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If you are one of the approximately 53 million family caregivers in the United States who is watching over your elderly loved one on a daily basis, your work is invaluable[1]. What you’re doing is a labor of love, often volunteered, that helps keep your loved one as safe and healthy as possible. And though that care can never truly be quantified, AARP has tried to put a dollar amount on it, with the economic value of caregiving for seniors aging in place being over $470 billion.[2]
Family caregivers experience significant impacts on their lifestyles that cumulates over time to affect their health, relationships, and finances. The National Alliance for Caregiving and AARP teamed up for a survey that found disturbing trends: 61% of family caregivers have a job outside the home and have faced work strain due to caregiving, from lost wages to lost promotions. About 45% of family caregivers for the elderly have experienced a negative economic impact, and 23% believe that caregiving has made their own health worse[3].
Though family caregivers do the best they can to keep their loved one safe and healthy, such as monitoring medications, looking for signs of health problems, assisting with daily tasks, and investing in medical alert technology and aging in place home modifications, eventually there could come a time when a professional caregiver is needed.
When is it Time to Call the Professionals?
Professional caregivers provide a wealth of assistance to not only the elderly but to their families as well. They provide daily assistance with a variety of life tasks, from bathing to dressing to eating. They provide physical and emotional support for their clients. They serve as a vital link between their client and their client’s family, as well as a bridge between the client and their healthcare team; the professional caregiver can often spot physical or mental problems well before someone else might, as they are trained to see the signs that indicate a person needs more medical assistance[4].
When is it time to ease back from your family caregiver role and call in the professional caregiving for seniors? These questions might help you decide[5].
· Does your loved one want to continue living at home?
· Does your loved one now require more medications, daily medical treatment, or the kind of careful healthcare attention that you aren’t qualified to provide?
· Are there mobility issues that are getting worse? (a medical alert systems with fall detection may be a great option)
· Does your loved one have a chronic condition or memory issue that is now making day-to-day management of life activities too hard to handle?
· Are you dealing with significant stress, anxiety, or even depression, which is ultimately impacting your health in a negative way?
· Are you facing difficulties at work or with other family members, such as your spouse and children, because you are devoting so much time to being a family caregiver?
Remember, a good professional caregiver for the elderly doesn’t have to be in the home 24/7. If you are living with your loved one, for instance, perhaps you can still provide care during the evenings while you work during the day. The professional caregiver’s support could be enough to make life much easier for you. In other cases, you could turn to professional caregivers for 24/7 help, depending on your family and financial situation.
Different Types of Professional Caregivers
When considering your options for professional caregivers, there are a few ways to go. The caregiver for the elderly that you choose should be based on how much care and the type of care that your loved one actually needs. Some caregivers provide help around the house and companionship, while others provide very specific medical care, such as caring for the elderly with dementia. Here are your general options[6]:
· Personal care aides often don’t have to be licensed. They serve as companions, help around the house, assist with bathing and dressing, prepare meals, offer conversation, and might help with transportation, light housework, and shopping.
· Home health aides are often required to be licensed. They have some medical training, so in addition to all that a personal care aide provides, they can check vital signs and assist with ensuring medications are taken properly. These individuals must have 75 hours of training to meet federal requirements, and other training and certifications vary by state.
· Licensed nursing assistants or certified nursing assistants, known as LNAs or CNAs, have even more medical training. They can help with taking vital signs, setting up medical equipment, cleaning catheters, monitoring infections or illnesses, offering some appropriate exercise, and even administering some treatments. Their work is monitored by a registered nurse or nurse practitioner.
· Skilled nursing providers are also known as LPNs, or licensed practical nurses. These individuals are licensed by the states to work as nurses in a variety of settings, including the home. They provide direct care that goes beyond that of CNAs, such as administering tube feedings, injections, and IVs. They also work closely with family members and the client’s healthcare team.
· Registered nurses have completed at least two years of schooling to become licensed. These professionals are ideal for providing caregiving services and senior health care for those who have a variety of serious health conditions that might require 24/7 monitoring.
How to Find a Caregiver
There are a few ways to find a professional caregiver. Though you can look for someone “through the grapevine” and often find a personal care specialist who has worked with friends and their family members, most people choose to contact a home care agency. However, there are so many agencies out there that simply narrowing them down can be tough. Look to your loved one’s doctor and their staff for recommendations, as well as contacting your local senior center or your Area Agency on Aging.
The good thing about working with a home health agency is that everything is taken care of for you on the business end. You don’t have to worry about hiring or firing anyone, handling taxes or insurance, or finding a substitute if your usual caregiver is sick, on vacation, or otherwise unable to work their usual hours. However, there are downsides – one is that you might not have the same attendant each time, which can be tough for an individual who wants to get to know the people working with them. This can be especially tough for someone with dementia, as it can be difficult to establish trust when a caregiver is always changing[7].
If you do choose to hire someone privately, there are a few things you need to be sure about. It’s important to make sure the professional caregiver is exactly who you want working with your loved one.
Vetting the Short List of Potential Caregivers
When choosing a professional caregiver from your short list of options, it’s important to make sure there will be no problems up-front that could derail your selection. Here are a few ways to do that.
· Explain the situation at home. Are you looking for someone who will simply be a day-to-day companion and do things around the house, or does your loved one need more skilled medical care?
· If there is a pet, does the potential attendant have any allergies or issues that would make it tough to work in the home environment?
· If your loved one has dementia, look for someone who has experience in that area.
· Ask to see their credentials. Then check with the agency that provided those credentials to make sure they are up-to-date.
· Ask for references and make a point of calling them. Ask pointed questions about the work the person did for them and how well it went.
· Always perform a background check before letting someone into your home and make sure it comes back clean before making the hire. If the person will be transporting your loved one, check with the DMV to make sure they have a clean driving record.
· Write out a job description and contract so there is no doubt everyone is on the same page. Spell out the expectations.
· Interview the person at least once, in person, and preferably where your loved one can meet them and ask questions as well. Trust your gut instincts when the interview is over. Did everything feel right?
Understand that if you are hiring directly rather than through an agency, you will be responsible for a variety of legal things, such as providing a 1099 for an independent worker, taking out taxes (if that’s what you choose), and more. It’s important to speak to a financial advisor about how to handle all of this before you hire anyone.
Keeping Tabs on How Things are Going
Good communication is absolutely paramount when you’re hiring a professional caregiver to take care of your loved one. It’s important to set up regular meetings to talk about how things are going and what parts of the senior care plan might need to be changed. If you are often in your loved one’s home, this part is easy – you could even have a short discussion about how each day went. But if you are long distance or otherwise unable to be around that often, you can talk with the caregiver over video chat or phone on a regular basis.
Look for a variety of issues that might not be discussed. For instance, is the professional caregiver making sure that your loved one is wearing a medical alert pendant at all times? Is your loved one maintaining a good weight? Are medical supplies disposed of properly after use? Is your loved one making it to all their appointments? Are they keeping the home free of clutter and fall risks? Is there some documentation (if necessary) of their vital signs and other medical-related tests or observations?
Talk to your loved one about their experience, assuming they are able to do so. Are they comfortable with their professional caregiver? Do they have any concerns? Do they feel stress or anxiety when the caregiver arrives, or is it an enjoyable moment? Are they ever afraid of their caregiver? Pay close attention to what they say – even those who have dementia might be able to tell you the absolute truth about how they are feeling and what is happening in their home. Everyone must be comfortable with the caregiver in order for the arrangement to work.
And finally, never hesitate to do what you have to do for the health and safety of your loved one. If a caregiver isn’t working out, make that clear in the kindest way possible before parting ways and looking for another person to work in that role. On the other hand, if the caregiver is absolutely wonderful, make sure to shower them with the praise they deserve!
Alert1 wishes health and safety to you and your loved ones!