Caregivers: Finding The Right Home Caregiver For Your Loved One Is an Important Step
Hiring a caregiver may be necessary when you can no longer care for your loved one on your own. But, where do you find the right home-based caregiver? What’s more, what type of caregiver does your loved one need?
The demand for home-based live-in professional caregivers is expected to grow as the older adult population increases over the next two decades. The U.S. Census projects that the number of people aged 65 years old and older will reach 98 million, or 23.5 percent of the population, by 2060.
While seniors may be living independently in their homes, many need help managing household chores and health conditions that can affect their daily living activities.
Family members are usually the first caregivers. But, as seniors age and their conditions become worse, family members have difficulty providing care and juggling their own daily responsibilities. So, the discussion begins about hiring in-home care caregivers.
Different Types of Caregivers
There is no “one size fits all” when it comes to home-based caregivers because older adults require different types of care. The following are the types of caregivers available and the services they provide:
1. Home Health Aide (HHA). An HHA provides simple medical care for patients recovering from an illness or a hospital stay. An HHA also helps clients with grooming, bathing, dressing, moving from place to place, and performs light housekeeping tasks. An HHA must meet the federal standard minimum of 75 training hours before being certified. States also have different requirements for HAA candidates to fulfill before becoming certified.
2. Licensed Practical Nurse (LPN). An LPN works under the supervision of a registered nurse. An LPN can check vital signs, change bandages, insert catheters, and perform emergency CPR, among other things. LPNs are required to pass their state’s requirements for licensing as well as the National Council Licensure Examination.
3. Certified Nursing Assistant (CNA). A CNA works under the supervision of a registered nurse. CNAs perform a variety of tasks, from taking vitals signs and dressing wounds to recording patients’ health issues to report to the supervising nurse. CNA candidates must complete a state-approved CNA training program to become licensed and certified.
4. Personal Care Assistant (PCA). Provides non-medical, personal services, such as bathing, dressing, grooming, and toileting. A PCA can prepare and serve meals, run errands, provide transportation to medical appointments, pick up prescriptions, provide companionship, and engage with older adults in hobbies and other interests. Some states only require PCAs to have a high school diploma and short-term training, while other states require certification.
When it comes to health care, it’s important to remember that nursing providers are restricted in what they can do on their own. For example, some nursing providers cannot administer certain drugs or perform injections. Yet, registered nurses can perform certain medical duties that a doctor may request for a patient.
So, knowing the type of home-based services your loved one needs will determine the type of caregiver that will work best for your family member.
Home Health Care vs. Home Care
Home health care agencies and home care agencies usually serve the same client. However, home care health agencies provide skilled or clinical medical services.
Home care agencies offer non-medical care. In-Home Caregivers help older adults with bathing, grooming, dressing, toileting, and other daily living activities. They also perform light housekeeping duties so that seniors can live safely in their homes.
An agency that provides skilled or clinical caregiving is typically licensed and certified by Medicare and accepts third-party billings from insurances.
Private Duty Nursing
Some families prefer hiring a private duty nurse who can provide individualized medical care for as long as an older adult needs the services. Private duty nurses are usually RNs trained to care for more serious health conditions such as a traumatic brain injury or spinal cord injury. The nurses also work with patients dependent on medical devices, such as feeding tubes or catheters, and who require long-term intravenous drug therapy or nutrition.
Keep in mind that some private duty nurses are independent contractors, meaning they do not work as an employee of an agency. Under IRS tax rules, caregivers paid a certain amount per year are considered a household employee. Before hiring a private duty nurse, talk to your tax preparer or use IRS Form SS-8 to determine whether the IRS will consider you an employer.
Who Pays for Caregiving?
There are different ways to pay for in-home caregiving services. Costs will vary, depending on the type of services provided.
Generally, Medicare covers eligible skilled or clinical caregiving services provided by a Medicare-approved home health care agency. Medicare only pays for services that are considered reasonable and necessary for treating an injury or illness. Medicare has an online tool called, “Home Health Compare,” to help you find a Medicare-approved home health agency in your loved one’s area.
Medicare does not pay for non-medical care, but Medicaid pays for personal care, such as bathing, dressing and grooming. Medicaid also pays family members to provide non-medical caregiving services.
In addition to that, Veterans Affairs benefits pay for personal care and home health care, if the veteran meets certain qualifications for the services. The VA’s Homemaker and Home Health Aide services can be used in combination with other home- and community-based services.
Private health insurance, long-term care insurance, and life insurance policies may also be used to pay for personal care services. Without insurance or other types of benefits, you may have to pay out-of-pocket for in-home services.
Finding a Caregiver
Finding caregivers that will be a good match for your loved one takes time and effort on your part. Start your research by asking other family members, friends, neighbors, or your loved one’s doctor for referrals of agencies or private duty nurses. You can also check online job boards, online nurse registries, senior centers, and the local Area Agency on Aging near your loved one’s home.
With extensive research, guidance from those knowledgeable about caregiving services, and understanding the pros and cons of private nursing, you will be able to find the right caregiving services your loved one needs.