Long-Distance Caregiving | Part Two: Hiring Help At Home
Long-Distance Caregiving
Part Two: Hiring Help At Home
By Carolyn Campbell
In Part One of this series, we covered making an assessment visit to your loved one who lives far away. This article covers hiring trustworthy help. Marilyn felt sadly torn. When she visited her father’s home in Washington, there were warm memories of her childhood in the familiar furniture, her favorite paintings, and the ocean view that she had always loved. But she soon realized her father was trying to disguise the reality that he could no longer live alone without help.
Marilyn’s father had hired his lawn maintenance man to do errands as a side job. Besides being an untrained caregiver, the man charged her father $30.00 for a single trip to the post office five blocks away. Her dad had also rented a basement room to a man who agreed to provide “help” in exchange for free rent. After he moved in, the man never once came upstairs to find out what the “help” tasks would be. While her dad tried to hang on to his pride and independence, after a third makeshift “helper” gained access to his bank account pin number and began siphoning funds, Marilyn knew that her father was vulnerable and a victim of elder abuse.
She felt guilty, sad, and somewhat responsible for not stepping in sooner. She knew that she had indulged her father’s preference for being independent to the point where he had put himself at risk. That painful understanding included her realization that any future caregivers required her supervision. But how could she do that from three states away?
Gather Information on Community Services
A county senior services agency referred Marilyn to Eldercare Locator[i] to determine which local agencies provided services in her father’s town. This resource directed her to the area agency on aging in his community. She located services that fit her father’s needs, as well as a provider that would work with her long-distance.
When searching for a local area agency on aging, take notes on the services offered, the application process, waiting lists, and fees. If an organization requires an in-person interview with your parent, find out what documents you will need prior to the meeting and whether copies are acceptable. If you can’t be with your parent at the meeting, consider having one of her or his emergency contacts stand in for you. You might be able to join the conversation by telephone. Make a list of questions you want answered and be sure to have a contact person to follow up with.
Research Public Benefits Online
You can now go online and safely and conveniently learn about the different public assistance programs for which your parents might be eligible. By completing a Benefits Checkup[ii], you can find helpful state, federal, and private benefits programs available where your parents live. By answering a few questions, you will get fact sheets, applications, and websites for programs that can help save money and cover costs of everyday expenses.
Get Help with Managing the Care
Most communities have professionals who can gauge your loved one’s abilities and needs and set up a plan for care. (You can find this assistance through government-funded programs by using the Eldercare Locator1.) Another option is to hire a private geriatric care manager. A number of employers are starting to pay for these services, and if your family member has long-term care insurance, this might be covered under the policy. For a list of local professionals, visit the National Association of Professional Geriatric Care Managers[iii] or the National Association of Social Workers[iv]. If you can afford it, a private care manager is the ideal solution for any and all needs, especially during long-distance caregiving situations. A care manager not only provides continuous assessment but also can arrange and monitor any services provided privately or through community concerns.
Care managers provide a multitude of services to ensure that all of your loved one’s needs are being met. Care managers can:
Assess health and lifestyle concerns on an ongoing basis and report back to you;
Determine eligibility for community program assistance;
Screen, arrange, and monitor in-home help or other services;
Review financial, legal, or medical issues and offer referrals to specialists to avoid future problems and conserve assets;
Provide crisis intervention;
Help move your loved one to or from a retirement complex, care home, or nursing home;
Provide consumer advocacy; and
Offer counseling and support.
Private care managers are an excellent resource for providing detailed reports on your loved one’s health and lifestyle needs. You can advertise for one, but care management agencies employ certified and licensed care managers with references.
Long-Distance Caregiving Help
If your loved one lives alone in his or her own home and needs help with certain activities, a variety of professional home-health agencies offer a full range of services. Home-health agencies can cut through most of your hiring headaches. Not only do they have a ready supply of workers to suit your loved one’s needs, but they also maintain a level of professionalism by making sure employee certifications and licenses are current. Also, they’re obligated to provide solutions to any problems your loved one may have with workers. When deciding on a home-health agency, the Administration on Aging recommends asking the following questions.
What type of employee screening is done?
Is the employee paid by the agency or the caregiver?
Who supervises the worker?
What types of general and specialized training have the workers received?
Who do you call if the worker doesn’t come?
What are the fees and what do they cover?
Is there a sliding fee scale?
What are the minimum and maximum hours of service?
Are there limitations in terms of tasks performed or times of day when services are furnished?
After assessing your loved one’s needs, decide which type of home-care worker is most appropriate. Home-health nurses, therapists, or certified aides provide in-home medical care when it’s authorized by a physician. Home health care may include help with medications, exercises, wound care, or monitoring medical conditions.
A housekeeper or chore worker performs basic household tasks and light cleaning.
A homemaker or personal care worker provides personal care, assistance with medication, meal planning, and household management.
A companion or live-in provides personal care, light housework, exercise, companionship, and medication reminders. These aides will usually work for a lower salary in exchange for room and board.
When hiring a home-care worker yourself, be sure that the prospective employee has the necessary qualifications and/or training. Ask to see training certificates, particularly if your loved one has special medical needs.
Keep the Lines of Communication Open
Be sensitive to your parent’s view of the situation. At first, he or she may not want strangers in his or her home, or he or she may have trouble facing change. Maintain a positive focus, explain how the services will work, and remind your parent you want to help him or her remain independent. If possible, offer to contribute to the cost of care without appearing to offer charity. If your suggestions of service are rebuffed, you can have an objective third party—such as a doctor—recommend the service.
Don’t Forget Your Own Needs
Recognize the strain that long-distance caregiving causes, and take steps to reduce it. Accept that it's impossible for you to provide all the help your parent needs. Give yourself credit for your efforts to determine needs, coordinate services, and offer support by phone and occasional visits. Ask for help when you need it. If you feel that other family members are not doing their fair share, consider holding a family meeting to help resolve any issues. Eat right, exercise, and get enough sleep. Remember that your ability to help others depends on keeping yourself h
[i] Learn more at www.eldercare.gov.
[ii] Learn more at www.benefitscheckup.org.
[iii] Learn more at www.caremanager.org.
[iv] Learn more at www.naswdc.org.