Your Real-World Guide To Finding A Home Care Provider
Preparation Results In Success
Let’s Define Home Care
Medicare Home Health Agency – Generally ordered by a Physician. Paid by Medicare. Schedules are usually based on 2 hour visits.
Private Duty Homecare – Generally paid out of pocket. Schedules can be a few hours a day up to 24 hours per day. Also paid by Long Term Care Insurance if applicable.
Create Your List
POSSIBLE PROVIDER’S TO CALL
Now that you know what type of company to call, you’ll want to create a list of providers in your area that provide service. If you do not have a starting point for who to call, reach out to the social workers at a respected long term care facility in your area. They will give you a few names to start. In addition to the social worker referrals, do a Google search for providers as well. If thinking of hiring a ‘private’ caregiver, read some ideas here.
Now take that list and narrow it down to 3 or 4 names. This will give you an adequate starting point. One additional step you can do now quite quickly and easily is visit the Better Business Bureau website in your area and run the names on your list. If they are a member, this is an added element of professionalism. (In my opinion) Also important to note their score with the bureau.
Make sure at this point, if you are not using our free Homecare Research document, to have a notebook available for adequate note-taking space.
LET’S MAKE SOME CALLS
A GENERAL GUIDE FOR QUESTIONS TO ASK
- Responsive? – Did you get a live person on your first call? If you had to leave a message for a callback, how long did it take for the return call to come? Note this. It can be a good indication of overall responsiveness.
- Knowledgeable? How does the representative respond to your questions? This person should be knowledgeable and honest. If you get the sense they are making answers up…move on.
- Company Overview – Have them start by telling you a bit about their company. Take notes on anything they mention that you may want additional information on later.
- Are They licensed? – If using a Long Term Care Policy to pay, this can be an important issue. Check our Guide For Long Term Care Insurance for things to look for.
- Nurse On Staff? – Important for some people, not so much for others. Good information to know regardless. Medications involved? Check out our discussion here.
- Contract Or No Contract? – Most company’s do not lock you in to a contract when starting services. Home care needs can change; being committed to a ‘contract’ is not very appealing.
- Employees – Are they contracted staff or does the company employ them directly? If a caregiver gets hurt while working, who is responsible? This can be a VERY important issue for some.
- Size Of Staff – The answer here does not need to be a specific number. What you are looking for is the peace of mind that if your caregiver calls off for the shift, is there enough staff for a replacement to be sent?
- Current Testimonials? – Are they able to provide you with current or recent client testimonials? One answer acceptable here: YES. If not, move on.
- Last For A Reason! – How much does it cost? The only thing that is important here is the fact that they are in-line with other provider’s in the area. DO NOT shop home care based on price.
THE NEXT STEP
WHAT YOU SHOULD EXPECT FROM THE HOME-VISIT
Your initial questions have been answered on the phone. The next step: ‘The Home Visit.’ This will usually be done at the home of your loved one who will be receiving care but is also done at times in the hospital before being discharged.
This is when the company will send out their representative(s) to meet with you, your loved-one, and whomever else you would like to be present.
If an ‘assessment’ needs to be done on the person receiving the care, this will oftentimes be done at this time as well. Generally speaking the assessment is done by a nurse and is more of a high-level evaluation to determine the level of care that will be required.
One thing to note, if using Long Term Care Insurance, an assessment is usually required to start services.
At this time, assuming you are wanting to move forward and start care with this company, paperwork will be completed. Depending on the state you live in, the amount of paperwork may vary.
A general service agreement will lay out the terms such as bill rate, hourly minimums, deposit, mileage reimbursement, etc. This usually is not locking you into a certain period that you must utilize a company. It is normally just a document stating the specifics of how their company operates and what you agree to.
A couple things to note regarding home-visits.
- If you are not comfortable with the company for any reason, look for a different provider. Thank them for coming and tell them you will be in touch.
- If you have agreed to start service, generally speaking a deposit will be collected. A common deposit is 2 weeks of service based on the average hours you will be using. So a 20 hour week, would result in a 40 hour deposit being held on file.
If all goes well with the home-visit, congratulations! You are ready to start services!
Today’s The Day
What To Expect From Day 1 And Beyond
- Day 1 – The caregiver’s name has been given to you and they are supposed to be at Dad’s house at 8am. You decide to go over and introduce yourself and make sure it gets off to a good start.
- Recommendation: If it is not necessary for you to be there on day 1, do not be. Go on day 2. Dad will be fine. Let the caregiver and your father adjust on their own. This allows for the caregiver to be more comfortable and not feel as though someone is looking over their shoulder.
- The caregiver’s are used to knocking on the door of stranger’s and introducing themselves for home care. Just have any notes you want the caregiver to be aware of in the home and make the office aware as well if you choose to. You want things to get off to a good start on day 1.
- Day 2 – You arrive early to look around and see how day 1 had gone. You notice most things that had been requested were completed but you do notice that the trash was not taken out! This is unacceptable! STOP! If that’s the only thing that was overlooked and it was only the first day, relax. Do not ‘look’ for issues that didn’t go as planned. Look for the positives. If a certain task continues to get ignored, of course you will want to address it. It probably isn’t necessary after the very first shift.
- It’s 8:10 and the caregiver arrives. They were supposed to be there at 8:00! Do you say something? No. It’s only the second day. Trust me when I say this, because it comes from experience. The first week of receiving home care services is the most challenging. If something can go wrong, assume it will. It’s Murphy’s Law. Again, if a pattern forms, you’ll address it. Just not yet.
- You introduce yourself to the caregiver and they seem like a very nice person. Keep in mind they will be nervous meeting you for the first time. Just give your relationship, as well as your Dad’s, time to develop. You’re not looking for a new best friend. You are looking for a trusted individual to take care of your Dad.
‘Family is not an important thing. It’s everything.’—Michael J. Fox
Just a tip from years of experience, home care is about maintaining Mom or Dad’s independence. The more that you stay at a distance, the more smoothly things may run. They’ve made it this far on their own, give them the space they deserve. Check our Real World Blog out for various home care situations explained.
- Day 7 – Wow, you’re one week in already and things are moving along. You have done a good job of giving the relationship time to develop but there are a few things that are really starting to bother you. That is perfectly normal. Here are a couple notes:
- How is Dad doing with the caregiver? If he is getting along nicely with them, that is the most important thing to keep in mind.
- You are paying for a service, so you have every right to voice your concerns at this point. You just want to make sure to do it in the best manner. If the relationship is good, tread cautiously with your feedback. If the relationship isn’t all that strong, you can be a little more demanding in your tone.
- Depending on your relationship with the caregiver, I would suggest calling the office and sharing your concerns first. Let them pass the information on to their employee. This way you keep a distance and confrontation is avoided. Keep in mind, caregivers are used to getting feedback on things that may need to be addressed. They will not think twice about it when the office tells them a few things to focus on.
- If you have what you consider a good relationship, pass the feedback on directly if you want to. They’ll understand. Just be tactful on how you present your concerns and don’t forget to mention the positives as well.
- Day 14 – Two weeks in now; how time flies! Here’s the thing, you have shared your concerns on things that need attention and they are just not being addressed. It’s time for a change. If it is has been with one caregiver specifically, call the office and ask for a new caregiver to be assigned. Dad will have to adjust to a new person but that’s okay. He probably wasn’t getting the best care he deserved to begin with.
- A couple things to keep in mind here. First, if multiple caregivers have been involved and things are not being addressed, the office is probably at fault just as much as the caregivers. You may want to consider finding a different agency at this point.
- If it’s a specific caregiver and they have a solid relationship with Dad, it’s your call. You may or may not want to request a new caregiver. Home care is about the relationship first and foremost, you must ask yourself if the issues are severe enough to want to change.
TIPS TO KEEP THINGS RUNNING SMOOTHLY
Congratulations, you have made it through the most challenging part of home care and things seem to be going well! Here are 5 tips to keep in mind as you continue to use your home care provider.
- Make sure you are holding the caregiver and company accountable. If little things are not being done that at one time were, have a talk with the caregiver. It is not uncommon for the caregiver to get comfortable with the situation and start to slack. The relationship is the most important thing, however, the little things need to be done as well.
- Be sure to get continual updates from the caregiver. Again, the more comfortable they get with a family, they may not communicate the little details. This is important; make sure they are communicating thoroughly.
- No friends or family along for the shift. I realize this should go without saying. If a caregiver thinks it is okay to bring their child along to work for example, you need to call the office immediately and make them aware. This is not acceptable. Too much risk.
- Do not give personal gifts to employees. (At least make the office aware if you do.) It seems innocent enough, they have become like family. Just make sure the office is aware. Different company’s will have different policies on this.
- The caregiver is not calling the shots. It is not uncommon with a long-term caregiver where they start to think they are in charge. ALWAYS defer to the office and what is the best way to address this. You, the client, are in charge. Just because they have been with you a long time, it does not make them an expert. The office will assist when necessary.
TIME TO PART COMPANY
ENDING SERVICE WITH YOUR HOME CARE COMPANY
Every good (hopefully) relationship has to come to an end. Home care is no exception. If you have had a good experience with a caregiver or multiple caregiver’s it can be difficult to say goodbye. If the experience has been not so pleasant, then saying goodbye is more like good riddance!
A few things to keep in mind when discontinuing service with a provider.
- Give as much notice as possible. (It’s the polite thing to do!)
- Do any of the caregiver’s have personal belongings at the home? It is not uncommon, especially on 24 hour care, for staff to leave things at the house. If there is, you will want to make arrangements for the office to come pick it up.
- Care notes may be in the house as well. The office will need to pick those up in order to close out your file when service comes to an end.
- Did you pay a deposit when you started service? Generally speaking, billing runs about 2 weeks behind the actual service date. You should expect your deposit to be returned to you (assuming your account is current) within 2-3 weeks of service ending.
- You may want to send a thank-you card to your caregiver(s) after everything is settled. It is not uncommon for caregiver / client relationships to become quite close. Just a simple note can really make a difference.
Caregiver’s are special people. They have a tough job. I understand you probably had challenges with them at different times. The important thing to consider is ‘would I use them again if needed?’ This is important.
If you would, please keep in mind to drop just a quick letter of recommendation in the mail when all is said and done. It goes a long way in helping the next person who is in need of finding a reliable service provider.
Your Real-World Guide To Finding A Homecare Provider
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