Home Care Frequently Asked Questions

Many people are unfamiliar with what exactly home care is, and how it differs from other services.  The aim of this list of questions is to help you better understand the nuances of home care, what to expect, what not to expect, etc. Have a look at the following home care frequently asked questions, and learn how it may fit into your, or your loved ones, life.

  1. What is home care?
    1. Home care is a non-medical service that allows seniors and disabled persons the ability to continue to live independently in their own home. Home care services consist of a caregiver being sent to the private residence of the client to assist them with activities of daily living (ADL’s).  Activities of daily living include companionship, light housekeeping, laundry, meal planning and preparation, errands/transportation assistance, incontinent care, bathing assistance, Alzheimer’s and dementia care, pet care, etc.
  2. How much/little care am I able to get?
    1. Generally speaking, agencies will have a daily minimum of 4 hours per shift, meaning if you need only 4 hours each Monday morning, and that’s it, that can be accommodated. With that being said, some agencies also enforce a weekly minimum, meaning you are obligated to pay for service at least two to three days per week.  Services also range up to 24 hours per day, 7 days per week and everything in between.
  3. Should I hire a private caregiver, or go through an agency?
    1. We would recommend to ALWAYS go through an agency, and here’s why:
      1. Private caregivers have not been vetted by a third party (background check, drug screening, reference check, training, etc)
      2. They are not covered by worker’s comp insurance, meaning you as the homeowner are legally obligated to modify your home owner’s insurance to cover domestic help. Otherwise, should your caregiver get hurt while in your home, you are held responsible.
      3. You, as the employer of the caregiver, are obligated to pay the employer’s portion of the caregiver’s taxes.
      4. If your privately hired caregiver calls out sick, or goes on vacation, there are no backup caregivers to fill in; Meaning you are left without your much needed assistance.
      5. Privately hired caregivers are not bonded, or covered by general liability insurance leaving you open to more risk.
      6. The cheaper price of independent caregivers may look appealing at first, but remember there is a good reason they are cheaper.
  1. Does my insurance cover the costs of home care?
    1. Unfortunately, the answer is no. Medicare/Medical, private health insurances, etc, none of them cover these services.  There are only three ways to pay for home care services.
      1. Long-term care insurance (Amount depends on individual policy)
      2. The Aid & Attendance benefit through the VA (Can cover up to $2,100 per month)
      3. Private pay (90% of home care recipients pay out of pocket)
  1. How much does home care cost?
    1. Home care services are charged by the hour. Most agencies vary their rate based on the level of care required. Example:
      1. Companion care: $20 per hour
      2. Meal prep/planning: +$2 per hour
      3. Bathing assistance/incontinent care: +$2 per hour
      4. Alzheimer’s/dementia care: +$5 per hour
      5. Couple care: $25-30 per hour
      6. Mileage reimbursement: 57.5-75 cents/mile. (IRS mandated rate is 57.5 cents/mile as on 2015)
      7. With that being said, there are many very good agencies who charge a flat rate that does not vary with the level of care being rendered. These agencies will typically charge between $20 and $25 per hour and all levels of care are offered.  These agencies offer better value.
  1. What should I ask when talking with an agency?
    1. Starting January 2016, the state of California will require all home care agencies to be licensed through the state (with the deadline being July of 2016). Make sure the agency is properly licensed.
    2. Verify that all caregivers are W2 employees and NOT 1099 independent contractors. Independent contractors are not bonded, insured, etc.
    3. Verify that the agency carries the necessary insurance policies (workers compensation, general liability, non-owned auto, and that they are bonded)
    4. Ask about upfront training/ongoing training offered to the caregivers.
    5. Make sure caregivers are background checked
    6. Make sure caregivers are drug tested
    7. Make sure the agency has obtained a copy of all caregiver’s driving records
    8. Make sure the agency tests their caregivers for tuberculosis.
  2. What can home care agencies NOT do?
    1. Industry regulations dictate that these activities are “medical” in nature and cannot be performed by a home care agency:
      1. Heavy lifting: we can monitor/supervise clients who use walkers or wheelchairs but we are not allowed to lift dead weight.
      2. Medications: We are not allowed to touch medications. We can only remind clients to take their medications.
      3. Nail trimming or hair cutting: We are not allowed to cut hair/nails but we can escort clients to the manicurist/hair salon. Hair styling (curling) and nail polishing are allowed.
      4. Shaving: We can only help clients shave (face/legs) with electric shavers. We are not allowed to shave clients with a bladed razor.
      5. Medical emergencies: We can only call 911 and stabilize the surroundings to avoid further injury.
  1. Agencies keep asking me for an in home assessment, what is that?
    1. An in home assessment is when a representative from the agency comes to your home to meet with you, your loved one who will be receiving the care, other decision makers, etc to get a more in depth look and understanding of what it is you are looking for, learn about the personality of the prospective client, and it allows the family to ask any questions and voice any concerns all at one time. The assessment is typically just an information gathering meeting, not a high pressure sales situation.
  2. My loved one is receiving care from home health/hospice, isn’t that the same thing?
    1. No it is not. Home health is where nurses will come by two or three times a week for about 20-30 minutes to address only your medical needs such as wound care, physical therapy, medications, etc.  Hospice is along the same lines where they visit only a few times a week for about 20 minutes per visit to administer medication and make sure your loved one is comfortable.  Home health nor hospice will prepare meals, provide housekeeping, assist with bathing, etc.  Home care agencies often work in conjunction with home health and/or hospice, but home health and hospice cannot and will not provide the same services.
  3. How do I go about finding a quality home care agency?
    1. Start by asking your doctor, social worker, or case manager for a recommendation. They will typically know of a few good ones.  There are also many good online resources that you can utilize.  A couple of the good online databases are as follows:
      1. Caring.com: https://www.caring.com/
      2. Carepathways.com: http://www.carepathways.com/
    2. There are also referral agencies that do senior placement free of charge. They will give you two or three agencies that they have thoroughly vetted for you to contact.
  4. What if I/my loved one doesn’t get along with the caregiver?
    1. If you hired an independent caregiver, you are now tasked with starting the process over to try and find someone who is a better fit. This is another area where an agency is better.
    2. If you work with an agency, and you don’t get along with the caregiver for whatever reason, let the agency know and they will have no problem placing other caregivers with you until a good match is found.
A Helping Hand

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