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Bringing Care Home: Exploring the Journey to In Home Senior Care


Volume III:

Finding the Right In-Home Senior Care Agency

In home senior care

The previous articles in this series discussed both recognizing the signs that it’s time to seek home care and how to talk about home care as a family.  If your family has made the decision to seek in home senior care, the next step is to determine which agency is best suited to meet the needs of your loved one.

The process of selecting a home care agency starts with doing your research.  There are many home health care agencies out there that your family will be able to choose from and there is even more information that you will need to learn about the agencies you consider prior to making your selection.  To ensure that your search is successful, manage the process so that it doesn’t overwhelm you.  Make things easier for yourself by organizing your thoughts and questions into the following categories to simplify your search: the patient, the agency and the caregiver.

We’ll review each of these categories and discuss things that you’ll want to cover during your research.

The Patient

Understanding your loved one’s needs is a critical factor in seeking senior in home care.  Consider how often your loved one needs help. Do they need assistance around the clock?  Do they only need help a few hours each day or a couple of days a week?   Is someone only needed when the family caregiver is away from the home?  Understanding the timing needed for care will make it easier for the agencies you work with provide coverage and pricing estimates.

Another area that is key to seeking senior in home care relates to medical conditions.  Is your loved one someone who was recently hospitalized or is in a rehabilitation center that is now ready to return home?  Does your relative have instructions from a medical provider detailing a regimen that will need to be followed in the home home?  Does your loved one take medication or use medical equipment in the home?  The care plan for your loved one will be the main focus of your conversation with the home care agency, make sure that you can communicate the patient’s needs clearly.

Does your loved on live alone?  Will your loved one need a caregiver to run errands for them or take them to doctor’s appointments?  Does the caregiver need to assist with meals, light housekeeping and personal grooming? Be aware of all non-medical needs that your loved one may have, as these will be discussed as well.

Create a list of all of the things that are important to your loved one’s care.  Think about all aspects of what your loved one will need assistance with throughout the day and make your list as complete as possible.  When speaking to agencies, refer to your list often to make sure you don’t forget to mention anything.   This helps the agency ensure that they are able to meet the needs of the patient.

Why Not Go Private?

It is not unusual for people to consider finding and hiring a private home health aide and avoid having to work with an agency at all.  At first this option might seem ideal, however, there are some things you should know prior to taking that route.

The state requires that home health aides be certified and licensed to work in the home by the state.  Caregivers that are licensed are not permitted to work independently; they must be employed by an agency.  This requirement is meant to ensure the safety of all clients and promote the best care.

There are also other legal and tax implications with working with a caregiver that are not covered when they work privately.  Employer tax contributions, payroll tax withholding and submissions for the caregiver, quarterly and annual tax form filings, preparation of W2 or 1099 forms would not be covered when working with a private aide, as well as employment benefits and insurance coverage (including workman’s compensation.)   Things like getting background checks and ensuring that the caregivers’ licensing and continuing education is up to date would also present a challenge.

As a private employee, the patient and their family would manage the caregiver’s schedule, including finding someone to cover for them when they need time off.

An agency would be responsible for all of the payroll, scheduling, legal and compliance items listed above, leaving the family to focus solely on their loved one and their care.


The Agency

Now that you have a full understanding of what your loved one needs and recognize the benefits of using an agency, it’s time to consider what you need to know about the agencies themselves before making a selection.  Talking with more than one agency is a recommended practice because it allows you to make the best choice for your loved one while getting the best value for the service.

With the number of home health care companies offering in-home senior care, there will be many options available to choose from.  Something to consider is whether or not to work with a local agency.  Local agencies operate independently within their service area and are usually well known in their community.  One of the benefits of working with an independently operated agency is that it is self-contained, which can allow for more flexibility for service offerings and rates to cater to the needs of each client.  Another benefit of working with a local agency is that they are based in your neighborhood, which means they know the area and they are more accessible to the client and their family.  Caregivers who work for local agencies will likely live in the area as well, making commuting and meeting the transportation and errands portion of their role much easier to navigate.

When you talk to an agency, make sure that they are licensed by the state to operate a home care service.  Verify whether or not the agency works as a placement service or if the caregivers are employees of the agency.  Agencies that act as a placement service are only responsible for their caregivers up until they are placed in the patient’s home, at which time the client and their family manages the caregiver as their own employee.  That would leave the family to manage all of the things that were mentioned above relating to tax withholding, employment benefits as well as scheduling and coverage continuity.

As part of your conversation, the agency should provide you with their rates for either live in and/or hourly service as well as what methods of payment are accepted.  The estimate for service is generally based on the needs of the client and therefore often is discussed after talking through the details of the case.  Take notes of the rates quoted by each agency and compare them to one another to get an idea of what the average cost for care should look like.  Keep in mind that rates should be competitive and that cost often reflects quality of care.  If you speak to an agency that is willing to provide service at a significantly lower cost than other agencies, it could indicate that the care they are providing may not be the best care and is therefore not a fit for your loved one.

Knowing an agency’s track record when it comes to care is helpful in the agency selection process because feedback and reviews from past and current clients can be a good indicator of what your family can expect from the agency.  Reviews are readily available; many appearing on home health care websites, search engines, review websites and social media pages.  The client feedback found in reviews may provide information that helps you determine which agency is the best fit for your family.

The Caregiver

The caregiver provided to you by the agency will be the person that your loved one will depend on for assistance with their daily care.  It is important that the person who cares for your loved one is properly trained to assist the patient in the home.  Always confirm with agencies that the caregivers that work with them are all certified and licensed by the state to work as a health aide in the home.

Bringing someone into the home will require some adjustments for all involved. Successfully assimilating the caregiver into the home routine works best when the caregiver excels at meeting the needs of the patient and getting along with the client.  In order to determine if the caregiver will be a good fit, patients and their families often meet with the caregiver before opting to begin service with the agency.  These meetings give the family an opportunity to get to know the caregiver face to face to assess their skills and determine if the caregiver and the client will be compatible.

Meet with as many caregivers as is practical so that you have the opportunity to identify the best candidate.  Keep in mind that while the caregiver is a very important part of the agency selection decision, you should not overlook the rest of your research while making your final choice.

You’ve Found Your Agency

Now you’ve spoken to a few agencies and covered all of the topics outlined above.  You’ve reviewed all of the information that you gathered about each agency, met with potential caregivers and you’ve finally made a selection.

Now it’s time to start thinking about funding.  There are a handful of options available to assist with covering the costs of senior home care.  In our next article, we will review all of the options available and how to know which one is right for your loved one.




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