When To Hire In-Home or Live-In Help?

When To Hire In-Home or Live-In Help?

When To Hire In-Home or Live-In Help?

There comes a time when older adults wonder if they need someone to help them manage daily tasks that are becoming harder to do on their own. While many seniors want to continue living independently at home, they also realize that washing dishes, taking a shower, and other simple tasks are not as simple anymore.

It’s common for older adults to start calling on family and friends to help them out. But, as requests for assistance become more frequent, loved ones and friends with job and family demands or health challenges of their own, begin to feel pressured to help and question what is going on.

“A lot of times these observations are made by family members or friends, and they start the discussion about getting help,” Dr. Suzanne Salamon, associate chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center, told the Harvard Health Letter.

According to Dr. Salamon, older adults do not have to wait for family and friends to approach them about whether to hire in-home help. Dr. Salamon recommends seniors ask themselves hard questions, such as:

  • Is it harder to get in and out of the bathtub because of muscle weakness or balance problems?
  • Has driving become difficult because of vision changes, arthritis, or other reasons?
  • Are you keeping up with your medication regimen, or are you sometimes not sure if you’ve taken pills?
  • Are cooking and cleaning becoming much more of a chore than they used to be?
  • Do you find grocery shopping or errands a little overwhelming?
  • Do you need help bathing or getting dressed?

Assessing your current needs can help you answer these questions, and take action, if necessary.

“You might not need a home health aide yet,” Dr. Salamon said. “Maybe you only need a cleaning service to come in every other week. But if you need more assistance, it’s probably time to hire health aides.”

What Are Health Aides?

Health aides are trained to care for people who want to live independently but cannot care for themselves. There are different types of aides and most of these professional caregivers perform the same duties, such as helping older adults with bathing, dressing, going to the toilet, and other daily living activities. Health aides also do light housework, prepare meals according to the individual’s dietary specifications, and handle other tasks, such as shopping, running errands, and taking clients to their medical appointments.

While caregiving professionals may share some commonalities, there are differences, such as:

1. Home Health Aides

Home health aides (HHA) are considered health care paraprofessionals and must meet training requirements, which vary widely from state to state, according to AARP. Besides helping with daily living activities, HHAs check their clients’ vital signs and observe their health and behavior. HHAs do not perform medical procedures but are trained to handle health emergencies, such as a heart attack or stroke.

2. Personal Care Assistant

A personal care assistant (PCA), also known as a personal care aide, is someone who provides assistance with daily living activities to individuals who need help due to age, disability, illness, or injury. Personal care assistants are not medical professionals and cannot provide medical care. The specific tasks and responsibilities of a personal care assistant can vary depending on the needs of the client and the setting.

3. Certified Nursing Assistant

A Certified Nursing Assistant (CNA) must go through a state-approved training program and pass a state exam before becoming certified to work with clients in their homes or with patients in an assisted living or nursing facility. Unlike HHAs, some states allow CNAs to perform certain medical procedures, such as changing wound dressings, drawing blood, and administering medications.

4. Companion

Providing companionship, preparing meals, shopping, running errands and light housekeeping are among the primary responsibilities of this registered professional. Unlike HHAs and CNAs, companions are not required to be certified or licensed and cannot provide hands-on care.

Should You Hire In-Home or Live-In Help?

So, how do seniors know whether to hire a live-in caregiver or weekly home care help? Healthcare experts say it all depends on their needs and income. Also, HHAs and CNAs can work in either capacity.

1. Live-In Care

Live-in care may be beneficial for an elderly individual with chronic health challenges who lives alone or whose spouse cannot help with care. These caregivers live in the same home as their older adult clients. Live-in caregivers have their own room and can take a break during the day and sleep at night. However, they provide care at night if their client needs help. When live-in caregivers take a vacation or take time off for other reasons, the home care agency will send a substitute caregiver until the regularly assigned live-in caregiver returns.

2. In-Home Help

In this scenario, older adults receive help from two or three caregivers who work 8-12-hour shifts during the day and overnight. The caregivers who work in the daytime and overnight shifts are not allowed to sleep but they can take breaks.

Besides physical health needs, cost is a factor that determines what type of care to receive. On average, it costs $27 per hour for private home health aide services, according to the 2021 Genworth Cost of Care Survey. For instance, seniors needing help two days a week for three hours a day will pay about $1,296 a month. Medicare does not pay for private duty costs, but Veteran benefits often cover them. In some cases, home health aide services are fully or partially covered by long-term care insurance, state or local aging agencies, or nonprofit groups.

How To Find Home Health Aides

Healthcare experts recommend hiring home health aides through a state-licensed home care agency because the agency will provide support for both the caregiver and the client. A home care agency also handles human resources matters, such as conducting background checks on applicants and taking care of payroll, insurance, taxes, and Social Security withholdings.

There are several way to find licensed agencies:

  • Dr. Salamon suggests asking for recommendations from friends, your doctor, local senior services, or your local Area Agency on Aging.
  • AARP has a Family Caregiver Resource Guide that links to each state and has a checklist of questions to help potential clients evaluate in-home care agencies.
  • Medicare has a page on its website that allows users to find and compare home health service providers.

Are You Hesitant To Get Help?

Older adults may be hesitant to have strangers come into their homes and help them, especially with hands-on personal care. So, Dr. Salamon suggests trying the services out just once a week to see how it goes. For example, set up a routine that includes an aide doing laundry or preparing a large meal that can be frozen into smaller portions.

Getting used to professional caregivers now will help older adults later when they might need much more assistance.

“This is your opportunity to get the help you need, whether it’s with jobs around the house or basic activities of daily living,” Dr. Salamon said. “In the long run, it’s the kind of service that will keep you living on your own longer.”

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