Whether your parent suffers from Alzheimer's disease, decreased mobility, or any other problem, you may want help.
To decide whether to try a home caregiver, mull over the answers to the following questions:
When should you hire a caregiver? Typically families do it when they feel burned out and need a break. You're most often to think about it seriously after your parent falls, after a hospitalization, or after a visit that reveals a parent is wandering around or not eating, says Lily Sarafan, president and COO of Homecare Assistance.
Can you get your parent to buy into the idea? "Involving them in the process can really go a long way with helping them accept or welcome the help," says Greg Archer, CEO and co-founder of Age Advantage, a nonmedical, in–home, full-service senior care provider. "We actually talk to the senior and not to the children."
What questions should you ask a potential caregiver? Ask about past experience and past training. Ask what the caregiver would do if she shows up and the client doesn't answer the door. The answer: Call the primary contact or the building manager, and look in the window to see if the client fell on the floor at night, says Archer. If all else fails, call 911.
Should you hire a caregiver on your own or through an agency? It depends on your job, your management and vetting skills, and your budget. Agency caregivers are more expensive — $16 to $30 an hour, depending where you live. But they eliminate a lot of headaches. A big downside to doing it on your own: "If the caregiver is unable to show up, there really isn't a backup caregiver," says Sarafan. Then you need to take time off from work. Also, think about whether you feel equipped to call references, figure out whether your homeowners' insurance covers someone in your house, take care of an employee's Social Security and taxes, and run driving record and criminal background checks. Full-service agencies do all these tasks for you.
Should you get round-the-clock care? Some agencies, such as Homecare Assistance, offer live-in care. Providers rest in the evenings but remain on call. It's also possible to get shift workers at standard hourly rates.
How much does your parent want to live at his or her own house? "We really want to be that full alternative to a nursing home and allow people to live in the comfort of home all the way through the end of life," says Sarafan.
How much do you want your caregiver to do? Some agencies, such as Homecare Assistance, train their caregivers in nutrition, physical activity, and mental stimulation (puzzles and hobbies), so they do more than just make sure your parents are safe and fed.
How open is your parent to getting outside help? Don't force it. "It's not just your decision," says psychiatrist Mary Alice O'Dowd, director of psychosomatic medicine at Montefiore Medical Center in the Bronx. "The parent has to be willing to accept the help."
What is your parent's personality and current condition? Alzheimer's patients can become paranoid. Delusions of theft are common since they forget where they put items, says O'Dowd. "The caregivers have to be replaced because the person isn't trustful of them." She may even think someone is purposefully putting stains on her clothes since she can't remember that she spilled something herself. "Clearly they're not able to take their medication and keep the house clean," says O'Dowd. "And yet they'll say, 'I'm able to.' There aren't easy answers…It can be a real struggle to override the wish of a parent for independence."
Do you want to try "share-care" with other family members? That's the approach that registered nurse Gina Kaurich, a certified dementia practitioner and the executive director of client care services at FirstLight HomeCare, took with her 89-year-old mother-in-law, Martha, who has Alzheimer's disease. "She almost burned the house down just warming up some green beans," she says. "It just became a safety issue." Martha spends a couple weeks in a room at Kaurich's home and then moves to her sister-in-law's place for the rest of the month.
How much time are you available? Since Kaurich and her husband work full time, FirstLife caregivers, trained in dementia, help out 40 hours a week. Kaurich likes knowing that her mother-in-law is getting lots of tender loving care at all times. "With homecare, there's more of a one-on-one type of attention," says Kaurich. "With a nursing facility, usually it's 15 people to one." A nursing home can be as high as $20,000 a month—far more expensive than an in-home caregiver, says Kaurich. Like FirstLight's other clients, she feels safe since she knows providers have had drug screens and background checks. And she appreciates that they also act as companions who look through her mother-in-law's photo album with her.
For more stories about caring for aging parents, read: