Showing posts with label help for family caregivers. Show all posts
Showing posts with label help for family caregivers. Show all posts

Friday, September 17, 2021

In-Home Caregivers: How to Find and Hire The the Right Caregiver

As we age, the time may come when many of us may need a caregiver, whether it is a temporary arrangement after surgery, or a permanent way to avoid moving into an assisted living facility.  You may need the caregiver for yourself, or for someone in your family.  When the need arises, do you know how to find one and what services they can be expected to handle?  How can you be confident that you can trust the person you hire?  What do you need to do to avoid financial and legal problems?

These are all important questions for patients and their families to ask themselves before hiring a caregiver.  The more you educate yourself and the better you prepare to benefit from the service they provide, the smoother things will go for both the patient and caregiver.

What Services are Performed by Caregivers?

Caregivers can be expected to help a patient with their normal activities of daily living. This can include:

Dressing and bathing
Personal hygiene
Ambulation or transferring between a bed and wheelchair
Help with medications
Shopping and food preparation
Light housekeeping and laundry
Transportation to medical appointments or for personal care

In addition, having a caregiver will reduce your loneliness, because they will have conversations with you and may even play card games or engage in similar activities, all of which can help you postpone dementia.

Best Way to Find a Caregiver

In order to avoid the risks involved in using an unlicensed caregiver, it is best to use an in-home care agency which is licensed in your state.  These companies have to meet their state's requirements regarding training and background checks.  

If possible, it is important for a family member to supervise the hired caregiver, especially at first.  According to inhomecare.com, the average state-mandated training hours for certified caregivers is approximately 75 hours of study.  Some states require even less time; others require more.  Essentially, this means caregivers must participate in only about two weeks of training.  

Before leaving your loved one with a hired caregiver, or hiring one for yourself, you will want to make sure the person fully understands their duties, including how to properly dispense medication, prepare meals the patient will enjoy, manage the transition in and out of chairs and beds, assist in dressing the patient, know how to use common home appliances, and is capable of helping the patient use the toilet, etc.  Do not leave a patient alone with a caregiver until you are completely satisfied that the person is able to handle all their routine duties, as well as any emergencies which could arise.  

In addition, make sure you write down a detailed fact sheet for the caregiver.  It should include instructions on how they can best help the patient, including allergies the patient may have, medications they take, contact numbers for doctors, neighbors and family members, and any other information you think would help the caregiver.   Even if you are the patient, make sure you put all this important information in writing. This will help the caregiver know what to do in the event you are injured or have a medical emergency and are unable to communicate your needs. 

In hiring a caregiver, you will also want to use an agency which has been approved by the American Board of Home Care.  Their goal is to "uphold the trust you have placed in them to review, check, and ensure the best quality of home care providers looking over your family, friends, and patients."

You can contact the American Board of Home Care at:

(877) 436-5259
www.americanboardofhomecare.org


Finally, it wouldn't hurt to do a Google search of your own on the caregiver, to see if this person has been mentioned negatively online or has been accused of any crimes. If you suspect they may have had a past problem, bring up the issue with the agency for an explanation.  You would not want to put yourself or a family member in the care of anyone who could be dangerous, or take financial advantage of a fragile person.

What If a Family Member Offers to be the Caregiver?

In some cases, a member of your family may be the best caregiver.  In this case, it would be smart for both the patient and the family member to sign a Long-term Care Personal Support Services Agreement.  In this way, everyone knows exactly what care will be provided, how often, and during what period of time.  In addition, it also will clarify what financial compensation they may receive, and whether this compensation will come from the person receiving the care, other family members, or the state.

A family member may be uncertain exactly what services they need to provide and how to keep track of everything.  You might find it helpful to get a copy of the "Caregiver's Workbook:  Checklists and Worksheets for Family Caregivers."  (Ad) It could help reduce your stress and keep you organized. 

In many cases, state governments will pay caregivers through Medicaid to assist low-income patients who qualify for in-home care. Having a written agreement will show the state where the money is going and what services are being provided.  The checklists and worksheets mentioned in the book above can also help you prove to Medicaid that you are performing the necessary tasks, and the hours you are working.  

Having a written agreement and agreed compensation will also reduce misunderstandings among heirs over the reduced amount of money which they might inherit, as a result of the financial compensation paid to the caregiver.

What Should be Included in the Agreement for a Family Caregiver?

If a friend or family member is going to be paid to provide the care, everyone should see this as fair and reasonable. In order to do that, the caregiver agreement should include the information listed below.  You may want to consider having an attorney draw up the agreement.

* It should be a written agreement.
* It should cover only services which will be provided after the agreement is written; not services provided in the past.
* It should provide for reasonable compensation which would not be greater than would be charged by a licensed caregiver service in your area.
* It should stipulate the types of care which will be performed and the hours the caregiver will work.
* It should specify who will pay the caregiver and how frequently. 
* It should be flexible and include the statement that the services provided may change as mutually agreed upon by the parties.
* There should be a clause allowing either party to terminate the agreement in writing.
* There should be a "backup" person listed in the event the primary caregiver is temporarily not able to provide their services (for example, if they become ill themselves).
* It should cover any additional factors such as room and board, if the caregiver lives with the patient, income tax withholding, medical insurance for the caregiver, vacation pay, etc.
* It should require a detailed log of duties performed, to justify their salary

Advantages of a Family Caregiver

Although having a family member perform the caregiver duties can cause jealousy and problems with other family members, it can also provide an extra level of care which might not be appropriate if the family hires a professional caregiver.  Some of these extra duties include:

Dealing with household and medical bills
Handling other finances
Going to medical appointments and assisting in making medical decisions

Whether you decide to go with a professional caregiver or have a family member provide that service, it will make life much easier on everyone to know that appropriate care is being provided either temporarily or permanently for yourself or a frail or ill member of your family. 


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Saturday, December 12, 2020

Why Family Caregivers Reject Help and How to Help Them Anyway

At some point in our lives, we may become a caregiver for another family member, or we may know someone else who is a caregiver.  The work can be overwhelming and exhausting.  A family caregiver may be "on call" 24-hours a day, seven days a week.  The work can be physically demanding, depending on how much assistance the patient needs.  In the case of caring for someone with dementia or Alzheimer's Disease, it can be all-consuming to make sure they do not wander away or accidentally hurt themselves.

Surprisingly, family caregivers often reject help when it is offered to them.  Whether it is a relative who offers to give them a break for a weekend, or a local nursing home or adult day care center which offers temporary respite care, the caregiver may refuse to even consider using the available help.

Unfortunately, refusing to accept assistance can put the caregiver's own life at risk.  People who care for family members who are chronically ill tend to die four to eight years sooner than they would have without this added responsibility.  In fact, sometimes they die before the family member they have been caring for.

Why do caregivers die sooner than expected?  Stress is a major factor in heart disease, strokes and cancer, and being a caregiver can be extremely stressful.  In addition, the caregiver is typically the person who must leave the home to do the shopping or handle other business.  This makes them more vulnerable to catching Covid-19 or other contagious diseases.  Being a caregiver is a high risk occupation.

If you are concerned about a family caregiver, how can you help them?  You may want to start by understanding why the caregiver resists getting help, and by learning everything you can about their situation.  It could also be helpful to read a book such as "When Caregiving Calls: Guidance as You Care for a Parent, Spouse or Aging Relative." (Ad)  If you become more knowledgeable about how to take some of the burden from them, they may be more willing to accept your help..

Why Caregivers Resist Getting Help and How to Solve the Problem

Protecting the Patient - The caregiver may believe that leaving the patient with someone else could put the patient in danger.  As a result, they are reluctant to leave them, even with a friend or family member, unless the other person seems completely capable of handling any situation which could arise. If you sincerely want to help, you may be able to overcome this objection by offering to "shadow" the caregiver for a few days, learning everything you can about the patient's medical condition, and winning the confidence of the primary caregiver. Gaining all the knowledge and experience you can will help them feel more relaxed when you offer to take over for a few days or even just a few hours.

The Caregiver May Feel Guilty - Some people, especially older couples in long marriages, or parents of an ill child, may feel that it is their sole responsibility to be the caregiver. They may feel they signed up to take care of this person no matter what happens, so they may feel guilty leaving them with someone else.  It might help to have them talk about their guilt with a therapist or family clergyman.  It could also help if you can explain to them that their loved one could actually benefit from the stimulus of being with others or going to adult day care a few times a week.  The patient may become bored with the same routine day after day, which can actually worsen their condition.  A little variety could cheer them up.

The Caregiver and the Patient May Both Fear Having Strangers in the Home -  We have all heard horrible stories about paid healthcare aides who physically or mentally abused their patients or stole from them.  Even though these situations are very rare, the fear can be real.  As a result of these stories, both the patient and the caregiver may be extremely uncomfortable about letting someone else help, especially a paid home health aide or other stranger.  The caregiver may also believe that a paid healthcare aide will not be able to handle an emergency. If anything goes wrong, for example if the patient has a seizure, the family caregiver may be consumed with guilt over leaving their loved one with someone else. This may be true even though the event could have happened regardless of who was there. It may be possible to reassure a family caregiver by asking the healthcare aide or other assistant to start by just helping out for short periods of time.  It might also reassure them if the aide only works under the supervision of the primary caregiver, who can use the time when the aide is in the home to do other things, such as rest, work in their garden, putter in the kitchen or work on their favorite hobby.  

They May Prefer their Privacy - It can be very uncomfortable for either a patient or their family to have home health aides, friends, or relatives in their home all day long.  Instead of making them feel more relaxed, they may feel more stressed, believing they need to entertain or talk to these other people all day.  It could be easier if the caregiver takes advantage of a little free time by leaving the house, visiting friends, going shopping, or simply retreating to their bedroom and taking a restorative nap.  Someone who is trying to give a family caregiver a little time off should encourage the primary caregiver to use the time to do whatever they want or need to do, and not feel obligated to treat the helper as a guest. The paid healthcare aide or helper should also ask the patient whether or not they want to talk or do anything.  The patient may welcome a new visitor who is willing to listen to their stories or play a card game, or they may just want to be left alone, depending on the circumstances.  Honor their preference, if at all possible.

Pride May Be Standing in The Caregiver's Way - Some caregivers are proud of the fact that they have always been able to manage things on their own, without help.  Now, it may feel like a loss if they suddenly feel dependent on others to help them.  You might remind them that they are helping other family members when they give them the opportunity to help take care of their loved one and spend some quality time with them.  

If you want to assist a caregiver in your family, or if you are the family caregiver, you may find encouragement in the book, "The Conscious Caregiver: A Mindful Approach to Caring for Your Loved One Without Losing Yourself."  (Ad)  This book could also give you some great suggestions for ways caregivers can take better care of themselves.

The Cost of Paid Help May Seem Unaffordable - Getting outside help, either in the form of a paid home health aide or at an adult day care center, can be expensive.  However, in certain situations Medicare, Medicaid or the Veteran's Administration may cover the cost of temporary help. In some communities, the charge for adult day care is based on the family's income and the cost is charged on a sliding fee scale. If the patient is near the end of their life, hospice care is usually free and is covered by Medicare. Friends and relatives can help the caregiver explore the various programs and find out what different levels of assistance might cost and how they could pay for it. Other family members may even want to help out financially with the cost. For example, an adult child living in another city might offer to pay for adult day care one or two days a week, which could take a huge strain off the caregiver.  

If you truly want to give a break to a caregiver, despite their resistance, you have a variety of options.  You just have to let them know you are sincere in your desire to help, you are capable of providing the assistance they need, and everyone will benefit from the new arrangement. It may take a little time to break down the caregiver's resistance, but don't give up.  It could literally save the caregiver's life.

Disclosure: This blog may contain affiliate links. If you decide to make a purchase from an Amazon ad, I'll make a small commission at no extra cost to you.

If you are interested in reading more about common medical issues as we age, where to retire, financial planning, Social Security, Medicare and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional articles.

You are reading from the blog:  http://www.baby-boomer-retirement.com

Photo credits:  Morguefile