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Raising 'Rents (as in paRents)

Raising 'Rents (as in paRents) podcast show will give you everything you need to take care of your aging parents or an aging adult. It will inspire, educate and support through stories and experiences shared by those who have cared for an aging adult or is one themself!
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Now displaying: Category: health

Raising 'Rents (paRents) Podcast

Nov 8, 2018

Host Zack Demopoulos launches his 30 day preparation plan to care for an aging adult.  He continues with Day 17 where he talks about
hiring a professional caregiver.  Specifically how to choose a home care agency, what to look out for, what to ask, and how to protect your family. 

In Part 2 we will cover questions that you should ask a home care agency before you hire them, what the next steps are after you have identified the right home agency for your parent or parents, the different type of options for shifts including 24/7 or live in’s, how to protect your family when aides visit their home, what home care costs, and the pro’s and con’s of hiring a caregiver privately. 

 

This show is sponsored by ComForCare, a national home care provider that will help you live your best life possible.  https://comforcare.com/

 

This is Part 2 of Day 17 of the 30 Day Preparation Plan to care for an aging parent.  The Prep Plan is all about helping you the family caregiver provide your loved one with the best comfortable safest and efficient caring environment in which they can grow old in.

 

The topic we continue with today is one option for long term care which is home care.

 

If you have not had a chance to listen to Days 1 through 16, please go back to Season 1 and check out these episodes.  Also in Season 1 we introduce the 9 beginner steps in raising your parents.  http://raisingparentspodcast.com/page/5/

 

We also discussed on the Day 14 Episode how your parents can age in place—what to consider so that they can live at home independently as they get older in a safe environment and with dignity.  Be sure to check that show out to if you haven’t already.     http://raisingparentspodcast.com/episode-023-day-14-what-is-aging-in-place-for-mom-dad/

 

So now you have done your initial research and you have a few home care agencies that you want to ask questions.  Here are a list of example questions you should be asking a home care agency you are considering to hire: 

  • What type of agency are they? Are the aides their employees that is they are W2’s and all appropriate taxes are taken out by them or are they more of a placement agency and the aides are independent contractors that is they are 1099’s.  Typically an agency will appear to be much less expensive but what might be happening is that they are just placing aides in your home and you are considered the employer making you responsible for things like employee taxes, social security, and workers compensation.
  • Are they licensed, insured and bonded? Most states require these.  I would not put anyone in my house if they weren’t.
  • Will they provide you references. And if you get them, call them!  Ask for an actual client and another one that is a family member the agency assisted in caring for their loved one.
  • What are the office hours? What happens after hours?  When they tell you they are 24/7, clarify what that means.  VOicemail?  On call service?  And I would go as far as testing them.  Okay don’t call them 3 in the morning but I would definitely call them after hours to see the response rate and availability.
  • Is there a nurse on staff? What do they do?  Look for things like create the care plan, supervise the aides, monitor the care the aides are providing, assess your family member and do reassessments through out the year to keep the care plan up to date.  The care plan, by the way, should be written, a copy left in the house, and the aide or aides use it to review what is expected of them in caring for your parent.
  • Are the aides certified or licensed? How do they get certified?  What is your hiring process when you hire an aide.  What is your training program?  What is your follow up once you place an aide in your parents home.  Do they make unannounced visits?  When can you expect these?
  • What are the costs? Is there a charge for the nurse?  Additional costs beyond the hourly rate?  IS there a night or weekend rate?  How about holidays?  Is a deposit required and how does that work? Is there a minimum hourly commitment per shift and per week?  What is the cancellation policy?  When are you billed?  Do they take any insurances?  (Usually not, long term care insurance, Medicaid).  Medicare supplemental in 2019.
  • Ask for copy of the written agreement that your parent or you will have to sign. Be sure to read it thoroughly and ask questions before you sign it.  Typically these agreements are more about protecting you than the provider but still very important to understand what you are signing.
  • Ask if you can meet the aide in advance? And what is the process if it is not working out with the aide they assigned.  What do they do when an aide cant make it to their shift?

 

Next steps:  Nurse conducts an initial assessment of whom is receiving the care and they create the care plan.  The agency then matches from their qualified staff who would be the best choice.  Ask about this process. 

 

Typically you can find aides to do pretty much any kind of shift you need.  As little as one hour or two per day or week, shifts that match your working hours, overnight staff, weekend help, around the clock 24/7 or someone who lives with your parent.  Important to note that someone who lives with someone they are caring for is NOT considered working around the clock.  Zack reviews these types of shifts.

 

 

Must protect your family. First of all, even though agencies will tell you they are bonded and insured, you still want to eliminate any chances of theft.  I would make sure all valuables are locked up.  I would also make sure any information with social security numbers and confidential information that can lead to identity theft be out eyesight.  Warn your parents of any suspicious behavior and how they must report it immediately.  Never never give an aide money or credit cards unless you know about it and it is for an exact purchase—like groceries.  No check books should be out.  Make unannounced visits all the time with no real schedule.  The aide should never know when you are coming.  The agency should be making unannounced visits as well and report to you anything they observe.

 

Zack reviews what homecare can cost and some ways to pay for it.

 

  • You’ll get a few hours paid for by Medicare if a doctor prescribes it and if it is related to a hospital discharge.
  • If a parent qualifies for Medicaid, which I recommend everyone always explore as a long term back up plan, then home care can be paid for by them.
  • There is long term care insurance which pays for some home care but typically you need to have had that for a while and it is expensive.
  • The Veterans Administration has a program called Aid and Attendance which if someone qualifies as a vet during an active war and they fall under thefinancial guidelines, they can receive a pension payment every month towards home care. https://www.benefits.va.gov/pension/aid_attendance_housebound.asp  
  • The Alzheimer’s Association may provide some relief as well if the care recipient has dementia. You would need to contact your local chapter to see there are any funds available.  https://www.alz.org/help-support/caregiving/care-options/in-home-care
  • Contact the Area Agency On Aging to see if there is any kind of respite care that is paid for.
  • The average cost across the nation is $20 an hour according to a survey conducted by Genworth Financial in 2015.    http://www.aging.com/in-home-care-costs-breakdown/.   The average monthly cost is around $4,000 per month. Of course this depends on how much home care you are getting, are there overnight and weekend higher rates, are you higher in a live in?

 

The Survey Showed That The Most Expensive States As Far As Senior In-Home Care Is Concerned Include (Average Costs):
North Dakota – $27
Alaska – $26
Hawaii – $25
Massachusetts – $25
Minnesota – $25
Rhode Island – $25
While The States With The Least Expensive Senior In-Home Care Services Include (Average Costs):
Louisiana and West Virginia – $16
Alabama, Arkansas and Mississippi – $17
Georgia, North Carolina and Tennessee – $18

 

Other issues around cost:  Be sure to ask the agency about all costs involved.  Is there a charge for the nurse when they conduct assessments?  Most agencies include the cost in their rates.  Others do not.  Is there a deposit required?  Is it 100% refundable.  Some agencies ask for two weeks of service in advance.  How is payment received?  Credit card?  Automatic electronic withdrawal from checking accounts which is convenient for long distance caregivers.  WHat is the cancellation policy and are there any costs involved with that? 

 

Hiring a family caregiver has a lot of upside. 

  • Usually already trusted and known by the family. Feel more comfortable with them.
  • Usually affordable.
  • May show more care and compassion and attention to your parents.

The down side? 

  • Family conflicts arise from family caregivers. It is important to clarify their role and be specific to what they can and cant do and who they “report” to. 
  • If you are paying them, then remember, you are the employer. Taxes and workers compensation may be required to be taken out.  Check with your state laws. 
  • And most long term care insurance companies will only reimburse home care costs if the caregiver came from an agency so check with them as well before you start.

 

Hiring a private aide is also affordable but like the family caregivers has some risks:

  • Tey are your employee so check with your state laws. You usually as the employer are responsible to report their wages, take out for taxes and social security, and pay for workers compensation. 
  • Did you conduct a background check and thoroughly research their references.
  • What is their training? Usually they are not certified and they are not being supervised by a nurse. 
  • If something happens, like they have an accident or theft occurs, how will you handle it? If they do not show up to work or get sick, how will you replace them? 

Be extra diligent in your evaluation of that option and know that you will need to closely manage the situation to make sure it is a good option. 

 

Here is the last piece of advice if this applies to you:  If it is not urgent or an emergency to hire a caregiver whether it is private or from a home care agency, take your time and do your research.  That way the head will work equally as the heart.  This is an emotional process and a very important decision to make.  Take it seriously.  The good news is that there are many good agencies out there so doing your research will reveal good choices. 

 

So that’s Day 17.  Join us for Day 18 as we talk about another long term care option:  Adult Day Care Centers.

 

Thank you for listening to the Raising ‘Rents podcast. If you have any questions or feedback, please go to our website www.raisingrents.com and click on the “Contact” tab.  Let us know about any topics you want covered.  You can also find the show notes and references to anything we talked about.  Until we talk again, remember that our parents raised us, the least we can do is help raise them. Talk to you later.

Sources used in this series:

Intro/outro music: Arthaiz

Other music:  Philipp_Weigl_-_01_-_Subdivision_of_the_Masses, Blue_Dot_Sessions_-_06_-_Wahre
Daughter Anastasia Demopoulos does the opening voice over
Website created and managed by Philip Golden

 

 

 

Sep 28, 2018

Host Zack Demopoulos launches his 30 day preparation plan to care for an aging adult.  In Day 17, Zack talks about
hiring a professional caregiver.  Specifically how to choose a home care agency, how, what to look out  for, what to ask, and how to protect your family.

You finally have come to the realization that you need to hire some outside help to care for mom or dad. 

 

As a home care provider myself, and having hired over 500 aides in 10 years, I will tell you the good news—most of the horror stories you have heard are not true or can be avoided.  The bad news—-you still have to manage the aides no different if you let a plumber into your house.  But we’re going to talk about how to do all of this the easiest way possible, how to find a good agency, what to ask and look for, and how to protect your family on this episode of Raising ‘Rents Podcast.

 

This show is sponsored by ComForCare, a national home care provider that will help you live your best life possible.  https://comforcare.com/

 

This is Day 17 of the 30 Day Preparation Plan to care for an aging parent.  The Prep Plan is all about helping you the family caregiver provide your loved one with the best comfortable safest and efficient caring environment in which they can grow old in.

 

The topic today is one option for long term care which is home care.

 

If you have not had a chance to listen to Days 1 through 15, please go back to Season 1 and check out these episodes.  Also in Season 1 we introduce the 9 beginner steps in raising your parents.  http://raisingparentspodcast.com/page/5/

 

 

Back on the episode that was Day 14 of the 30 Day Preparation Plan To Care For An Aging Parent we talked about how your parents can age in place—what to consider so that they can live at home independently  as they get older in a safe environment and with dignity.   http://raisingparentspodcast.com/episode-023-day-14-what-is-aging-in-place-for-mom-dad/

 

It really is what most people prefer— to remain living at home as they get older. 

 

In the beginning the family caregiver steps in.  It could be the spouse.  It could be an adult kid who lives nearby or even a long distance adult kid.  After a while though, that is just not enough or practical. 

 

When we plan for long term care as someone ages, the first goal should be that they stay home or if the situation calls for it, in someone’s home.  Anywhere but a facility if it can be helped is usually the most effective option to begin with.  But to make that happen, besides being the family caregiver, you need help.  It is time to hire a caregiver, a professional aide from a reputable home care agency. 

 

There are two types of services that come to the home—typically referred to as home care and home health.  Home care is considered non medical and home health is considered medical, that is, it is prescribed by a medical provider like a doctor...services like physical or occupational therapy, skilled nursing, administration of medicines, wound care and monitoring of health status. Usually these services are part of a care plan following a hospitalization. By the way, these services are usually paid for by medical insurance, including Medicare and Medicaid, because they are prescribed by a doctor and typically associated with a hospital discharge.

 

In this episode we are only talking about home care the is non medical.  Services like Helping with adult daily activities or referred to as ADL’s in the industry, things like grooming, dressing bathing and using the toilet.  There are others services as well such as assistance with safely managing tasks around the house like preparing meals, shopping, medication reminders, assistance with walking or transferring from a bed to a wheelchair, assistance with chores like light housekeeping and then there is safety supervision  such as fall prevention and monitoring someone with dementia.  There is also Companionship which include things like engaging in conversation and helping them with their hobbies—gardening, reading a book, listening to music.   Some agencies will even allow their aides to drive a client’s vehicle or their own vehicle to run errands, do some shopping, and transport to doctor appointments.

 

Different terms for a caregiver:  aide, companion, home maker, home care aide, certified nursing assistant or CNA, Home health aide, or Certified Home Health Aide CHHA. It varies depending on which state you live in and how they are regulated.  For example in New Jersey a CNA is an aide that works in a hospital or facility like skilled nursing and a CHHA is the aide that works in a private residence.  New Jersey leans heavily towards protecting the consumer by regulating home care agencies and their employees—that is good news for a family that needs to hire an aide. 

 

The agency has to be licensed and regulated under the Division of Consumer Affairs, renew on an annual basis, comply with strict requirements like having a RN on staff who supervises the aides and carrying the right insurance, and starting in 2019 agencies in New Jersey must be accredited which is an extra step in meeting the highest quality standards in the home care industry. 

 

The CHHA is regulated under the Board of Nursing, must renew their certification every two years, has to successfully finish a course and gets fingerprinted and background checked.  The state also monitors CHHA’s and agencies for any criminal activity and reports it on their site

 

Best way to search an agency is plugging in your state with terms like home care agency, home care aide, caregiver as a start.  Some of the state government departments offer information about how to pick an agency and what a home care aide is.  You can check out the one New Jersey provides as good reading—just remember that it is specifically for New Jersey but a lot of it is applicable to general home care knowledge.  https://www.njconsumeraffairs.gov/hhh/Documents/A-Consumers-Guide-to-Homemaker-Home-Health-Aides.pdf

 

 

We get calls to our own home care agency from stressed adult kids all the time who were told by a discharging personnel like a social worker from a hospital or rehab center that their parent is being released tomorrow and they will need home care. 

 

Zack’s personal experience:  After calling the Employee Assistance Program at my job years ago it was suggested to me to hire an agency for my father who was in North Carolina and I am in New Jersey.  I went about it blindly hiring the first agency I spoke to without doing any research, not knowing what they do, what they require, what they cost.  It was stupid when I think back on it. 

 

It really pays to do your research. I would recommend no less than speaking with three agencies and if possible having a face to face meeting with them. 

 

Speaking about associations, if your state has one, which most states do, that is a great resource to check in with and ask questions or ask for their membership list.  Typically associations like these only have members that are very reputable and credible but do not assume that—you still need to do your research.  Go to their websites, check out their list of members, read some of their resources, and even reach out and ask questions.    https://www.hhsanj.org/ and https://www.homecarenj.org/

 

 

Each county also typically has some type of resources for elder care, usually called the area agency on aging.  They also can provide lists of home care agencies they have worked that are reputable.  They are also a great resource to answer questions you may have about how to pay for some of these services such as the Veterans Administration https://www.benefits.va.gov/pension/aid_attendance_housebound.asp  and Medicaid https://www.medicaid.gov/medicaid/hcbs/index.html

 

 

There are plenty of other places to find lists of home care agencies.  There are publications that you can find in hospitals, libraries, senior centers or online.  Just keep in mind just because they are listed somewhere doesn’t mean they are endorsed by anyone or anything in particular.  It usually means they paid for an ad to be on that list.  One professional publication that is nationwide that I have had a great experience here in New Jersey is the Senior Blue Book https://www.seniorsbluebook.com/.       https://www.seniorsbluebook.com/local/newjersey/.    The book lists many reputable home care agencies that the publisher of the book personally vouches for.  By the way, the book also has multiple resources of other areas of need such as medical home care services, housing, and moving services just to mention a few. 

 

 

The internet has plenty of information too.  As you plug in “Home care” into your browser and the geographical area you are searching for, you will get a long list of options.  Some referral sites will pop up too. 

 

Another great source are Social workers.  They usually have a list of reputable home care agencies, or at least ones they have had their discharged patient or resident use and there have not been any issues they know of. 

 

And don’t forget your EAP —-Employee Assistance Program.  Most companies now offer that to their employees.  They usually can also provide you some guidance as to where to look and perhaps offer a few recommendations.

 

There are major franchise home care chains.  Typically these are considered reputable because they not only follow their own states regulations but have to follow their franchise system requirements that usually are more strict than what the state requires. 

 

I recommend you have at least two if not three or four to evaluate and now you should call them.  Because most of you work, you will probably have to do this after hours. Not to worry.  Most agencies tout they are 24/7 and this is the first test to see how 24/7 they are. 

 

Once on the phone, you should be prepared to ask questions.  They will go into their pitch I am sure but a very good agency will listen to you first, ask clarifying questions, then proceed to share with you what they can do.  And this is very very important to me...I hope it is to you.  I would at the very least ask them to meet you, preferably in your parent’s home or where the care will take place.  And if you can’t meet them because you are long distance, get another family member or responsible decision maker to be there. 

 

The face to face meet and greet is important for a few reasons.  It will give you a good impression of who you are dealing with, it will equally give them the same impression and put them in a better position to help your family.  Are they professional?  Are they the owners?  Are they more educators or are they trying to just make a sale.  It will also help start a relationship for your parent or parents—remember this is their home and they probably did not ask for someone to be sending someone into it.  As the owner of a home care agency and with many years of experience, I also like to give safety suggestions by inspecting the home for fall prevention—regardless if they pick me or not.  Home care providers are usually very knowledgeable with this and should offer. 

 

This was Day 17 part 1 of the 30 Day Preparation Plan to care for an aging parent.   Tune in for the next episode when we continue to talk about Home Care.  In this episode I will share with you questions that you should ask a home care agency before you hire them.   We will also discuss what the next steps are after you have identified the right home agency for your parent or parents, the different type of options for shifts including 24/7 or live in’s, how to protect your family when aides visit their home, what home care costs, and the pro’s and con’s of hiring a caregiver privately. 

 

 

Thank you for listening to the Raising ‘Rents podcast. If you have any questions or feedback, please go to our website http://raisingparentspodcast.com/ and click on the “Contact” tab.  Let us know about any topics you want covered.  You can also find the show notes and references to anything we talked about.  Until we talk again, remember that our parents raised us, the least we can do is help raise them. Talk to you later.  


 

Sources used in this series:

Intro/outro music: Arthaiz

Other music:  Philipp_Weigl_-_01_-_Subdivision_of_the_Masses, Blue_Dot_Sessions_-_06_-_Wahre
Daughter Anastasia Demopoulos does the opening voice over
Website created and managed by Philip Golden

Nov 1, 2017

Host Zack Demopoulos launches his 30 day preparation plan to care for an aging adult. In Day 15, Zack talks about what is involved when it is time for your parents to down size and move.

Oct 25, 2017

Host Zack Demopoulos launches his 30 day preparation plan to care for an aging adult. In Day 14, Zack talks about what it means when the term “aging in place” is used and how this may apply to you and your parents or an aging adult you know. 

Oct 20, 2017

Host Zack Demopoulos launches his 30 day preparation plan to care for an aging adult. In Day 13, Zack talks about being a long distance adult kid caring and worrying about your aging parent and some things you can do about it.

Oct 17, 2017

Host Zack Demopoulos launches his 30 day preparation plan to care for an aging adult. In Day 11, Zack talks about how important estate planning is, and how an elder care attorney can help with that and long term planning. 

Oct 13, 2017

Host Zack Demopoulos launches his 30 day preparation plan to care for an aging adult. In Day 9, Zack talks about how important it is to stay on top of your parents hearing and some of the things to look for as they age. 

Oct 8, 2017

Host Zack Demopoulos launches his 30 day preparation plan to care for an aging adult. In Day 5, he talks about what some of the signs are that Mom or Dad should not be driving anymore and how to take the keys away.

Oct 7, 2017

Host Zack Demopoulos launches his 30 day preparation plan to care for an aging adult.  In Day 4, he talks about what to look for when you visit your mother and father’s house in terms of safety and aging in place.  There are simple measures one can take to ensure that their home is as safe as possible.  One of the primary goals is to make a home safer to prevent falls.  

Oct 5, 2017

Host Zack Demopoulos launches his 30 Day Preparation Plan to Care For an Aging Parent. In Day 2, it is still all about Y.O.U. as the caregiver.  “O” stands for “Overall Financial Situation, both yours and your parents.”  Zack shares how important it is to not only help your parents to prepare for long term care expenses but you should also plan for yourself accordingly due to caregiver costs that can unexpectedly hit you. 

Mar 7, 2017
  • Step 3 "Be talking and listening" and Step 4 "Be patient" are introduced as the next Beginner Steps To Raising Parents or an Aging Adult.  Stories and tips are shared about how to have a conversation with someone who needs help, how important it is to listen, and how being patient will increase the probability that they will listen. Resources are shared to help you prepare in caring for an aging adult.  Zack Demopoulos is your host and has guests provide insights.  Guests include wife Phyllis, an aging adult, and a senior advocate/home health care provider/author/radio host.  This show is dedicated to all Social Workers.  March is National Professional Social Worker Month.  
Feb 28, 2017

Step 1 "Be good to your self" and Step 2 "Be resourceful" are introduced as the first two Beginner Steps in Raising Parents or an Aging Adult.  Stories and tips are shared about caring for yourself before you can care for someone else.  Resources are shared to help you prepare for caring for an aging adult.  Zack Demopoulos is your host, his wife Phyllis joins in the conversation, and Zack has two industry providers share their experiences.   This show is dedicated to Zack's best friend Tracy Armstrong.  

Nov 3, 2016

The new Raising 'Rents podcast series introduces itself.  Raising 'Rents is the show that will share everything you need to know in caring for your aging parents.  Experts, adult kids, caregivers, and aging parents themselves share experiences about aging and how to care for aging adults.  Zack Demopoulos is your host, and he will share clips of future episodes.

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