So, this is an information packed post!

I sat down with our CEO, Joe Bidwell, and got really pushy asking him all sorts of important questions about his home care business. His candid and detailed answers can be found below. PAY CLOSE ATTENTION to these answers. Joe and his team have really done their homework in positioning Home Instead Senior Care to be the best in the business. I may have gotten a little personal in the part about our Vets and what an honor it is to have the opportunity to serve them, but tears aside, lots of great info for anyone considering home care for a loved on in Naples, Fort Myers and Port Charlotte, FL areas. I think you will enjoy this insight and hope you will learn something new about home care.

1. How much care do we need?
2. What are the options for Senior Care?
3. Do you provide 24/7 care?
4. Who needs 24/7 care?
5. Why doesn’t Home Instead provide “live in” care?
6. How does your “team approach” to 24/7 care work?
7. What are the benefits to your “team approach”?
8. What if a potential client requires care, but not 24/7?
9. What if someone only needs care temporarily?
10. What else can you tell me about your CAREGivers?
11. What other services do you offer?
12. How do you (and your clients) know if your CAREGivers are living up to Home Instead’s standards?
13. Is in home caregiving affordable?

Q: How much care do we need?

A: This is exactly the right question to be asking when considering options for care. Having been in business for 15 years, we have seen many situations. In our experience, crisis occurs when a clients needs exceed the amount of care provided. But when you get the right amount of care for physical and emotional care needs, it is a beautiful thing and the senior thrives.

I have a team of Home Care Experts that come to your home to do an initial care consultation. At this free, initial visit their goal is to get to know the client and their family and perform an assessment of all the care needs and goals. Once they understand that full picture, they will provide a prescribed level of care we know will ensure success.

If this is your first time evaluating care for a loved one, that's ok! My home care experts ask lots of great questions to really get you thinking about care needs in a way you may not have before. It is in these meetings that many newcomers to home care have "Ah-ha!" moments where everything makes sense.

In addition to constant communication between our office and your CAREGiver, as our client, you will be visited regularly by one of our Care Experts. These ongoing visits are aimed at Quality Assurance. It not only allows us to make sure we are doing a great job but it also gives us an opportunity to reassess the client and make sure their needs have not changed. Any changes we see, we alert the family to. It's really a win/win for everyone.

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2. What are the options for senior care?

In the past, there were only two options when caring for an aging loved one: move them in with family or downsize and move them to a facility like assisted living or a nursing home. Luckily, these days there are more options. There are many different types of facilities, from assisted living all the way through skilled nursing facilities (what used to be called nursing homes). But now there is a home care option which, with a prescribed amount of assistance, can allow for seniors to stay in their own home.

Research and common sense shows that 90% of seniors want to stay in their home. Despite the options to do just that, many seniors resort to choosing a facility route as they do not want to burden family and they see staying home with care as more expensive. There are many great facilities out there with each with various appealing amenities. However, the facility route has several potentially negative outcomes that we believe seniors and their family need to understand before making a decision.

• At the end of the day, it's really NOT a less expensive option. In a facility setting, it's no secret that the majority of what you are paying for is rent for your room in the facility (either private or shared) and amenities (some that that you can’t or don’t want to utilize). With most of your money going to cover those costs, very little goes actually goes toward providing actual care for the client. You already own your home, all you need is care. I believe that 100% of your money should go toward engaging and caring for your loved one, not rent.
• It is not your home. Downsizing into a facility means having to get rid of many of your things. Transitioning out of their home and all the memories there can be devastating for many seniors and you really don't know the real impact that has on the senior until it's too late and its all gone. With a home care option, a senior care remain in their home significantly longer extending quality of life for that person.
• One-on-one care is scarce. A facility is organized around providing group care. Typically, there are 10 to 20 clients per care aide which equates to roughly 1-2 hours of actual care per day. With home care, you get one on one care with someone who actually has the ability to immediately respond to needs and will spend quality time with your senior loved one doing the things THEY like to do.
• You’re not in control. Because of the group care model, a facility team must focus on getting a whole group of residents through any given task, like bathing or mealtimes. So, the senior can end up being on the facility’s schedule (wake up, meals, bathing, activities, etc.). Retaining independence is a crucial aspect when we talk about quality of life. To allow a senior to dictate when they are ready to eat or ready to shower retains their dignity, which is one of our goals at Home Instead Senior Care.
• Limited amount of care. If the senior’s care needs grow and require more than a handful of hours of care a day, the facility may require you supplement with a private duty caregiver (like Home Instead) anyways. Otherwise the senior may not be able to stay in the facility. This is in many ways the worst-case scenario as the cost can be very high or it may require another transition for the senior which is undesirable.

With home care, aging in place is a possibility. You can always suppliment with skilled nursing and/or therapy home visits. Many of our clients start with home care knowing that right now, being in their own home is important to them, but down the road it may not be as important. Where a senior is currently, both emotionally and mentally, should always be strongly considered when creating a plan for long-term care. If you're considering care, this free Guide to Selecting a Home Care Provider is a great place to start!

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3. Does Home Instead provide 24/7 care?

Yes. We specialize in providing expert around the clock care for those clients who need it. Over the years we have perfected our process and have a unique approach to make sure we retain the highest quality care 24/7. It's a delicate balance and I'm confident we do it better than anyone else.

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4. Who needs 24/7 care?

Our clients have various needs and we provide care tailored to those specific needs. Here are some of the needs that require around the clock help:

• A potential fall risk
• Occasionally up in the middle of the night
• Prone to wandering
• Bed-bound
• Advanced Alzheimer’s or Dementia
• Requires more intensive care

That being said, most seniors do not require this level of care to be successful at home. Schedule a time to talk to one of our senior care experts about what level of care is needed for the senior in your life.

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5. Why doesn’t Home Instead provide “live in” care?

We used to provide live-in care years ago, but realized it was not a good solution for the client or the caregiver. Rather than providing live in care for families who require around the clock care, we prefer to provide CAREGivers in shifts. We made this decision, based on our years of helping seniors, for several reasons:

• In a live-in care situation, the caregiver is required by law to sleep six hours per night. We believe that if you are paying for someone to be with you 24/7, they should not be sleeping.
• Even if the caregiver is not a heavy sleeper when the client moves or attempts to wander, he or she may not be able to reach the client in time to prevent a fall or an accident.
• Most companies/families are not aware that if the caregiver does not sleep their alloted six hours per night the client/company may be required to pay them time and a half for that week or night.
• It’s very hard to calculate how many hours of sleep a caregiver gets each night for each day, week, etc. that they work. The Department of Labor requires that the employer (which in the case of a registry could be the family themselves) prove through electronic records that they are paying the caregiver accurately minimum wage and overtime according to the Fair Labor Standards Act as well as comply with the Affordable Care Act.
• Due to overtime requirements, the cost of live-in care may be more than 24/7 care provided in shifts.
• What happens when the caregiver calls in sick? Or gets sick while in the client’s home? Who will cover their live-in care shifts? It is very difficult to replace a live-in caregiver with another one. It is even more difficult to find another live-in caregiver who knows you and your needs.
• Live-in caregivers required adequate housing, potentially leading to a dependence on the senior they serve.
• Lastly, and potentially most importantly, having a live-in caregiver imposes a large liability on the senior and/or family if the caregiver is in the home, but "off the clock". You’ll need separate liability and worker’s compensation insurance to cover those times.

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6. How does your “team approach” to 24/7 care work?

For a client requiring 24/7 care a team of our compassionate CAREGivers assist your loved one throughout each day and throughout the night in shifts. This allows each caregiver to have a break and prevent burn out or exhaustion. This is not a constant rotation of new faces, but a specific team designed to maximize familiarity with the client’s routine and avoid disruption as much as possible.

We have a team member live-answering our phone lines 24/7, that can handle any issue that comes up throughout the evening hours. Some of our clients want assurance that our team is awake and alert. In those cases, we have our CAREGiving team call in every hour, on the hour.

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7. What are the benefits to your “team approach?”

Having the team approach means that our caregivers do not and will not sleep during night shifts. If your loved one needs any assistance at all, we will be there ready to act. Taking this approach also means improved quality of care for the client. If one of the caregivers needs a day off because of illness, vacation or for family obligations, another caregiver with knowledge of the case will be able to fill their shift without having to place a “new face” or a new caregiver with the client who is not familiar with the family or the client’s needs.

Our CAREGivers are specifically trained in communication and hand-off between shifts so the in-coming CAREGiver is up to speed and ready to continue great care.

We also do periodic in-office team roundtable discussions with our client teams and our on staff nurses to communicate best practices and ensure exceptional care. It's one of the many extra steps we take to ensure we are doing right by our clients.

Our team approach also improves client interaction. The senior is more engaged having different people in the home to relate to, allowing for a variety of conversations and experiences to share.

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8. What if a potential client requires care, but not 24/7?

Here at Home Instead Senior Care we tailor caregiving services each client’s needs. This could mean as little as one visit a week to around the clock care. This tailored approach gives options to families outside assisted living. Assisted living facilities are expensive and you get little one-on-one care. For the same cost of a basic assisted living, you can have 8-12 hours of on-on-one care EVERY DAY OF THE WEEK, provided by one of our expert CAREGivers in your own home. To put that in perspective, 8-12 hours everyday is a lot of care and many of our clients do not require that level of care. If you do require that level of care, staying home with Home Instead is a better value.

So many people go the assisted living route prematurely. You can get so much more dedicated, compassionate care in the comfort of your home. My advice to families that are considering care options is, make sure you spend your money on care, not rent and of course to let us come to you and provide a care consultation so you can see first hand the value we can provide.

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9. What if someone only needs care temporarily?

We help many clients transitioning home or into a rehab after an injury or surgery. We have developed a proprietary Transitional Care Plan (TCP) and have utilized it frequently and with great success. We work with your case managers, hospital social workers and health care professionals to generate a TCP specific to you and we follow-up with your care team as we help execute your plan of care. This partnership and service help reduce hospital re-admission rates which impact hospital and government spending. In the last 6 months our hospitalization rates for our clients is less than 4% and our re-admission rate is less than 1%.

We also serve many clients who visit Southwest Florida seasonally. We have lots of success helping our seasonal clients get settled and enjoy their winters here with great help.

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10. What else can you tell me about your CAREGivers?

Our highly trained and compassionate CAREGivers provide customized care based on the individual needs and schedules of each client, allowing them to enjoy life on their own terms. Every Home Instead CAREGiver is comprehensively screened, interviewed, trained, bonded, insured and covered under worker’s compensation to ensure that our clients receive the highest quality service from trustworthy, experienced professionals without the worry.

I promise that every person on my team that sets foot in your home goes through this rigorous process and is bonded and insured. If you are looking at employing a registry, please ask them to make this same promise. It can save you a lot of headache in the future.

We specifically look for candidates that have the “heart”. That is a trait that cannot be taught in a classroom but is essential to be successful in this career. We dedicate more time to training our caregiving team than anyone else. Our goal is to have the most caring, prepared and supported care team in the world.

Because of our wonderful team of CAREGivers and office staff, we have a 99.2% satisfaction rating from the last 400 clients we’ve served.

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11. What other services do you offer?

Our CAREGivers go above and beyond for our clients. Our goal is to help our clients remain active and maintain valued activities. Our Home Care Experts work with our clients and their families to establish Care Goals. These goals could be physical or social related. We want to help our clients enjoy activities that they used to love but can no longer do on their own because of their limitations. Our CAREGivers thrive on making those goals a reality. We have helped our clients get back into cooking, music, social engagements, family events, musical performances, bird watching, botanical gardens, etc. The list goes on and on.

We also help plan arrangements and provide a travel companion for clients visiting family up north or for our seasonal clients who are ready to return to their tropical paradise for the winter. Our website shows all the different types of service we provide. Something special you are looking for? Please ask. In over 15 years of business we've gone above and beyond for our senior clients and their families and we look forward to delighting you too.

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12. How do you (and your clients) know if your CAREGivers are living up to Home Instead’s standards?

Maintaining high quality service and standards are paramount in this business. If we drop the ball, even once, we lose trust of that client and their family. We are committed to providing excellent service at every step of the process with you and your family.

We routinely conduct Quality Assurance visits with all our clients. As well as consistently request honest feedback from clients, CAREGivers and administrative team.

Home Instead has implemented Telephony System (or telephone time clock) with online and mobile access for management to quickly address any issue and guarantee we honor our commitment and be there for our clients. This system also provides excellent accountability for billing/responsible parties.

I guarantee that if one of my CAREGivers is not able to fulfill a shift, we are working on finding another member of your care team to be there. If we cannot find a CAREGiver to fill that need, a member of my administrative team (who is also cross-trained as CAREGivers) will be sent to provide your care.

We also provide a free online service called The Family Room in which the families and POA's of our clients may log in to their account to look at the schedule, review our CAREGiver's notes and look at billing. It's just another free service we offer to raise the bar of service and provide piece of mind to families locally and out of town.

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13. Is in-home caregiving affordable?

The short answer is yes. In fact, in most situations staying home is the most affordable option. Senior care is expensive and most families do not budget for it. Therefore, when it comes to finding care, they look for the least expensive option. I liken it to any other care need. If you break your leg and your doctor says you need surgery, your focus should be on meeting your care needs. The same is true for meeting the care needs of a senior, they can be just as dire and immediate as a broken leg. Because a senior’s care needs don’t always heal like an injury you should be very focused on what care you are paying for and what quality and value you are getting. My team of senior care experts will help you design a care plan around your care needs and your budget.

While Medicare does not pay for in home caregiving, we are happy to help you determine how we can supplement the services that Medicare does cover. The medical services of Medicare Home Health do not address many activities of daily living, just focusing on physical therapy, occupational therapy and skilled nursing. Home Instead CAREGivers provide assistance around the schedule of your Medicare Home Health provider to build a continuum of care. A lack of these non-Medicare services are the largest cause of hospitalizations and hospital re-admissions.

We can help answer your questions about what Medicare may cover and how Home Instead can provide the non-Medicare services. We will also coordinate with your Medicare Home Health service to coordinate schedules and a care plan to provide you with optimum service.

Long-term Care Insurance will likely cover our home care services, but it isn't always clear. We offer a free consultation to help you determine how to maximize your benefit from your policy. We also assist you with insurance claims and paperwork. We work with many insurance companies and will bill them directly for you.

The Veterans Administration (VA) also provides benefits to veterans and their families that can cover home care from Home Instead. (*Here's where Audra gets emotional* We have vets in our own family. Both of my grandfather's served in WWII, one in the Navy and the other in the Army, both deployed to the Pacific theatre. After seeing all the names on the WWII memorial in Washington D.C., I'm blessed they came back. My grandpa, who is and always will be my hero, was the recipient of 5 bronze stars for his service to our country. I miss him everyday.) To say we have a heart for vets is an understatement. We are proud to serve those who have served our country and have been since we opened our doors 15 years ago. We would be honored to help you and your family through the process of applying for your VA benefits.

We also work with many federal, state and county funded services that provide home care. The goal of these programs is to divert seniors from costly nursing homes and keep them successful at home. We have helped thousands of seniors through these programs over the years.

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It NEVER hurts to just ask! See if Home Care may be a good fit for you, or a loved one. Schedule a time to talk with one of our Care Experts!