Thousands of families across the country are faced with decisions about finding care for a parent or loved one. These decisions may include whether to hire an agency to come into the home of a parent or loved one to provide care or services.  The decision to hire home care is largely based on a parent or loved one’s needs and circumstances, as well as anyone is may currently be providing care for them.  The need may arise from an injury, hospitalization, illness, or simply the effects of aging.  In any case, families deciding to hire a caregiver to provide services in the home of a parent or loved one experience concern and very often fear about doing so.  Putting fears to rest can generally be accomplished by asking a lot of questions.  And then asking more questions.  Here are the top concerns about hiring home care for your parent or loved one, as well as some suggestions about how to address those concerns.

1. How can I trust the person being sent to care for my parent or loved one?

This is number one on our list, and it is a difficult question.  The key is choosing an agency that is reputable and trustworthy and it is the first step to gaining trust.  Do your homework.  Licensed agencies generally go through a rigorous licensing process. Make sure the agency you are considering is licensed, as well as bonded and insured. Many states, including Minnesota, conduct “surveys” of agencies to make sure that they are providing quality care and are compliant with licensing laws.  Copies of survey results in Minnesota are available online at the Minnesota Department of Health.

Reputable agencies conduct thorough background checks for employees.  While no agency can guarantee that a care provider is perfect, the more rigorous the agency’s screening process, the more likely it is that agency’s employees are trustworthy.

Be sure you don’t write off companies that have just opened their doors.  There will be a number of these in the coming years as the numbers of individuals needing services continues to grow.  It is worth your time to meet with them.  Their first clients are often on the receiving end of a high level of care simply because the company needs to establish credibility, a good reputation, and is working toward growth.  New agencies may also work harder to gain your trust, a win-win for the clients and the company.

2. What happens if my parent or loved one doesn’t like the caregiver assigned to them?

Trust your instincts and speak up!  We cannot stress enough how important it is that you and your loved one recognize you have rights.  Never lose sight of the fact that you are the “employer” in this situation and absolutely have the right to request a substitute provider.  Communication with the agency’s management is critical to assuring your loved one is comfortable with a caregiver.  Contact the care manager or the office for the company providing care.  You are not required to give a lengthy explanation in order to obtain a substitute caregiver.  It is enough to say that you or your loved one do not feel the current provider is a good fit.  Your agency should happily provide a substitute.  It is very common in home care to switch caregivers.

Companies that provide home care make every effort to match clients and caregivers in a way that works for both the client and the caregiver.  If you or your loved one have any reservations at all, contact a manager.  If your provider agency does not have an employee they can substitute, ask questions about whether they anticipate new hires.  A lack of employees is common in smaller towns or communities where the pool for employees is much smaller.  If no substitute is available and the company does not anticipate new hires, it may be time to look at other companies near you.

3. Shouldn’t I just take care of my parent or loved one myself?

This is definitely an option.  Family caregiving is much more manageable when there are multiple family members to share the responsibility.  When it is one or two people, it can be exhausting both physically and financially.   A decision about whether the family should provide care or whether care should be provided by an agency will often depend on your loved one’s needs and preferences.  It should also take into account the toll it takes on family members, as well as the economic realities of hiring care.  While you may feel a great sense of obligation, this should not be the only consideration.  Long term, it can have effects on your stress levels and ultimately your health, as well as your finances.

If your loved one has the resources to hire private care, the responsibility for ongoing care is shouldered by the caregiver agency, leaving family members and friends free to simply enjoy the time they spend with a loved one rather than making each visit a “working visit.”  It also frees up family members to provide care that a home care agency does not provide.

4. How can I monitor the way my parent or loved one is being treated?
   

There are many ways to assure your loved one is being treated respectfully and with dignity.  Communication with your loved one is a key component for monitoring care, as is communication with the care provider.  Speak with your parent or loved one after each caregiver visit or at least regularly and ask questions.  Asking open-ended questions generates more information than questions which lead to a “yes” or “no” response.  Ask about how time is spent together or what your loved one talks about with a caregiver.  Ask questions about your loved one’s feelings when the caregiver is in the home. Keep track of the information you receive so that you have a record of it.

You should also consult with the agency providing care.  The agency and its caregivers must keep a record of the care and services provided to your loved one.  These are often referred to as “care notes.”  Find out how you can obtain access to the notes, and make a request for a report from the agency.  They should be more than willing to provide this to you.  In addition, you can ask for information about how caregiver performance is monitored by the agency and how the caregiver communicates with the agency supervisor.  If you are still feeling uneasy or unsettled, you can always make unannounced visits to the home of your parent or loved one during the times that care and services are scheduled.  Observe the interaction and pay attention to what is happening during the visit.  If the television is on and your parent or loved one does not watch TV, for example, ask questions.  If anything strikes you as “off” contact the manager and discuss it.  Communication and observation is the best way to assure that your parent or loved one is being treated well.

5. Will my parent or loved one lose their independence?

The quick answer is: maybe.  The difficulty in addressing a question like this is that the level of care and types or service your parent or loved one will receive is typically based entirely on their needs and wants.  In Minnesota, the Department of Health requires home care agencies to conduct an individualized review of a client’s needs and preferences, taking into account and assessing any areas of vulnerability, as well as their level of ability, physical health and mental health.  Concerned family members or friends often participate in the process of arranging in-home care, working with the provider agency and their parent or loved one to determine the specific services that will be provided.  An individualized review or needs assessment is supposed to be a person-centered decision-making process.  In other words, the focus is and should be on your parent or loved one.  The services provided then, should be centered around tasks that your parent or loved one can or cannot do on their own, or tasks that they can substantially do on their own but often need assistance.  They may also include tasks that your parent or loved one would prefer to have someone else do, such as laundry or housekeeping.

That being said, you can protect your parent or loved one from being deprived of their independence or sense of independence by discussing the policies and philosophy of the home care agency as it relates to independence.  CareAparent, for example, has a clearly stated mission to assist clients in remaining as independent as possible for as long as possible.  Our caregivers are trained to be vigilant about assisting our clients in ways that specifically contemplate the client’s desire to remain independent while compassionately providing the care the client may actually need.  Ask your provider about their policies and how the agency employees are trained.

You should also be alert to the personality types that the agency is planning to or has assigned as a caregiver for your parent or loved one.  Is the caregiver too bossy?  Does the caregiver try to do everything without leaving room for your parent or loved one to act on their own? Is the caregiver making decisions during the course of care that should be made by your parent or loved one?  Talk to your parent or loved one. Find out about the dynamic between them and the caregiver.  Ask questions.  And if there is any issue or concern, speak to the caregiver’s supervisor to have the situation corrected or have a different caregiver assigned.

© 2015 CareAparent™

All rights reserved.  No part or portion of this article can be reprinted without the express written permission of the CareAparent.™

Lisa McLeod Lofquist is an attorney in St. Paul, Minnesota and co-founder of CareAparent™, a home care agency for seniors.  Contact Lisa by email at lisa.lofquist@careAparent.com