Ask a Care Manager: Looking for help in all the right and wrong places

By From page A5 | February 15, 2017

Linda got a telephone call late one night from her father. The call worried her because her Dad seldom called and this time He said her mother was in the hospital again. 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 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 their family agree that staying at home will work, the next issue and most important is to find “the 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 and 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:

Safety and well-being of the elder:
Hire someone trained and experienced in the home care field.
Ask: What kind of training is provided?

Continuity of care:
Hire through a home care agency with coverage assured.
Ask: Are these employees? What licensing do you carry? What is the screening process when hiring?

Cost of services:
Hire an agency’s employee and all wages, etc. are paid.
Ask: How many hours/day is needed to provide safety & care?

Hiring someone you know:
Hire an experienced professional who will respect the elder.
Ask: How does your agency assure competence and a good fit?

Trusting the arrangement:
Hire a care-managed home care agency with home visits by credentialed experts (nurses and social workers)
Ask: What difference does it make to have care managers?

When care needs 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/day are care managers on duty?

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 us?

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 an aging life care manager close by look on

Carol S. Heape, MSW, CMC, is executive director/CEO of Elder Options,Inc., a care managed home care agency serving the greater El Dorado, Sacramento, Placer, and Douglas Counties, since 1988.

Carol Heape


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