Choosing a provider
Many older adults needing help with daily activities prefer to continue living at home with familiar and comfortable surroundings. Home care is a great option if you prefer to remain at home and require extra care that cannot be provided by friends and family.
Having someone help you at home might feel difficult since it involves having a stranger enter very personal areas of your life. Accepting help with various tasks can trigger feelings of shame, helplessness or anxiety. For example, receiving help with dressing and bathing may be embarrassing. Discuss your emotions and any problems that may arise with someone you trust, such as a loved one, a doctor, or a clergy member. Sharing your feelings and concerns can help you plan for home care in a safe and manageable way. Eventually, you may come to realize that you are not alone in needing help. Indeed, by using home care services as a solution to maintaining maximum independence, older adults often develop feelings of satisfaction, relief, joy, and renewed hope.
What should I consider when looking for home care?
What services do I need?
Typically, a disease, illness, or disability leads people to seek home care. Services are needed when your safety, health, or overall well being may be in jeopardy without them. For example, if you are unable to prepare meals — a situation that could affect your diet and health — then you would need assistance with meal preparation. Some older people find it difficult to accept the reality that help is needed. Therefore, deciding which home and personal care services you need might be best done through conversations with someone you trust, such as a loved one, a friend, a doctor, a social worker, or a nurse.
How often and how long will I need these services?
As your needs change, the length and types of home care may vary. For example, at first you may just need a few hours per week for house cleaning and grocery shopping, but later, recovering from surgery, you may need help with meal preparation and nursing care for a couple of months. Someone who is living with a difficult chronic medical condition like macular degeneration (an often incurable disease that impairs vision) or Alzheimer’s disease may require services long into the future. Your doctor, family members, home care provider, and other concerned people in your life can all help you determine how much care, what kind of care, and the frequency of care that is needed.
How am I going to pay for these services?
1) Private insurance or long-term care insurance that aid in paying for services. Some policies cover certain types of home care for specified periods of time. It’s important to find out exactly what your insurance covers before you arrange for home care.
2) Medicare. Medicare may partially cover home care expenses for a short period of time, up to 2 to 3 weeks, but only for skilled nursing care as related to an acute medical situation or physical or speech therapy that is prescribed by a physician nurse practitioner or physician assistant.
Unfortunately, Preferred Home Health Solutions is not a Medicare provider.
3) Medicaid. State Medicaid programs may provide personal and home health care services for persons with very low assets and limited incomes. If you currently receive Medicaid, talk with your health care provider about receiving home care services through Medicaid. To apply for Medicaid, you must file an application withyour local Medicaid office or call your local Health and Human Service Department for assistance. You can also complete the application and obtain more information by visiting Wisconsin’s Medicaid website or benefits.gov.
4) Private Pay, also known as “out-of-pocket.” If your private insurance or Medicare or Medicaid does not cover the cost of your home care services, you will have to pay privately. Most licensed home care agencies in Wisconsin charge by the hour for a home attendant to help with personal care services, and often these agencies require the aide be hired for a minimum of 1 – 3 hours per day.
Who will provide these services for me?
If Medicare and/or Medicaid pay for home care services, then the home care services must be provided by a Certified Home Health Agency. If you are paying through a private insurance company, you will need to find out how to handle costs with your insurance company. If you are paying “out-of-pocket,” you will have all of the following options:
Private Individuals. You may prefer to hire help through friends or family recommendations or through answering an ad in the newspaper. Although the cost for private individuals is often significantly less than what is charged by an agency, the worker may have little or no training in the home care field and require on the- job training. In addition, you will have to call references and do the background checks to make sure the person does not have a prior criminal record, and you have to make arrangements for back-up coverage should the worker be late or unavailable due to illness, personal reasons, or vacations.
Home Care Agency. A home care agency should be certified or licensed and ensure that workers will be trained and supervised according to State regulations. Many home care agencies require a four-hour minimum for each visit to the home. The agency should be responsible if a worker is tardy or absent from work or if a worker needs to be replaced for any reason. Employees of Preferred Home Health Solutions are screened thoroughly by extensive reference checks, criminal background checks, driving history checks, pre-employment and random drug screens including on-going training.
What should I ask a home care worker before hiring?
Whether hiring a home care worker through an agency or any other means, you should interview the candidate(s) in person before hiring. If at all possible, do the interviews with a loved one, friend, or social worker so that you can have another point of view about the candidate(s). This is helpful so that a candidate knows that you are not isolated and that you have someone else involved in your life.
During the interview, ask the following questions:
Have you ever cared for an older person before? If so, what did you do?
Did you like the work? Why or why not?
What brings you to be looking for this kind of work now?
Do you have references? (All candidates should be able to provide at least 2-3 work and personal references).
During the interview, discuss the following:
What specific work you want the person to do every day?
What hours and days you want the person to work for you?
The salary you will be paying (if the person is not from an agency), how you will pay the person (cash or check), and what day of the week is payday.
Your expectations regarding promptness, attitude, and behavior.
How your money will be handled. Develop safety measures to protect yourself from financial abuse. For example, if the home care worker will be grocery shopping, set up an account at the grocery store with a periodic statement of purchases or devise a system of cash and receipts for monitoring spending.
During the interview, consider the following:
How does the candidate present her/himself?
Is the person clean and neatly dressed?
Did the person come on time for the interview?
Did the person act respectfully towards you?
Did you feel comfortable being with this person?
Before the candidate leaves the interview:
Get the candidate’s name, address and phone number.
Information on the best time to reach the candidate.
If the candidate is not coming to you through an agency, get the following:
Driver’s license number (if the person will be driving).
Names and phone numbers of 2-3 references (at least one person should be a work reference).
After the interview:
Contact the references and ask how long they have known the candidate, the candidate’s strengths and weaknesses, as well as attitude, trustworthiness, and work habits.
If you do the interviewing alone, discuss your impressions with someone you trust after the interview, if possible.
Reasonable Expectations of a Home Care Worker
Your service provider should:
- Be on time.
- Provide the agreed upon and proper level of care.
- Be respectful to you and your home.
- Never use the phone for personal non-urgent reasons.
- Never borrow or buy anything of value from you.
- Be neat, clean, and professional.
- Be sensitive to your needs and concerns.
- Be trustworthy.
If you have any concerns about the quality of care or type of service you are receiving, you should never keep the concerns to yourself. Talk to the agency, a family member, a friend, or your health care provider. Trust your instincts and always tell someone if a relationship with a home care worker feels uncomfortable.
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