Savvy Senior
How to Find a Good Home-Care Aide
By
Feb 28, 2008 - 12:25:06 PM

Dear Savvy Senior
What’s the best way to find a good home-care aide to help my elderly mother?
--Worn Out

Dear Worn,
According to the Centers for Disease Control and Prevention, around 1.4 million Americans require the help of a paid caregiver each year. But finding good home-care can be a real challenge. Here are some tips that can help.

Know Your Needs
The first step to take before hiring someone is to determine the level of help your mother will need. If she is ill or needs health care services, there are registered nurses who can manage medical conditions and administer medications. At the next level are nursing aides who have training in first aid and in helping patients bathe, go to the bathroom and transfer from bed to a wheelchair. And for those who don’t need skilled assistance, there are companions and homemakers who can handle household chores.

Once you settle on a level of care, decide how many hours of assistance she’ll need. Does your mom need someone to come in just a few mornings a week to help her cook, clean, run errands or perhaps bathe? If mom needs constant care, you can hire aides to work eight or 12-hour shifts or hire a live-in aide.

Finding Home-Care
Once you figure out your mother’s needs, there are three ways in which you can go about hiring a home-care aide. Through a:  

• Home health agency: This is the easiest but most expensive option. Certified home health agencies provide and manage all levels of home-care with their trained employees. You pay the agency, and they handle everything including an assessment of your mom’s needs, assigning appropriate staff, finding a fill-in on days your aide cannot come and more. In many cities, the going rate is around $20 an hour for a certified aide. A registered nurse will likely cost twice as much. Medicare may cover services provided by an approved agency but guidelines are strict and the coverage is limited. To locate and compare agencies visit www.medicare.gov/hhcompare or call 800-633-4227.

• Nursing registry: These are private employment agencies that also provide various levels of care. Registries are usually more affordable than home health agencies because you are taking on the responsibility of supervising and managing the aide. You pay the worker directly. The registry will provide backup in the event that the assigned worker is unavailable. Optimally, the agency and its employees should be bonded. To find a registry check your yellow pages under “nurse registries.”

• Gray market: The least expensive way to find home-care is to hire an aide on your own. You may find one through a friend, newspaper ad or an online service such as www.craigslist.org. The problem with this method is that you become the employer so there’s no agency support to fall back on if a problem occurs or if the aide doesn’t show up. You are also responsible for negotiating their fee (expect to pay about $10 to $12 an hour), paying payroll taxes and any worker-related injuries that may happen. If you choose this option make sure you check the aide’s references thoroughly, and do a criminal background check.

What to Ask
If you opt for a home health agency or registry it’s wise to call several providers and ask many questions: How long have you been in business? Are you insured? How do you handle complaints? How do you screen your employees and what kind of training do they have? Most important, you’ll want to learn all you can about the individual aide you are getting.

Before choosing an aide (whether it’s through an agency, registry or on your own), conduct an in-home interview. Ask the aide about their experience. If your mom has dementia or other special needs, see if the aide has cared for such patients before. Find out if the agency or aide has malpractice insurance. Who will cover if the aide is out sick or takes a few days off?

And after you hire someone, it’s a good idea to prepare a daily schedule of duties so your expectations are clear, and visit frequent and at irregular times to keep an eye on things.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.



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