7 minute read

We pick most of the topics for our blog posts based on questions from people as they inquire about home care. Some times families call us because their parent(s) are unhappy in their assisted living arrangement. They had a certain expectation but once actually there, things became different. 

“The concept of assisted living facilities seemed great when our parents originally looked into them. But the reality of it hasn’t lived up to their or our expectations.”

“The downsizing transition was hard for my parents. Moving away from their known environment and memories was very difficult.”

“The facility my parents are in has great activities and amenities, but my Mom rarely, if ever utilizes them.”

“The facility is telling me that I need to supplement my Father’s care because he is wandering and they are worried that he might get out an exit.”

“The facility told me that I have to bring in additional help for my mom because her needs have increased and she is taking up too much of the staff’s time.”

To avoid any misconceptions regarding the intent of this post, we acknowledge that there is absolutely a place for all kinds of senior care in the care continuum. Every situation is different and while we are a proud proponent of home care, there are some amazing facilities out there that are really good at what they do and are a great fit for a certain population. We appreciate their compassion for our seniors and love assisting them in any way we can. At the same time, for the benefit of a senior who's desire is to remain in their homes as long as possible, we firmly believe that home care should be included as part of the conversation early and always. 

The conversation we like to have is this: What can we be doing for your Mom right NOW to allow her to stay at home for as long as possible?

Many times moving Mom to a facility is the first thought that comes to mind, not because that is necessarily the desire, but because historically that's been the only option. I encourage families to try to avoid premature institutionalization by considering home care first and early on. Knowing that at some point an assisted living or nursing home facility may be necessary, it most likely isn't initially. How can you extend the quality of life Mom and Dad have right NOW, ensure their safety and keep them in the place they want to be? 90% of seniors want to live in their homes, in the communities they love.  

Let's explore the options.   

"When I talk with families about senior care I encourage them to focus on what is most important right NOW."

There are two main types of care: Facility-based care and Home care  

Facility-Based Care

Facility-based care is delivered in group setting. Group care means there are a number of residents receiving care by one or two aides. State law requires no more than 20 residents per aide. The best facilities in our area have 10-15 to 1. These facilities are great, but even the most amazing aide, if you are in charge of taking care of 10 people, cannot spend much time and individual attention to a single person. These amazing individuals have to get everybody up and dressed and down to breakfast, or everyone through shower/bath & change of clothes. That model doesn't allow for those aides to have quality time with their residents and care has to mostly be delivered on the facility's schedule, not the senior's.

Assisted living is considered facility based group care. Residents are grouped into care levels. If a resident's care needs exceed those levels, the assisted living facility may inform the family that they need to supplement their loved ones care with a service like Home Instead, or they can no longer stay in the assisted living and must move to a higher needs care situation. Typically you hit that threshold if your loved one needs more than 25-30 hours of care a week. This makes sense because most of the cost associated with an assisted living facility goes toward paying for the actual room in that facility (essentially rent + amenities), not necessarily the care itself. From a cost perspective, this is the worst case scenario as you have to pay for the assisted living plus for private duty care. We supplement care for people in facilities all the time in this situation. 

Aren’t facilities great for Social Engagement? The activities may or may not be something an elderly person wants/enjoys. Seniors say their favorite kind of activity is one-on-one conversation.  Personal interaction is key for all of us, but especially our elderly. You will find that a great relationship for your elderly loved one is incredibly important. It sheds feelings of loneliness and isolation (especially for those who are no longer mobile or are incredibly difficult to move)

Aren’t facilities safer? The facility and rooms are built to be safer than home environments with appropriate hand rails, call buttons, etc. The facility’s on-call staff is very helpful in emergency situations. Many times families place their loved one in an assisted living facility because they are a fall risk. But even fall risks, without supplemental care, are still at risk of falling. My wife's grandmother has fallen many times in her assisted living facility in Ohio, both with and without an aide present, not unlike when she was living independently. Most true emergencies will still require a trip off-site to the emergency room.

My parents can’t afford in-home care. Isn’t that expensive? Senior care in general isn't an inexpensive proposition. If you are currently paying for or are seeing what your parents are paying for an assisted living facility (ALF) you'll already know that. Here is an interesting study performed independently by Genworth Financial to compare the costs for various types of senior care. It shows a cost comparison between different care models.

When I talk with families about senior care I encourage them to focus on what is most important right now. In a couple years Mom may not care as much about where she is living or increasing health issues may dictate her situation, but right now, if she still has the desire and ability to stay in her home with the help of a home CAREGiver, you should absolutely try your best to do that. When evaluating providers, look to where your money is going. The most important thing in senior care is the actual care your parents receive. If I had a dollar to spend, I would want that to go toward actively caring and engaging with my family member.

Care provided on an hourly basis is tailored to the needs of the client. Our average client has 20-25 hours of care a week. That is roughly half the cost of an ALF. For the cost of a basic ALF you can have 40-50 hours of one-on-one care in the client's home. Private duty home care is currently private pay, but there are some changes occurring with Medicare that are looking positive for potential help in covering these costs.

Home Care

With home care, focus is on the individual. Home care tailors care plans, schedules, activities and routines around the person and their immediate needs. All care is provided one-on-one. The care environment is the comfort of home with opportunity for community outings accompanied by a trained caregiver. Home care providers can provide home safety assessments and make recommendation to make that environment as safe as any facility. Care is provided in shifts which is designed to allow the caregiver and the client time to interact and build a trusting relationship. I tell people that not only are we in the home care business, but we are even more-so in the relationship building business. That is because I guarantee the client/CAREGiver match. We know how critical a strong relationship is to success of any care situation. We do not provide skilled nursing, PT, OT, etc. But those services are offered in-home as well through our partner agencies.

Aren’t facilities better in case of emergencies? I have trained staff on call 24/7. I have one of my Director's and a nurse on-call 24/7. That allows us to handle emergency situations quickly and to get emergency services involved in true emergencies. 

Home care is geared towards reducing risk and preventing emergencies. Over the last 6 months only 4% of my clients have had a trip to the hospital, and we care for a large number of clients suffering from chronic illnesses. Due to the nature of home care, and the one-on-one attention each client receives from our CAREGivers, we can function as a second set of eyes, watching for changes in health, safety hazards and ensure a good nutritional and personal hygiene routine for each person we serve. A facility may have a nurse on the premises to respond to an emergency, but typically true emergencies will require a trip to the ER, even in a facility. 

Do you provide 24 hour care? I do provide care around the clock for clients. I do not provide live-in care. The Department of Labor laws make that difficult and we've found that the benefits don't justify the risk to the client and agency. We provide care in those situations on a shift basis. That way we always have CAREGiver who is fresh and ready to provide great care at any hour. Here is a discussion on live-in care that talks about the pros and cons in more detail. 

Selecting the right provider for your loved one

Here is the link to a guide that helps families navigate the decision process of finding the right care solution for their loved ones. Be wary of private caregivers and registries who are 1099 contractors. They may be able to charge less hourly than we do, but understand that all the risk and liability falls on the family. I have 200+ W2 employees. Everyone is Level 2 FBI background screened, drug screened, bonded and insured by me. My team has 16 years experience taking wonderful care of families, including mine. We have had our own CAREGivers take care of my Nana, who suffered from Alzheimer's for 10 years. I trust my caregivers to take care of my family, so I have confidence that I have great people to help yours.

How to get started with home care. I would encourage you to set up a free in-home care consultation with one of my home care experts. There is no obligation to move forward. The benefit is that my team can help you and your family find the care solution that works for you. Even if we discover we can't help, we have a wealth of resources and connections in our community and would be happy to point you in the right direction. The value of home care is goes far beyond the price tag, especially when it means a higher quality of life for your loved one.

Do you have a loved one who wants to stay in their home for as long as possible? Give Laura a call at (239) 433-4025 to see how home care can work for your specific situation.