Will you receive a list of the “Clients Rights and Responsibilities?”
All clients have certain rights and responsibilities and they should be made aware of these.
Will the agency refer you to other specialists if needed?
Specialists can be doctors as well as other home health care professionals and referral partners who work in conjunction with the agency to insure the proper care, regardless if it outside of the scope of what their caregivers can do.
Will the agency work with you or your loved one, family members and health providers?
Yes, an agency will work with all parties to keep everyone informed and to coordinate the proper care
What hours and days will care be provided? If necessary, is round-the-clock live-in care available?
Most agencies will provide hourly, overnight, weekend, live-in, respite care to their clients.
What procedures does the agency have in place for emergencies?
Emergencies are not just related to an incident in the home but are for storms, floods, power outages etc and procedures need to put in place in case any of these situations arise.
How does the agency resolve and address any issues?
The agency and their RN are in constant contact with the caregiver, family members, and client and are there at all times to address any issues or concerns.
How soon can the agency properly staff a case and start care?
This is important to know as many times families will need a caregiver in an emergency situation or their loved one might be discharged from a facility sooner than they anticipated. Any reliable agency should be able to staff a case with 24 hours notice.
Will the same caregivers taking care of your loved one or will they be utilizing different caregivers?
Most clients prefer to have the same caregiver(s) take care of their loved ones and in the majority of the cases. This is done. The only time where it is difficult is on a short hour case and these cases in general require different caregivers.
Is there a minimum of hours needed for service?
This varies by agency
What are the costs of services and how are the prices determined?
There are 3 factors that determine prices: 1- Location 2- Skill Set required 3- Hours and Days of Service. Hourly rates will differ from Live-in rates.
Is there a deposit required?
Most agencies require a 1 week deposit that is refundable when services are ended.
How often will the agency bill for their services?
It differs by agency but usually on a weekly basis.
Will the agency bill my LTC insurance company directly?
Yes. They will send all invoices, caregiver timesheets and progress notes directly to the LTC company.
Who owns the agency and for how many years?
Can you reach the agency in evenings and weekends?
Any reliable agency will have staff on call 24/7 as well as having their RN on call as well.
What is the contractual policy in regards to terminating services?
This differs by agency and should be in their client service agreement.
Will there be a HIPAA form in place?
What are the holiday and overtime rates?
The Holiday rates vary by Agency but overtime would be 1 1/2 the hourly rate for any caregiver working over 40 hours per week.
Can the caregivers drive the clients in their vehicle or the clients vehicle?
This varies by agency but an agency who has proper insurance coverage in place will allow the caregiver to drive either their car or the clients car.
Can the family interview the caregivers?
Yes, the family can usually interview the prospective caregiver prior to commencing services depending on the nature of the case.
Are the caregivers employees of the agency?
Legally, all caregivers must be employees of the agency and cannot be contractors. This is an important question when speaking to a home health agency and if they are not employees of the agency, you should not utilize their services.
Are the caregivers bonded as well?
For most professional agencies, this is the case.
Can a different caregiver be requested if the client is unhappy with the caregiver the agency provided?
Absolutely. The client always can request another caregiver as they ultimately must be comfortable with the caregiver who is providing the care.
How many caregivers does the agency employ?
This varies based on the areas they service and the number of clients they have.
Does the agency provide literature explaining it’s services?
Any professional agency should have literature to provide to the client.
Does the agency do a home safety evaluation?
Yes. This is done during the RN’s assessment.
How does the agency document the tasks that the caregiver is supposed to provide?
This is done by the caregiver filling out on a weekly basis their timesheets and progress notes which the family can review and sign.
How to find home health care agencies
There are many resources available to clients and their families in finding a home health care agency to speak with.
Some of these resources are:
- Assisting Hands Home Care
- Jewish Family Services
Other resources would be:
- GCM’s (Geriatric Care Managers)
- Elder-Care Attorney’s
- Sub-Acute/Rehabilitation Centers
- Senior Centers
- Veterans Administration
- Long Term Care Insurance companies
- Wellness Advocates
- Places of Worship
- Social Service Agencies
Of course, the best referral would be from someone who has utilized a home health care agency and was happy with the services they provided.