Tuesday, June 7, 2011

Creating Comfort with In-Home Care

It is quite normal for a family caregiver to feel some anxiety when a new person comes into the home to provide assistance, especially so because many caregivers have genuine concerns toward ensuring that the best possible care is provided to their loved one affected by dementia. When considering outside assistance, caregivers should make themselves comfortable in asking some or all of the following questions, prior to selecting an Independent or Agency Provider. This will help to decrease anxiety and promote an overall sense of comfort for everyone, especially for the individual being cared for. Below are some questions that a caregiver may consider.
Questions for an Independent Worker/Caregiver:
1. What kind of work experience do you have in caregiving?
2. What specifically makes you qualified to work with my loved one?
3. Are you comfortable dealing with my loved one’s emotional and/or mental changes?
4. Why are you interested in this type of work?
When asked upfront and respectively, these kinds of questions can create a dialogue for asking and answering all kinds of questions, while also setting an expectation for the kind of care that is sought and deserved.
Questions for an Agency:
1. What kind of background check is performed on the workers?
It's commonplace for employers to do criminal background checks on potential employees. Since trust is critical when hiring someone to help inside of your home setting, a background check can be a valuable screening tool.
2. Do you check your workers' driving record and driver's license?
If you need someone to drive your loved one, even occasionally, it is important to know what kind of driver you may be hiring. Car insurance requirements may differ from state by state. It is advisable to check with your local Department of Motor Vehicles (DMV) to see the requirements of your state. If the worker may be driving yours or your loved one’s car, check with the insurance company to find out how to include new drivers.
3. Are your workers bonded?
If someone is bonded, their work is basically insured and your loved one will be covered, in the event that the worker breaks or steals something. Bonding coverage varies, so you can ask for details. It's a level of reassurance that can make a difference; however, it is not necessarily essential to good care.
Do you provide any training for your workers?
If so, ask the agency whether training is done once or on an ongoing basis.
Are the healthcare workers your employees or independent contractors?
Some agencies function more like job referral services, linking independent workers with jobs, rather than managing their own employees. With independent contractors, you will likely be required to do more paperwork and supervision. It is a good idea to be clear about this from the very start.
What kind of supervision do you provide?
How often does the agency check in with its workers…daily or weekly? Is someone available to provide expertise or extra assistance, if needed?
How do you handle a worker's sick days, vacation days, and holidays? Will you automatically send a replacement worker?
Everyone needs breaks and time off, including yourself and those you may hire. Caregiving can be physically and emotionally demanding. Find out how agencies cover for worker absences and what's required from your end.
What's the turnover rate of your workers?
Do you think your employed caregivers enjoy their jobs? Do you offer benefits? It is hard to be certain that you will receive an honest answer, but it never hurts to ask. But, remember that one simple truth prevails: People who are happy with their work make better employees.
How do you handle conflict between a client and worker?
It helps to know how much support you'll get from an agency, should a conflict arise. Does the agency mediate conflicts, and if so, how? Is the agency flexible about changing workers, if things don't improve?
Do you have other people that I can talk to about their experiences?
It is perfectly ok to ask for several references. This is one of the best ways to get a sense of how an agency has performed over time.
Do you accept payment from insurance companies?
If your loved-one has long-term care insurance that pays for the cost of in-home care, you may want to make sure that the agency accepts this kind of payment. If not, you are likely better off using one that does.
What kind of service agreement is required?
This will help you to learn of any requirements or commitments on your end, as well as flexibility of services provided.
Will you take care of all required payroll paperwork?
A significant amount of paperwork may be involved when employing someone, covering such matters as taxes, Social Security, and disability. One benefit to hiring from an agency (and the reason it's usually more expensive than hiring independently) is that an agency will normally do this for you. However, it never hurts to double-check to see.
Are you Medicare certified?
Medicare certified agencies are eligible to be paid through Medicare, the government's health coverage for persons over 65. To become Medicare certified, an agency must meet federal standards for patient care.
Can my loved one and I interview candidates and give input on the choice?
The more control you and your loved one have over choosing an in-home health worker, the better you will feel about your choice. Agencies approach this differently, so you may need to ask.

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