Is In-Home Care Best for Your Aging Loved One? Key Questions to Ask
I often get calls for advice on home care and quite often it can be a very good interim situation. For some, in-home care can be ideal for the long term. Here are some questions to ask yourself when considering in-home care versus moving your loved one to a full-time care setting.
#1. Is the home set up safely for in-home care of your loved one?
By this, the most important question, I mean, is there adequate lighting, one-level living, and a bathroom set up with room to allow for assistance with toileting and bathing? Are hallways wide enough to get a walker or wheelchair through, and is the home safe, free of fire hazards, free of pests and fairly free of clutter that can impair the ability to provide care?
For someone who has lived in their own home for decades, without keeping it up properly, you must think about how a stranger will feel inside. Is the home pleasant and inviting for a caregiver to spend extended time in? Or, are there incontinent pets, pet waste or strong odors such as cigarette smoke in the home? If yes, you will struggle to keep good help which can be very stressful.
#2. Is your loved one “on-board” with having a caregiver come in?
In the case of my father, he was not welcoming to the caregiver, even though the person was there to help my mother, NOT him. My mother was bedbound and he simply could not care for her, yet he "ruled the roost" and fired a very kind and loving caregiver, forcing my mom to a skilled nursing care center, against all of our wishes. So, make sure your loved one who needs care and his/her partner (if there is one) are both in favor of the situation and willing to cooperate with a caregiver visiting and performing the needed tasks.
#3: Does full-time home care make financial sense?
Part-time care is usually affordable and can be a lot less expensive than moving to full-time home care. Sometimes just weekly visits for bathing and some light housekeeping is all that is needed. Perhaps you have a family member that can fill in a lot of the time, and hired help can visit a few hours daily to a few days weekly, to keep costs down. If full-time care is needed, the cost over the long haul may be prohibitive, and in this case, moving to an adult family home will be more economical.
Not everyone has to be concerned about cost, but most are. A good use of full-time care may be as an interim solution while you are searching for the ideal adult family home or if you are on a waitlist for your chosen one. It can also be helpful for short-term hospice situations. Full-time in-home care can run $20,000 to $30,000 per month in the King County area. Of course, there are inventive arrangements that can be made, such as a discount for a live-in caregiver. However, if the caregivers work in shifts (12 hours is typical) and they must remain awake overnight, the cost will be in the $20k - $30k/mo range.
#4: Should I hire a home care agency or an independent caregiver, like a friend or acquaintance?
When you go through a home care agency, you will be assured your caregiver is a Certified Nursing Assistant (CNA) or Home Care Aid Certified (HM) with a current state license. They will have a background check done through the state and they will have had training in CPR & first aid. They will also know good body mechanics to safely move, turn and transfer your loved one from bed to chair. Typically, the home care agency will have an RN do a nursing assessment and care plan to specifically outline the care needs of each client. The home care agency will handle all of the taxes and scheduling and will always make sure you have care when it is needed. The home care agency is also (or should be) licensed and bonded. If the agency provides you with a caregiver that is not a good fit, you can work with the agency to find a better fit. If you hire someone independently, you will need to take on all of those responsibilities yourself and this can be daunting to many people.
What I find in the ideal home care situation is that the primary caregivers become “part of the family” and grow quite close to those they are caring for. It often is a very nice way to allow your loved one to remain in their own home, maybe with a beloved pet, or dear neighbors that they don’t want to leave. In-home care can work very well, and it is an option if the home is set up for aging in place.
If you think in-home care is the right next step for your needs, I can recommend the following services. If you end up using either of them, please be sure and mention that Calm Harbor Placements referred you!
Family Best Care - offering home care services to help your loved ones rediscover a higher quality of life in the greater Seattle Area.
Elder Care Retreat - providing respectful, in-home hygiene and grooming visits for elderly clients who just need that little bit of support
Still unsure whether in-home care is the best fit? I’m always happy to help you evaluate the options—including adult family homes, assisted living, and home care services. Don’t hesitate to call or contact me if you have more questions or want personalized guidance.
