People don’t really think about homecare until they need it. When a situation arises that you need of someone to help you in your home or residence most people go into panic mode as they deal with the crisis. You then look in the Yellow Pages, call friends or rely on someone to guide you to the places and people that can assist you. If you are in this crisis intervention category rest assured you are not alone. This is typical of most of us when it comes to many healthcare issues particularly home care. We go about our days doing all our routine activities of daily living such as brushing our teeth, showering, putting on deodorant, tying your shoes, dressing, preparing our meals, eating, doing laundry and cleaning our living spaces. When you are healthy, these activities are taken for granted as they are just part of every day. What happens when we break a leg, are in a car accident or slip on ice and fracture an arm? We soon learn that those every day activities are not so ordinary or easy to do anymore. Aging can also play a part in our decreased ability to perform these activities without thinking about them. Diseases such as Arthritis, MS, Alzheimer’s, Parkinson’s and sometimes Diabetes can also add to our frustration in not being able to do those things for ourselves that we have done since our parents gave us the gift of independence and taught us self-care. Lets talk about a man in his early 80’s, living alone with arthritis. This person may find that he could use a little assistance with the housekeeping as it has become very difficult to carry that heavy vacuum up and down the stairs and changing their bed. They may require only a few hours a week to complete these tasks and then be able to cope themselves with everything else. Possibly a family member has been helping out doing his shopping and other tasks but he is finding when their loved one comes to help there is no time for a visit. He wants to remain independent, but realizes he requires assistance. This person would benefit from having a home care worker. There are different ways one could go about finding the right person to assist them. The local Community Care Access Centres (CCAC) are there to assist people in their home that meet a certain criteria. The service is paid through our OHIP dollars and being an Ontario resident with a valid Health Insurance Card would entitle you to this if you meet the criteria. Those criteria must usually include elements of personal care such as bathing, dressing, feeding or grooming. Our man suffering with Arthritis would likely not qualify for this assistance through the CCAC and would have to purchase this service on his own. He may have a benefit plan from his former or current employment that assists in paying for some or all of his homecare or maybe he carries Long Term Care Insurance that will also pay for a portion. Assistance in payment for homecare may also be available if he was a war veteran. Under this category there is guidelines of qualification and it is best to contact the Department of Veteran Affairs to find out if you meet the criteria. Another way to gain information is to talk to others that may have a homecare worker or know of someone who has had one in the past. Ask them who the company is they are getting their worker from and if they are satisfied with the help provided. Call the company, tell them the situation, and ask about some of their policies, what they can provide as well as price per hour. Shop around just as you would for any other service you purchase. Look in the phone book, seniors magazines, and the internet and contact the CCAC for referrals of companies to call. I strongly suggest never hiring an individual person to do your care. This person may sound great and the price will usually be lower than going with a company but there are some red flags you should be aware of when hiring a private individual. There are concerns to consider such as: does this person carry liability insurance for the occasional accidental breakage of that priceless antique vase you have. Under most circumstances a private individual could not afford to carry this type of insurance. Would they have malpractice insurance in cases of professional medical care? An individual would not be able to carry insurance under the Workers Compensation Insurance Act so if they were hurt while on duty such as slipping on ice in your driveway, they could sue you for damages. What happens if the worker is ill- there is no one to replace them. With a company you have the assurance that you would have the option to take a replacement staff. If that person was not happy in their position and decides to leave, you are back to square one of finding another worker. If you hire a company, you would simply call the office and have them replaced. There is always the chance that you will not be happy with the individuals work habits or even personality which again brings you back to square one after you let them go. With a company just pick up the phone and let the office tell them not to return to your home and have someone new come to you. There are many companies to choose from but, they are not all created equal. Individual policies held by companies can differ from one to the next. It is important for you to find the best one to provide you with the service you need within your budget. Ask for options with the company and don’t be afraid to ask for a discount in price. Make sure a service agreement or contract is put into place between you and the company and set the price which should remain the same for a year from start date. Be up front if you find the price too high but remember to ask questions regarding their policies surrounding hiring practices. Make sure the company hires their staff based on criteria that includes a police reference check, full medicals, industry references, up to date CPR and First Aid certifications, employee continuing education and fire prevention training. Find out if the company offers workshops for their staff that keeps them up to date on new education in the health care field. Make sure that they are willing to come out to meet with you and discuss a plan of care that meets with your needs. This way you can feel more comfortable of who to speak with if an issue with a worker does arise. Be open to the fact that nothing is ever perfect and that not everyone is meant to work together. Sometimes personality conflicts arise and you may not meet eye to eye with a certain worker. Understand that mistakes do happen and because we are all human people can run late or become ill. The worker may not fold the towels the way you always did but be aware that you can teach them how you like things done. Enjoy having a new person to talk to, teach new things to and learn from. Look at the situation as a whole new learning experience for yourself and the worker and you will be surprised how easy it was to make the transition of accepting the help.
1. Use an agency, rather than hiring privately. Hiring privately places the individual receiving care at risk because people often answer private advertisements when they cannot find work with the agencies. With private hires, there is no screening, oversight, checking of identity documents, or insurance coverage, all of which can be expected from a reputable agency. 2. Consider the range of services offered by the agency. Non-medical care should include personal care (bathing, dressing, and continence care), not simply handing soap or shampoo to the person who needs care. 3. Does the agency have a consumer-driven approach? The agency should be willing to entertain special requests. Dates and times for service should occur based on the client’s needs and schedule, not the agency’s. 4. Is the agency responsive? How quickly the agency can find a caregiver initially is often indicative of the availability and reliability of substitutes. The agency should also be willing to offer replacements if the client is not satisfied with the performance of a caregiver. 5. Will the agency ensure the client’s continued satisfaction? An initial visit should be conducted in the home of the person who receives care. Ongoing visits and phone calls should continue throughout the duration of the case. 6. How affordable is the service, and will the company quote rates on the telephone? Be wary of an agency that will only give rates after seeing you in your home. Watch for any “hidden” fees, for example, extra charges for personal care or light housekeeping. 7. Does the agency offer a discounted daily or “live-in” rate, or merely charge the hourly rate multiplied by twenty-four? The cost for a live-in caregiver should be roughly the same as the cost (or less) than one day of care in a nursing home. 8. Of the total fee charged, how much does the Caregiver receive? More money does not always equate to better services. Some agencies charge more than double the fees that their caregivers earn. 9. Does the agency interview the caregivers, or merely process applicants? Interviews should be one-on-one, in-person, and extensive. Ask for samples of the types of questions the agency asks the caregivers. Remember, a group orientation is not a substitute for a fact-finding interview. 10. Are references checked, or does the agency merely confirm dates of employment and rehire eligibility? A thorough reference check will include comprehensive discussions with former supervisors to ascertain the caregivers’ past behavioral patterns. 11. Does the agency conduct statewide criminal background checks? Background checks should be comprehensive, not merely a county check. 12. Are health screenings required for the caregivers? A complete medical examination and TB test before referral will reduce risk for the person who receives care. Shopping for the homecare company that is right for you is as important as buying your first home, selecting the correct university, or choosing your best friend. Research the agency thoroughly and look for a company with a known reputation in the industry. If you make sure you are comfortable with the people with whom you are doing business and all parties should be pleased with the outcome.