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How to Choose the Right Home
Care Provider
In the last part of our series on home care services,
we discussed the difference between skilled and custodial home care services,
which is good preparation for this month's topic, the selection process. Why?
Because it helps to know what kind of care you need before choosing the right
home care provider for yourself or a loved one.
To begin with, those
needs are typically based on a physician's, case worker's or your own
assessment of what's needed. If both skilled and custodial care are required,
you could work with an agency that provides both, or just as easily, hire an
agency with certified nursing assistants that works directly with your
physician and/or nurse case manager. There are also individual or independent
caregivers with nursing backgrounds who may offer both kinds of care and who
work with other nursing professionals.
Depending on the scope of
services required, your first decision may be whether to go with an agency or
an individual, since the selection process for each will be quite different and
require very different time commitments.
Spelling Out
Services/Fees/Hours
When interviewing prospective home care
agencies, start by asking if they provide free estimates (surprisingly, not
everyone does). At the top of most people's list of the questions are fees:
they may be listed as hourly, daily and/or weekly. Ask if there are minimum and
maximum hours of service and if there are limitations as to the tasks and/or
times of the day when services are provided.
Some agencies provide a
customized plan of care, with all of the services, duties and responsibilities,
including financial arrangements, outlined in detail. Having a care plan can
help you keep track of the care being delivered to ensure it's what you
expected and/or what the doctor ordered. A care plan is especially important to
adult children who live away from parents for whom they've contracted services.
On the other hand, having a plan and executing it are entirely different
things.
That's why at Helpful Hands, we developed a remote computerized
system that allows us to keep tabs on our caregivers using the clients' own
telephone. Caregivers simply dial into our computer and are automatically
checked in and out for the day. The system also helps us provide substitutes
(often our own supervisors), if the regular caregiver can't make it in one day;
it matches special needs with unique caregiver skills, as well.
A home
care company may or may not offer a contract, but before you sign anything,
make sure you carefully review it. For example, make sure you understand who
will be providing the care and whether they are home care specialists, licensed
practical nurses or registered nurses, and who will be supervising the
caregivers (preferably some type of nursing professional). With an individual
caregiver, chances are you will be the supervisor, so ask yourself if you'll be
comfortable in that role.
Third Party, Independent Quality Measures
One way to judge the quality of an agency is to ask what kind of
training it provides caregivers and how often they receive subsequent training
to maintain their skills. You might also ask whether the agency's caregivers
are "W2 employees" or "1099" independent contractors. Your preference should be
for the former, since they are more likely to have liability, workers
compensation and other forms of insurance coverage that contractors seldom
have.
Among the most important questions to ask: Are caregivers bonded?
and What kind of background checks, tests and screens are conducted (e.g., law
enforcement, personnel, drug and history of infectious disease)? You'd be
surprised how many agencies don't conduct criminal background checks and drug
screens.
Find out how long the agency has been in business, or if an
individual, how much experience he or she has in providing home care services
(both on her own and working in a facility or an agency). References for both
individuals and agencies can include health care professionals who know them by
reputation and consumers who have used the service (or know the individual);
check every one thoroughly.
Also, find out if any complaints have been
filed with the Better Business Bureau, state consumer protection agency or
state attorney general's office. On the positive side, another quality measure
is whether or not the agency staffs its phones 24 hours a day, in case you,
your loved one or a caregiver needs help for any reason.
To some, this
may seem like a long list of issues to consider. The truth is, I've barely
scratched the surface here. When you consider that you're allowing perfect
strangers into your home to perform highly personal services, I think you'll
agree that it's important to be thorough and to ask a lot of probing questions.
Of course, uncertainty can be minimized by using a reputable agency,
which can screen, train and hire professional caregivers on your behalf, in
addition to protecting you against theft and other types of loss. What's more,
if the first caregiver doesn't happen to work out, you can always try another
one from the same agency, without having to go through the hiring process all
over again, as you would with an individual.
Selecting Home Care
Services:A Checklist
Individual or Agency?
- Fees -
- Hourly Daily Weekly Live-In
- Minimums? Maximums? Limitations?
Plan of Care? Contract?
- Who provides care? When? Supervised by whom?
Caregivers
- - Qualifications … Training/re-training …
Background
Checks ...Screens/Tests
Caregiver Monitoring
System?
Complaints
References
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