Home Health care givers

Home Health Care has become big business. As the population ages; there is a need for caregivers to help people stay home longer. Sitters as they are sometimes called; earn from $8-20 an hour depending on where you live.
Quite a few families handle the care giving duties themselves. For those who work outside the home; caring for a dementia patient can be overwhelming and emotionally draining. Studies show that more than half of all caregiving for elderly is done by family members.
As a teenager I was one of those family members. My great grandma had "hardening of the arteries" Now we know it was Alzheimer's. My aunts and uncles hired a lady to live with her during the week; two of my cousins and I took turns staying on the weekends. Sometimes she could be a handful for a 15/16 year old. She set the kitchen towels on fire one night- she told me she was trying to turn on a light to see. She locked me out of the house many times. I could go on with stories all too familiar to those who have been caregivers. Elderly with dementia or Alzheimer's may have nontraditional sleep patterns. I often wondered if she had Sundowner's; it sure did seem thatway.

Private duty caregivers such as the one my family had are less expensive but do pose risks. What if your caregiver becomes ill; what is the back- up plan? Get a back up plan. IS this person able to lift, or help your loved one into and out of the shower? These questions must be asked no matter which option you choose. Also ask them about taxes- Will they handle it? Remember you need to file them on your tax deductions- if you have a doctors prescription it is deductible. Does this person have references you can call? What are their credentials? How many elderly with dementia have they cared for in the past? How many patients with diabetes/ or any illness that runs on your family.

Companies- there are national chains with franchises located throughout the US. Local companies are also an option. I have been approached my no less than 5 new home health companies in the last two months alone. The advantage to these organizations is the back up staff and the insurance they carry when problems arise. For example- I have a client with Alheimers whose caregiver accidentally set the kitchen on fire- it was a mess- the home insurance covered it- but the family felt good about having a professional organization involved in case there was a problem. If a valuable gets broken- the insurance these companies carry will pay for the item. Most of the national companies do a background screening on all employees; and often they hire licensed CNA's. I tend to refer to a few companies that I trust and have known to work through crises with families. Talk to your friends- talk too your church- find out if they can recommend respected people to handle the care for your loved one.
Another advantage to utiltizing companies is the option of part time help. The disadvantage of companies vs. individuals is the cost. Companies are more expensive. Finances often play a role in the choice to remain home. Unfortunately state programs often help in nursing home care but ignore home health care as an option.

Nursing Homes - An explanation of state Audits

I spent several years working within the Rehab/ nursing home settings; and suffered through numerous state "rounds". Most nursing homes do not go by the Nursing Home title any longer. They are typically dually certified- which means that the facility takes state medicaid and is certified through the federal government to accept Medicare payments for Rehab. This being said- they often prefer to be called Health care and Rehabilitation facilities. This is a nationwide trend.

The federal government sets wide criteria for these facilities; and the state adds more detailed criteria for the facilities to receive payments. The state and federal programs are "tied together"; if a facility is not meeting state criteria they automatically lose the federal funding for the time allotted by the state.

Many websites encourage families to review the state findings which are available on the net as well as within each facility(this is required by law).

Facilities have state audits several times a year IF complaints have been made. Anyone can file a complaint (often disgruntled employees will call in complaints) the state is then obligated to investigate.

Nursing homes are highly regulated, more so than hospitals. This does not mean I am in favor of skilled nursing facilities for elderly. They are necessary on occasion; especially for Alzheimer's patients with wandering tendencies.

Each compliant results in an on site review by the government. The auditors or surveyors- as they are sometimes called- will review all aspects of the facility on each visit. They will occasionally decide to do a paper review and be gone in a day; but for the most part will remain for 3-5 days. These surveyors interview patients, staff, and families, they review admissions, discharges and will remain quiet about the actual complaint being made(to protect patients?).
At the end of the review they will tell the administrator and supervisory staff their findings, then write up a report which will be posted at the front of the building. The findings will reflect the initial complaint and any negative events that were not related to the complaint but need to be addressed.

A score is then given based on the findings from the past year of complaints. This score may not (in my opinion) reflect the daily events within a building.

It is more important to look at the cleanliness of the residents. Odors, it is against federal cover odors. SO the more often they are bathed and changed the better the building will smell. Friendliness of staff, do the CNA's know the residents by name- these are things to pay attention to. Check the bathrooms- my grandma taught me that- not for this reason- but it still applies- look in the corners of the rooms- On a tour you will see people that will yell out- they will appear confused, and those things can't be prevented. Also- ask a resident if they like the food. The audits are important but they do not tell you the whole picture.