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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
Share a few details and we will match you to trusted home care in your area:
Yes ask the PCP for a social worker or therapist to help them navigate elder services and the doctor can write a script for a VNA Nurse , Physical therapist which is helpful . Elder services can get a grocery shopper, house cleaner and a CNA to help Bathe if needed and Look into meal On Wheels,
Be careful about agencies and their costs. Mine charged by the minute and some caregivers clocked out at will costing me more. One even discussed what she was baking for Christmas and what she needed at the grocery store. I was charged that time. I was told by Hospice that there are private caregivers that cost a lot less than the $33/hour that I was paying. Maybe just talking to a kind person through Hospice. I know you do not need that now. Good luck! I am sure there is someone our there for you. Oh, another word of advice. Any contracted worker from an agency that you like cannot work for you outside that agency for a year. They have you sign this policy.
If they have long term care health insurance or Medicaid that insurance may help to pay for home health care, Medicare does not pay for these services unless it is under palliative care or hospice or the patient is housebound. It is out of pocket without the above circumstances. Figure out how often and for how many hours you would like the care for, what they need help with etc., contact a local aging agency and they should have names of places for caregivers. I just went through this with my Mom and unfortunately with no insurance coverage we were unable to afford it, in my area it was going to cost over $400.00 per week for just 9 hours per week and that was just the minimum pay. I wish you luck.
Doctors rarely grasp the family impact and social aspect of caregiving. they need to be be and usually are more focused on medical stability. Some doctors are still unaware that Medicare will reimburse them for reviewing Advanced Directives! ******************************************************************************** Ask a SW, Case manager or geriatric care mgr (see Aging Life Care Association Home) and find a local aging life care professional in your zip by following prompts on the ALCA website! Start wring down important details before you set out to find either a private in-home caregiver or an agency caregiver and distinguish the difference between the two such as cost, continuity of care and what to expect! What sort of "care" do you think they need? ADL's (activities of dly living; bathing, drsg, toileting, etc) IADL's (cognitive decision making such as grocer items, budgeting, etc.) How many days/hours? Hourly fee you are willing to pay? Is family members taking any part; nights/weekends? What are your short/long terms goals? Are loved ones "aging in place" Are benefit programs involved such as Medicaid, VA, etc.?
Early on, people may need rather simple non-personal care. You need to do some evaluation of their situation. Do they just need weekly housecleaning, lawn service, and snow clearing? For you to schedule home maintenance services like gutter cleaning and window washing? A neighborhood teen who will move their garbage cans out to the curb? Sometimes just relieving an older person of these strenuous tasks gives them the energy to keep taking care of themselves. Can they get out to the local senior center for lunches with other seniors? I'd start the conversation with household services, they may be more receptive. Then you can talk about aides. Suggesting someone to help changed the sheets and do the laundry once a week goes over well. Then segue into personal care.
Agree with everything you recommended. My parents lived two hours away and my sister looked after them. Dad used a walker and my mom had several strokes and got dialysis. Unfortunately after my sister suddenly passed away, they still needed help (they couldn't drive anymore but still had their car), so I heard about Care.com and hired a wonderful woman, who was able to do what they needed: light housekeeping, simple meal prep, showers and doctor appts. Until they both passed, we had four great ladies who took great care of them in their own home. FYI, the first woman insisted on a contract showing duties, hours and hourly payment amount, and created a timesheet so there were no questions. She was so organized with the paperwork that we insisted on this for her successors.
They need to have money. Just calculated on another post that to have round the clock care it cost almost $174k a year paying an aide $20 an hour. You will not get enough hours from Medicaid, Office of Aging much more than a few hours a day. Medicare only pays for in home when ordered by a doctor and thats temporary and only a couple of hoursva day. There is intermittent care, that a member has used, that Medicare will supply but I don't think thats too many hours.
If your in-laws have any assets, maybe a nice Assisted Living. If they own a home, it can be sold to pay for it. Office of Aging is a good place to start. They can evaluate the situation and help u find resourses.
They need cognitive & memory testing by their primary doc. They need to be assessed to see how many of their ADLs they can actually do. This can be through social services for their county, or an interview with a caregiving agency.
You will need to know who has the legal authority to make any decisions for them.
Do your inlaws have diagnosed cognitive impairment?
Do either of the have an assigned PoA for both medical & financial?
Do they see their need for care? If so, are they willing to cooperate & accept it?
If they have cognitive capacity then they get to decide about their care. If they want more care they have to be willing & able to pay for it.
If either of them has cognitive impairment, even if they have a PoA, they must be willing & able to cooperate with it.
If they have impairment and no PoA and are in denial or uncooperative, you have no legal power to do anything, really.
While I have been an independent provider of care for over 15 year (plus a massage therapist), and elevated to providing care management, I also have hired through agencies for my friend-companion, and others clientsL
Do consider:
1) some ind people could work out well although they need to be carefully vetted / interviewed; although this is true for those you hire through an agency. 2) "Most" people would find going through a caregiver agency/service easier and PRESUME the quality of a person (experience, dependability, ability) would be a highly level than hiring an ind person - NOT necessarily so.
(Lots) depends on who is doing the interviewing? You? Be prepared. Formulate questions ... the 'what if" and how would you handle it? Think of scenarios that might occur requiring someone to 'think on their feet' and see what they say. Their response also says a lot about their compassion and experience; as well as agency protocol.
If I were you, I would try out different situations, different agencies, and as perhaps referred to you, independent caregivers. (I was initially VETTED at / through a multi-level senior community (i.e., required to provide car insurance, TB testing, references, experience) - then I work(ed) independently with the residents. I still have clients there after 15+ years.
One of the main differences with ind caregivers vs hiring through an agency is tax reporting. My prior client got some 'reimbursement' for hiring me as a care provider (I worked with her as an ind caregiver for three years). I do not know how or why she was able to get some tax break although worth checking into.
Whoever you hire, it is a REALLY GOOD IDEA to check in with them the first few days or if longer, weekly to see how things are going. A good care provider should 'automatically' do: Active listening (focused attention on your mom) Be "ON" - meaning offering to help; asking what they might want/need... not 'just' sit there playing games on their phone (that does happen). Prepare a meal as asked / required Do laundry Keep in contact with you if you ask / require (some may only be allowed to contact their agency although somehow you want to know how things are going). Insure safety measures in the home - to avoid trips and falls. If needed, make sure experienced to do bathing. How to handle a fall? (They should immediately call 911 - then and/or you and the agency). Ask the agency about how their employees are instructed to handle a person who falls.
Create a form: 1. For the care provider (interview questions; and one page per person) Be sure to ask about. their availability. Ask for references.
2. For agencies (ask what references their employee provided to them; experience). Screen as best you can. Best to have these questions written down beforehand.
I could go on and on. Hopefully, some of these ideas will help you.
I recently found aids for my mom after much research. Most places were very very expensive. But if you go through a nursing home or assistant living facility, they sometimes have companies that work with them and they're much cheaper and that's who I went with. I also learned from experience that you have to include your mother, because what you thinks she needs and what she actually needs might be two different things so it's good to have your parents input.
I am working on this right now for my mom. I researched local home care agencies through A Place for Mom. Start there. I had to do preliminary phone interviews to find out what they offer, rates, service area, etc, and got it narrowed down to two agencies that could give her what she needs. We set up a meeting with each of those agencies at my mom’s home (so mom feels like part of the negotiation,) and chose one that way. There are many variables, in price, minimum hours, etc. but I found that just talking to the agency owners proves there can be some flexibility and variation among them. I put off this search as long as I could because it looked so daunting - but it really wasn’t so bad. I learned what questions to ask and what to look for.
Do some research first on places like Senior Centers to see what they themselves have to offer or can give referrals for home care. Home care agencies will come for a visit to find what sorts of care are needed, how many days, and how many hours. They will usually not send someone for less than four hours. Through agencies someone will always come. I found the smaller organizations to be more reliable. If you hire someone on your own, which tends to be less expensive, they might be sick and then no one will be there for care. That might be okay if only light housekeeping and companionship is what is needed, but if they need more than that, you will need backup. Yard work and house repairs have to be hired separately. It really depends on how much care will they need. It's a lot of work just organizing it all. Might they do better in Senior Living or Assisted Living?
yes ask the PCP for a referral for a social worker or therapist and they can assist with elder services which will be covered by medicare . Out of Pocket you can Look at care.com or Next Door.com or Place a ad on Next Door .
I think your answer depends on what the current needs are of your aging in-laws. Others have provided some good answers here. Please note based on experience with friends and family, if you choose the agency route often times you may not have the same person each time so there is no consistency which can be very. Agencies normally cost around $25 an hour and they take 50% of that approximately is my understanding.
I’ve had friends find people with care experience in their community that they work directly with an agency just to have more consistency. Or, often people that work in a care facility will often work on the side as well. We have found that by asking around somebody knew somebody who is interested in assisting.
I would start there. You may need to use a social worker when you decide just what type of care they need, ie do they need simply a companion/sitter, light housekeeping and a meal, transportation, chores around the house.
You can check on Care.com and such places as Visiting Angels in your area to find out what they provide in terms of vetting employees, what services they give and so on. If you know people who have some caregivers who can use extra work, speak with them. Next Door works in our area for many.
If your parents are Medicaid eligible there may be some inhome services to consider.
I wish you good luck. Talk with others who have elders in their care in your area. If you are a member of faith-based or other communities there may be some care. In the case of The Village in my area (San Franciso) if you are a member early on, and use for activities (support is monthly an amount you choose) you have access to their volunteers who can help with certain things; I know one who uses them for laundry as it involves up and down stairs, and has this person as volunteer once a week for about three hours.
So there are a lot of way to explore, and I have to warn, none of them are ideal.
I just read your profile. You say that you are not the caregiver but looking for ways to help them.
First of all, let me say that you are a thoughtful person who realizes that being a caregiver is hard work. Thank you for being kind.
Look at agencies for additional help. Contact Council on Aging in their area to get a needs assessment for her. They can help guide you through the caregiving process.
If caregiving becomes too much on them, you may also want to look at assisted living facilities if they have the financial means to place their family member.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
********************************************************************************
Ask a SW, Case manager or geriatric care mgr (see Aging Life Care Association Home) and find a local aging life care professional in your zip by following prompts on the ALCA website!
Start wring down important details before you set out to find either a private in-home caregiver or an agency caregiver and distinguish the difference between the two such as cost, continuity of care and what to expect!
What sort of "care" do you think they need?
ADL's (activities of dly living; bathing, drsg, toileting, etc)
IADL's (cognitive decision making such as grocer items, budgeting, etc.)
How many days/hours?
Hourly fee you are willing to pay?
Is family members taking any part; nights/weekends?
What are your short/long terms goals?
Are loved ones "aging in place"
Are benefit programs involved such as Medicaid, VA, etc.?
FYI, the first woman insisted on a contract showing duties, hours and hourly payment amount, and created a timesheet so there were no questions. She was so organized with the paperwork that we insisted on this for her successors.
If your in-laws have any assets, maybe a nice Assisted Living. If they own a home, it can be sold to pay for it. Office of Aging is a good place to start. They can evaluate the situation and help u find resourses.
You will need to know who has the legal authority to make any decisions for them.
Do your inlaws have diagnosed cognitive impairment?
Do either of the have an assigned PoA for both medical & financial?
Do they see their need for care? If so, are they willing to cooperate & accept it?
If they have cognitive capacity then they get to decide about their care. If they want more care they have to be willing & able to pay for it.
If either of them has cognitive impairment, even if they have a PoA, they must be willing & able to cooperate with it.
If they have impairment and no PoA and are in denial or uncooperative, you have no legal power to do anything, really.
Do consider:
1) some ind people could work out well although they need to be carefully vetted / interviewed; although this is true for those you hire through an agency.
2) "Most" people would find going through a caregiver agency/service easier and PRESUME the quality of a person (experience, dependability, ability) would be a highly level than hiring an ind person - NOT necessarily so.
(Lots) depends on who is doing the interviewing? You?
Be prepared. Formulate questions ... the 'what if" and how would you handle it?
Think of scenarios that might occur requiring someone to 'think on their feet' and see what they say. Their response also says a lot about their compassion and experience; as well as agency protocol.
If I were you, I would try out different situations, different agencies, and as perhaps referred to you, independent caregivers. (I was initially VETTED at / through a multi-level senior community (i.e., required to provide car insurance, TB testing, references, experience) - then I work(ed) independently with the residents. I still have clients there after 15+ years.
One of the main differences with ind caregivers vs hiring through an agency is tax reporting. My prior client got some 'reimbursement' for hiring me as a care provider (I worked with her as an ind caregiver for three years). I do not know how or why she was able to get some tax break although worth checking into.
Whoever you hire, it is a REALLY GOOD IDEA to check in with them the first few days or if longer, weekly to see how things are going.
A good care provider should 'automatically' do:
Active listening (focused attention on your mom)
Be "ON" - meaning offering to help; asking what they might want/need... not 'just' sit there playing games on their phone (that does happen).
Prepare a meal as asked / required
Do laundry
Keep in contact with you if you ask / require (some may only be allowed to contact their agency although somehow you want to know how things are going).
Insure safety measures in the home - to avoid trips and falls.
If needed, make sure experienced to do bathing.
How to handle a fall? (They should immediately call 911 - then and/or you and the agency). Ask the agency about how their employees are instructed to handle a person who falls.
Create a form:
1. For the care provider (interview questions; and one page per person)
Be sure to ask about. their availability. Ask for references.
2. For agencies (ask what references their employee provided to them; experience). Screen as best you can. Best to have these questions written down beforehand.
I could go on and on. Hopefully, some of these ideas will help you.
Gena / Touch Matters
I put off this search as long as I could because it looked so daunting - but it really wasn’t so bad. I learned what questions to ask and what to look for.
I’ve had friends find people with care experience in their community that they work directly with an agency just to have more consistency. Or, often people that work in a care facility will often work on the side as well.
We have found that by asking around somebody knew somebody who is interested in assisting.
Good luck with your journey.
You can check on Care.com and such places as Visiting Angels in your area to find out what they provide in terms of vetting employees, what services they give and so on. If you know people who have some caregivers who can use extra work, speak with them. Next Door works in our area for many.
If your parents are Medicaid eligible there may be some inhome services to consider.
I wish you good luck. Talk with others who have elders in their care in your area. If you are a member of faith-based or other communities there may be some care. In the case of The Village in my area (San Franciso) if you are a member early on, and use for activities (support is monthly an amount you choose) you have access to their volunteers who can help with certain things; I know one who uses them for laundry as it involves up and down stairs, and has this person as volunteer once a week for about three hours.
So there are a lot of way to explore, and I have to warn, none of them are ideal.
First of all, let me say that you are a thoughtful person who realizes that being a caregiver is hard work. Thank you for being kind.
Look at agencies for additional help. Contact Council on Aging in their area to get a needs assessment for her. They can help guide you through the caregiving process.
If caregiving becomes too much on them, you may also want to look at assisted living facilities if they have the financial means to place their family member.
Best wishes to you.