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Looking for help in all the right or wrong places

Carol S. Heape, MSW, CMC
Executive director and CEO of Elder Options

Linda got a telephone call late one night from her father. The call worried her because her dad seldom called and this time, he was calling because her mother was in the hospital once again. Her dad reminded her forcefully that they weren’t moving. They wanted to continue living at home but Linda knew they would now need some help in remaining independent. She assured her dad she would be on a plane the next day and would help him decide what to do next.

Studies abound that reinforce older adults’ wishes to age in place recognizing that declining health and increasing age make that more of a challenge. However, with some assistance, many people continue to remain safely at home and, in many cases, at a lower cost than a move to an assisted-living facility or a nursing home. The key to safely remaining at home is to agree to accepting help and to then to find the right kind of help.

Once the older adult and his or her family agree that staying at home will work, the next issue and most important is to find help. It is very common to have considerable reluctance in agreeing to hire anyone to come into the house to work. When the choice comes down to staying at home with help or moving into a placement facility, it’s easier to accept the help coming in. At that point, families may look to a neighbor or family friend to provide the help, regardless of the individual’s age and qualifications, because they know the person. They feel they have to look no further. Too often, this employer-employee relationship can strain the friendship and neither party is satisfied with the arrangement.



Once a person is hired in any capacity, the elder or the person who does the hiring is considered the employer. As such, if the employee gets hurt while working, the employer is responsible for covering medical bills and lost wages under worker’s compensation coverage. The employer is also responsible for payroll taxes such as Social Security, state disability, Medicare and unemployment insurance. Hiring someone privately without following the required laws can be the easiest at first glance but not necessarily the best solution for the long term. When there is a resolution to support living at home, keep these points in mind:

If you want safety and well-being of the elder, hire someone trained and experienced in the homecare field. Ask them what kind of training they provide their employees.




If you want continuity of care, hire through a home care agency with coverage assured. Ask if caregivers employees and, if so, what kind of screening the agency does.

If cost of services is an issue, hire an agency’s employee and all wages, etc. are paid. Ask how many hours perday is needed to provide safety and care.

If you hire someone you know, hire an experienced professional who will respect the elder. If hiring from an agency, ask how the agency can assure competence and a good fit.

To trust the arrangement, hire a care-managed home care agency with home visits by credentialed experts. Ask what difference it makes to have care managers.

If care needs to change, using a care-managed agency gives the client and you the knowledge that changes can be made as soon as needed. Ask how many hours per day care managers are on duty?

If you’re looking for help in the community, professional care managers are experts in community resources in their area and give families additional resources to utilize. Ask what other resources might be helpful for your situation.

If you have an aging family member who wishes to remain independent and it’s only a matter of time, begin looking into what’s available in their community to help them maintain their independence and well-being. It costs nothing to look and you’ll be better prepared when the time comes. To find a professional geriatric care manager close by, visit http://www.caremanager.org or call 800-336-1709.

– Carol S. Heape, MSW, CMC is executive director/CEO of Elder Options Inc., a care-managed home care agency serving the Sacramento Region and South Lake Tahoe area http://www.elderoptionsca.com.


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