Saturday, July 1, 2017

Guest Post: How to Decide What Kind of Elder Care Your Loved One Needs

By Kathleen Webb
HomeWork Solutions, Inc.

There are a myriad of factors to consider when the time comes for you to provide additional support to an elderly loved one. Elder care comes in many different forms, with more options available now than ever before, but that doesn’t mean the decision will be any easier or quicker to make.

The right kind of care will make all the difference to your loved one and the rest of your family. It’s important to begin the decision-making process as an open-ended conversation, preferably before the need for care is acute. Read on to discover helpful ways to approach the issue, as well as the different options to consider.

Conducting a Needs Assessment
Begin your journey by doing a needs assessment with your loved one. A needs assessment will help you get a clear picture of their current requirements and desires. Some of the primary areas to consider include physical, emotional, medical, financial and social needs.

Rather than just assuming the reasons for your loved one’s struggles, encourage them to help you understand the underlying problems of the symptoms. Perhaps you’ve noticed your mother has become more agitated as her dementia has progressed. Make space for an open and judgment-free conversation about this frustration. You may discover that it isn’t only the dementia that is provoking the reaction, but also a lack of healthy social connection with peers. This new information may change your approach to looking for elder care, as social programming and day outings become prioritized to meet your mother’s needs.

What Kind of Care?
Once you’ve carried out your needs assessment, you should have a better idea about the kind of care that your loved one would like, and the kind of care that he or she needs. Their medical requirements will determine the amount of training and skill required of your caregiver.

Elder care is offered by both custodial and skilled workers. Although custodial caregivers are able to support your loved one with day-to-day activities like bathing, eating and dressing, they are unable to provide any clinical support, such as checking on vitals and assisting with medical equipment. If your loved one requires clinical care, at-home healthcare will be a better match.

If you’re still unsure about the kind of support that would best suit your loved one, you can speak with a geriatric care manager, who can be accessed through either public or private means.

There are also digital marketplaces that can put you in touch with a care manager. Care managers, or case managers, as they’re known in the public sector, will assist your family in coming up with an individualized care plan. They can offer the option of arranging and monitoring care services, too.

Working with a care manager can save you time and money, as they’re already familiar with elderly needs and caregiving options. You won’t need to wade through masses of information on your own, and you won’t opt for elder care services that aren’t yet necessary for your loved one. After choosing the kind of care you want for your family member, you will have to decide whether you will hire through an agency or use the services of a private caregiver.

Using an Agency
Hiring through an agency is the least complex of the options, but it also comes with the highest price tag. An agency caregiver will cost you $25-40 per hour, depending on the agency and the part of the country. Usually, agency caregivers have already been run through a police check, and have all the required skills and training to qualify them for their role. What’s more, because the agency is their employer, you are not responsible for payroll, taxes, insurance and maybe even scheduling.

Working with an agency can offer greater convenience, but there are certain restrictions to bear in mind. You may be limited in terms of choice when selecting your caregiver, or you may be given an automatic replacement if your caregiver calls in sick. You may also be locked into a contract with an agency, and have less flexibility with scheduling.

Privately Hiring a Caregiver

If you want a privately hired caregiver to look after your loved one, you will enjoy a larger pool of candidates to choose from, so there’s a better chance of finding your perfect match. Private care also boasts more flexibility when it comes to scheduling, and lower hourly rates of $12-20 per hour.

You’re not limited to an agency’s existing employee base, either. That means you can advertise and seek out a candidate whose skills and training are tailored to your loved one’s needs. Some private caregivers may also offer mobile care, which would allow the caregiver to accompany your family on vacation or help out while you’re away.

New digital marketplaces are making it easier to find the right caregiver, by using robust algorithmic matching abilities. They also offer services similar to that of a geriatric care manager, to ensure you’re matching with the correct caregiver.

Privately hiring a caregiver also comes with unique responsibilities, relative to that of an agency. Because you hire the caregiver directly, you become that worker’s employer. Remember to factor in the costs of payroll taxes and insurance, which is roughly 12-15%. It is also recommended that you provide an employment contract, and negotiate all terms of service, including sick days and back up coverage.

Be Patient
The most important thing to remember is that there is no one solution that works for all older adults. Often a process of trial and error is necessary when looking for a good match, so don’t be discouraged. Be patient with yourself and your loved one as you navigate this new season of life together. Involve them as regularly as possible in all decisions, and give them the opportunity to try things out and change their mind.

Elder care is a shifting series of needs, and though you may find a caregiver who is a perfect fit for a certain period, be prepared to reconsider your care as time goes on. Stay attentive and responsive to your loved one's changing requirements, mobility, and desires. Ultimately, you want what’s best for that family member so they can live life to its fullest.

Additional Resources
HomeWork Solutions Knowledge Base

Long-Term Care

Elder Care Options

Kathleen Webb co-founded HomeWork Solutions, Inc. in 1993 to provide payroll and tax services to families employing household workers. Webb has been featured in the Wall Street Journal, Kiplinger’s Personal Finance, and Congressional Quarterly. She also consulted with Senate staffers in the drafting of the 1994 Nanny Tax Law. She is the former President of the International Nanny Association, the leading professional association in the in-home childcare industry. You can contact HomeWork Solutions directly via Twitter (@4NannyTaxes).

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