Choosing the RIGHT Type of Care for Your Aging Loved One Raleigh Geriatric Care Management Community Education Series Presented by Lauren Watral, MSW
What Types of Eldercare Are Available? Knowing that an elder requires care is one thing. Figuring out what sort of care arrangements can be made to address those care needs is another thing entirely.
What Types of Eldercare Are Available? Learning answers to the following questions can aid your task of determining what care arrangements should be pursued:
What types of care are available?
What types of professional providers help to provide care?
What sort of care do elders need at a minimum in order to insure their safety?
What Types of Eldercare Are Available? Adult Day Programs As their name suggests, adult day programs offer elders supervision and care in a structured setting during daytime hours. More specifically, they offer elders the opportunity to participate in structured social and personal activities, receive basic medical and therapy services, or participate in educational programs.
What Types of Eldercare Are Available? Adult day programs come in two varieties, which may or may not co-occur. There are programs that emphasize social interaction, and, separately, programs that exist to fulfill medical needs. Most all day programs are community-based and generally available only during regular business hours, Monday through Friday. Enrolled elders may attend programs one or more days each week.
What Types of Eldercare Are Available? Day programs are a good option for elders who do not require round-the-clock care, but who, for whatever reason, are also not safe remaining at home all day alone. Daily fees for day programming range from $75-$150 and up depending on the types of programming and services provided and the part of the country where services are offered. Generally program fees are paid out of pocket with private funds.
Independent Living Facilities Independent living facilities offer elders the opportunity to rent or purchase an apartment or condominium within a complex or campus offering recreational and social activities, and sometimes transportation services. What Types of Eldercare Are Available?
Independent Living Facilities Residents live independently while being part of a community of others in similar circumstances. The primary benefit of independent living facilities over conventional living situations are the recreational and social opportunities they offer residents, and the assistance such social opportunities may provide in preventing social isolation and depression. Generally, no special health care services or assistance with activities of daily living are offered. What Types of Eldercare Are Available?
Assisted Living Facilities Assisted living facilities are sometimes referred to as board and care, residential care, community-based retirement care, personal care, or adult foster care facilities. They offer residents comprehensive help with activities of daily living, but also feature an essentially independent living arrangement What Types of Eldercare Are Available?
Assisted Living Elders generally will occupy their own unit or apartment within the facility from which they can come and go as necessary. They will also have access to personal care workers as necessary to assist with their care needs. Skilled nursing services are not available on-site, by and large, but basic health services may be offered. Recreational and social activities are also made available to residents. What Types of Eldercare Are Available?
Nursing Home Care Nursing homes provide care for elders requiring constant, "round the clock" care. Care is provided by licensed health professionals, including registered nurses (RNs), licensed practical nurses (LPNs), and nurses’ aides. What Types of Eldercare Are Available?
Nursing Home Care Elder nursing home residents will reside in a room within the facility that may or may not be private. Housekeeping and linen services, meals, and care from the medical staff and a social worker are included. Elders may also be offered on-site social and recreational activities. What Types of Eldercare Are Available?
Family Provided and In-Home Care. Family provided care can occur in one of two ways: Either elders remains in their own home with family members providing them with assistance, or Elders move into the home of a family member. In either situation, in-home professional caregivers may still be needed to provide care during work hours or other times when responsible family members cannot be present. What Types of Eldercare Are Available?
It’s important to understand the differences between home care agencies and caregiver registries.
The key difference between agencies and registries is the caregiver’s employer.
Registries or referral services do not employ their caregivers.
Agencies take full responsibility for employing their caregivers.
Choosing the right home care provider:
Comparing agencies to registries: Agency Registry Home care agencies employ, train and supervise their employees. They are responsible for making sure care is provided to the patient. Registries act as matchmaker services, sending independent contractors to patients. DOES interview, check references and does a criminal background check on caregivers. MAY NOT interview, check references or perform a criminal background check on caregivers. DOES manage and supervise the caregiver. DOES NOT manage and supervise the caregiver. DOES maintain a payroll system, pays the caregiver, and provides records to the government. DOES NOT maintain a payroll system, pay the caregiver, and provide records to the government. DOES withhold and pays taxes on the caregiver’s wage. DOES NOT withhold and pay taxes on the caregiver’s wage. DOES insure caregivers with Worker’s Compensation. DOES NOT insure caregivers with Worker’s Compensation. DOES arrange for substitute care if the caregiver is absent. DOES NOT arrange for substitute care if the caregiver does not show up.
It’s important to understand the differences in liability between agencies and registries. Comparing agencies to registries:
With registries, the burden of screening, payroll, insurance, taxes, training, supervision and determining how and when care is provided is the responsibility of the patient or family.
How do I know they will accept this?
Clearly define the situation with your loved one.
Discuss with your loved one his/her capabilities and limitations.
Discuss current needs and possible future needs.
Talk about different options for care.
Understand your loved one’s perceptions of possible care arrangements.
Agree on a solution.
Talking with a loved one:
Choosing the right caregiver: How do I know my loved one will be safe? Look for these indicators that a caregiver is well-qualified and likely to provide caring, compassionate, care:
The caregiver is carefully screened before coming to your home for an interview.
The caregiver is bonded, insured and covered by Worker’s Compensation insurance.
The caregiver is experienced in specialized cared that your loved one may require (Alzheimer’s, dementia, arthritis, hospice care, mental/physical challenges).
Second, work to find a caregiving solution that meets your loved one’s needs and desires safely. Choosing the right caregiver:
Match your loved one’s needs and personality to an experienced caregiver with the skills that will provide the best care and companionship.
Be sure there is professional oversight of the caregiver to be sure services will be provided safely.
Be sure there is supervision in place that delivers ongoing assessments of care and recommendations as your loved one’s needs change
The Next Step:
Raleigh Geriatric Care Management exists to help families and friends navigate through the myriad of eldercare resources for the ones they love.
- Lauren Watral, MSW, Owner “ Managing Your Elder’s Care”