Question: I am caring for my mother in my home in California. It is a full time job. Will the state provide any kind of assistance to pay for this elder care?
Answer: The state of California offers a program called In-Home Supportive Services (IHSS), which is paid for by Medicaid funds (MediCal, in California). The program, administered by each county, does provide a certain number of home care hours, based upon an assessment by a county social worker.
The care may be provided by a family member, who is paid by IHSS, if the recipient qualifies for MediCal and the caregiver is acceptable to IHSS.
There is a Website with links to each of the counties’ offices: http://www.cdss.ca.gov/agedblinddisabled/pg1785.htm
If your mother does not qualify for MediCal, you can talk to a reputable employer-based home care agency about the possibility of working for that company. The care will not be free to your mother, of course, and you would have to pass the agency’s background screening, but you would be legally employed.
Bert Cave, President
Support For Home
Sacramento, California
916-482-8484
Member of the national ElderCare Matters Alliance, California chapter
Every day, more and more families from across America are relying on ElderCareMatters.com to help them find competent "Elder Care Experts" who are located near them and who can help them with a wide range of elder care matters, such as legal services, financial planning, home care, senior housing, adult day care, geriatric care management, money management, insurance services, aging in place services, etc.
Below are just a few of the many emails that ElderCareMatters.com receives daily from families across America requesting help with their elder care matters:
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- We need to find senior transportation services in the Miami area. Can you help us?
- My mother has been injured in an Assisted Living Home in Arizona and we need an attorney with whom to discuss this legal matter. Can you help us?
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If you are a competent, caring professional who helps families plan for and/or deal with elder care matters, then you should definitely become a professional member of the national Elder Care Matters Alliance and you should be listed on ElderCareMatters.com – America's #1 source for Elder Care Experts, Information & Answers about Elder Care Matters. Professional membership is just $15/month.
To request an Application for Membership to the national ElderCare Matters Alliance, send us an email at: info@ElderCareMatters.com
Phillip G. Sanders, MBA, MSHA, CPA
Founder & CEO, ElderCare Matters, LLC
ElderCareMatters.com
Answer: If you are a professional who helps families plan for or deal with ANY of their elder care matters, then you owe it to yourself to be listed on America's #1 online source for "Elder Care Experts"….
ElderCareMatters.com
ElderCareMatters.com is where you will find more than 2,000 competent, caring elder care experts located across America, including:
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So if you are a competent, caring elder care professional who helps families with ANY of their elder care matters, then request today an Application for Membership in the national ElderCare Matters Alliance and get listed on ElderCareMatters.com - America's #1 source for "Elder Care Experts" plus information and answers about a wide range of elder care matters.
Phillip G. Sanders, MBA, MSHA, CPA
Founder & CEO
ElderCare Matters, LLC
ElderCareMatters.com
Answer: It is my pleasure to provide you with the following list of the 87 different elder care services that are currently provided by the members of the national ElderCare Matters Alliance on ElderCareMatters.com:
- Accounting Services
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The goal of ElderCareMatters.com is to provide families across America with the help they need to plan for and deal with their elder care matters. Let us know if there are other elder care services that you would like to have us list on ElderCareMatters.com – America's #1 source for Elder Care Experts plus information & answers about a wide range of elder care matters.
Phillip G. Sanders, MBA, MSHA, CPA
Founder & CEO, ElderCare Matters, LLC
ElderCareMatters.com
1-877-379-4500
Answer: ElderCareMatters.com is an elder care resource to help families across America plan for and deal with their elder care matters. With this goal in mind, we will continue to add more elder care-related services to ElderCareMatters.com in order to make this online elder care resource invaluable for families looking for help in planning for and/or dealing with their elder care matters.
Below are the 72 different elder care services currently listed on ElderCareMatters.com (with more services soon to be added):
- Adult Day Care
- Advance Medical Directives
- Aging in Place Services
- Alzheimer's / Memory Care Communities
- Annuities
- Arbitration
- Asset Protection Planning
- Assisted Living Communities
- Assisted Living Referral Services
- Bankruptcy
- Caregiving Education
- Consumer Law
- Continuing Care Retirement Communities
- Crisis Intervention
- Daily Money Management / Bill Paying
- Dementia Care
- Disability Income Insurance
- Elder Abuse Litigation Services
- Elder Law
- ElderCare Planning / Long-Term Care Planning
- Estate Administration
- Estate Liquidation
- Estate Planning
- Financial Planning
- Funeral Services
- Geriatric Care Management
- Guardianship / Conservatorship
- Health Insurance
- Hoarding Clean Up and Coaching Services
- Home Care
- Home Downsizing Services
- Home Health Care
- Home Modifications
- Hospice Care
- Independent Living Communities
- Investment Services
- Life Care Planning
- Life Insurance
- Litigation
- Long-Term Care Insurance
- Medicaid / Disability Planning
- Medical / Healthcare
- Medical Alert Systems
- Medical Claims Processing
- Medical Equipment & Supplies
- Medicare Consulting
- Medicare Supplemental Insurance
- Medication Management Services
- Moving / Relocation Services
- Personal Finance / Accounting / Tax Preparation
- Powers of Attorney
- Probate
- Professional Organizing
- Public / Non-Profit Resources
- Real Estate Services
- Rehabilitation Services
- Residential Psychiatric Care
- Respite Care
- Retirement Planning
- Reverse Mortgages
- Securities Arbitration & Litigation Services
- Senior Move Management
- Senior Move Planning
- Social Security Disability Services
- Special Needs Planning
- Tax Law
- Tax Planning
- Transportation Services
- Trustee / Fiduciary Services
- Trusts
- VA Benefits
- Wills
If you need help with your family's elder care matters, you can count on ElderCareMatters.com to provide you with the experts, information & answers you need to plan for and deal with your elder care matters.
Phillip G. Sanders, MBA, MSHA, CPA
Founder & CEO of ElderCareMatters.com
1-877-379-4500
Answer: Our commitment at ElderCare Matters is to provide families across America with elder care resources (Experts, Information & Answers) to help them plan for and deal with their elder care matters. To this end, we have no set # of experts that we will showcase on ElderCareMatters.com but rather we are inviting ALL competent, caring elder care professionals across America to become a part of this phenonmenal elder care resource.
ElderCare Matters is where you will find 1,579 Elder Care Experts near YOU (and this # is growing daily) who have years of experience in helping families with elder care matters, including:
- Elder Law Attorneys
- Estate Planning Advisors
- Financial & Investment Advisors
- Geriatric Care Managers
- Insurance Professionals
- Reverse Mortgage Lenders
- Senior Move Managers
- Tax Advisors
- Daily Money Managers
- Other elder experts with long and successful careers working with seniors and their families
This is also where you will find some of America's best:
- Assisted Living Communities
- Alzheimer's / Memory Care Communities
- Continuing Care Retirement Communities
- Home Care Agencies
So if you help families plan for and/or deal with elder care matters and you are a competent, caring elder care professional, then you should be listed on ElderCareMatters.com – America's #1 source for Elder Care Experts plus information and answers about a wide range of elder care matters.
To request an Application for Membership to the national ElderCare Matters Alliance, send an email directly to: info@ElderCareMatters.com
Phillip G. Sanders, MBA, MSHA, CPA
Founder & CEO of ElderCare Matters
ElderCareMatters.com
1-877-379-4500
Answer: Yes, there are planning steps you can take now. First, check with your local agencies, such as the Area Council on Aging to find out what eldercare services are available in your area. You may find that there are adult day care centers that cost nothing or are very reasonably priced. Next, determine out what the cost of eldercare is in your community. These providers will include home health care agencies, nursing homes, and assisted living facilities. Prices vary, so survey the market carefully.
Involve your children and inform them of your wishes in the event you need custodial eldercare services, and write down your wishes. Name one of your children or friends that you trust as your eldercare coordinator. As an aside, it is always a good idea to consult with an attorney and have a durable power of attorney drafted, as well as a living will.
If you have assets available for possible eldercare expenses, you should designate those as being for that purpose. If you have existing life insurance or annuity policies, it may be possible to leverage those products by re-positioning them into products that can provide enhanced eldercare dollars in the event that you need them. Check with your financial advisor.
To find competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com - A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.
Gregory D. Roberts, CFP, CLU, ChFC, CLTC, EA
Life Solutions
Aiken, South Carolina 29803
803-617-9805
Member of the national ElderCare Matters Alliance, South Carolina chapter
Answer: You should contact the local authorities immediately, report the theft, and ensure they understand that you’re fearful for your safety. In addition, I would terminate the services of your current caregiver and contact a local licensed home health agency.
To find competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com - A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.
Bart Delsing, Owner & Chief Operating Officer
FirstLantic Healthcare, Inc.
Delray Beach, Florida 33445
561-243-7979
Member of the national ElderCare Matters Alliance, Florida chapter
Answer: This is a great question. Choosing the home health agency that is best-suited for your needs is essential, but the most important selection is the caregiver. Selecting a caregiver that understands the specific needs and dynamics of an Alzheimer’s patient is critical and will determine the success of a strong relationship between your parents. Here are the questions I suggest you ask:
- Is the home health agency licensed? If so, request a copy of their license. This will insure that the agency is operating under the regulations of the state.
- How long has the agency been in business? It is best to choose a well-established agency. They generally offer more experienced, trained caregivers.
- Are the caregivers licensed, insured and supervised? You want an agency that has professional, general liability and workers compensation coverage. If the caregivers are going to drive your parents, you should inquire about non-owned auto insurance. If caregivers are transporting patients and utilizing their own vehicle, this is a must. If they’re going to use your parents’ auto, call your parents’ insurance carrier and inquire about adding them to coverage. Moreover, if driving is required, ask the agency if they run a DMV check on the caregiver.
- Does the agency do an Assessment Visit? If so, is this done by a Registered Nurse and is there a cost ? This is another significant step in the process for a number of reasons. You might feel that your mother needs four hours per day, but after assessing her, the opinion of the licensed professional might be considerably different. A clinically trained expert can determine if other services are needed, e.g. physical therapy. In addition, a better understanding of the home surroundings will ensure a safer environment for your parents.
- How often is the caregiver supervised and by whom? Look for a RN supervision answer here. If not, that’s a concern.
- What type of background screening is required of the caregiver? You should focus on a criminal background, abuse registry and reference checks. For me, the criminal background and reference checks are the most important.
- Can I/we interview the caregiver(s)? If so, is there a charge? Either way take advantage of it.
- If we’re not satisfied with the current caregiver, what’s the agency policy on providing a replacement?
- Does the agency have a minimum amount of hours that are required? Although this varies agency by agency, most require a four hour minimum.
- What are the rates?
- Hourly
- Daily: This is typically a live-in case where the caregiver is present in the home for 24 hours per day. This practice varies agency by agency based on the availability of live-in caregivers.
- How often do they bill and are you required to pay in advance? If they request advanced payment, it is typically for two weeks. See if you can pay this on a credit card. The credit card will offer some safeguard to you if you’re not happy with the agency and want to make a change.
Another aspect of selection is whether or not your parents have Long Term Care insurance (LTC). If they do have coverage, here are some questions.
- What LTC carriers do they accept?
- Do they accept Assignment of Benefits (AOB)? If so, this allows the agency to bill the LTC carrier directly.
- Does the policy have an Elimination Period? If so, how long? If the policy does, which most do, you’re required to pay for services within the Elimination Policy. An Elimination Policy can range from 30 to as many as 120 days.
I hope that I’ve given you a starting point for discussions with prospective home health agencies. I would shop a minimum of three agencies and dig as much as possible.
To find competent, caring elder care professionals across America who are located near You and can help you with your elder care matters, go to: www.ElderCareMatters.com - A FREE online resource to find elder care experts plus elder care information & answers to your elder care questions.
Bart Delsing, Owner & Chief Operating Officer
FirstLantic Healthcare, Inc.
Delray Beach, Florida 33445
561-243-7979
Member of the national ElderCare Matters Alliance, Florida chapter
Answer: I do not mean to sound facetious when I say that your first responsibility when hiring a Home Care Aide is to avoid being the employer. I will come back to that.
First, let’s differentiate between a Home Health Aide and a Home Care Aide. The former is actually someone who works as part of a Home Health team, comprising Nurses, Physical Therapists, Speech Therapists, Occupational Therapists and Home Health Aides. Home Health is a prescribed set of short term services, under a doctor’s order, to assist a patient who is return home from hospitalization or skilled nursing facility rehabilitation. Such services may last 4-8 weeks. In this assignment, Home Health Aides are responsible primarily for bathing services.
In non-medical home care, a Home Care Aide provides support for Activities of Daily Living (ADLs and Instrumental ADLs). When a client or family hires a Home Care Aide, they should actually be hiring an agency, with the agency serving as the employer of record for the caregiver. That agency should be providing the client and family with protection that includes liability insurance, a large dishonesty bond (we recommend $50,000), Workers Compensation insurance, Unemployment Insurance, all the payroll taxes, including Social Security, etc. being the responsibility of the employer agency. There are many other reasons for ensuring that you hire an agency, rather than becoming the caregiver’s employer. For example, what happens when the caregiver is sick? The agency is responsible for covering. If the client does not get along with the Home Care Aide, you want that to be the agency’s problem, not a matter of you firing the caregiver and then having to deal with an unemployment claim.
If you do hiring a caregiver directly – or through a so-called “referral agency” – you are going to be considered the employer of record. You have enough on your hands without that added responsibility.
Bert Cave, President
Support For Home
Sacramento, California 95825
916-482-8484
Member of the national ElderCare Matters Alliance, California chapter
Answer: The first question you have already asked is the most important one. Choosing someone to care for a loved one is one of the very hardest decisions that families can make. Below are a number of the questions that we think should be asked to help ensure an informed decision.
- Do we hire a caregiver or do we hire an agency? The answer to that question is another question — "What happens if something goes wrong?" This is really important. In hiring individual caregivers, there is not much recourse if she or he does not show up or gets sick or does something they should not do. You can fire them, but then you are starting over, and, if they damaged property or, even worse, stole from you, you are on your own. With an agency as the actual employer of your Home Care Aide, it is their responsibility to "make things right." If your regular Home Care Aide is ill, the agency should provide backup coverage. Liability insurance, dishonesty bonds, Workers Comp insurance, background checks, payroll taxes, etc. — these are all things you should expect from an agency, not items you should have to worry about.
- Are the caregivers provided by the agency truly employees of that agency? Frankly, if the answer is “no,” look elsewhere. If a private duty (non-medical in-home care) agency does not take the responsibility of hiring caregivers, but tries to send “independent contractors,” there are several problems you need to worry about. The first is that the company is trying to back away from taking responsibility, legally and ethically, from the caregivers it sends. Secondly, there is the question of who is paying workers’ compensation, unemployment insurance and other personnel expenses. The chances are that you may end up, as the client, being responsible for more than you think. A referral agency that looks like it is cheaper, in terms of rates it quotes, may result in much higher real costs to you, as a result.
- Are the caregivers covered by liability insurance and adequate dishonesty bond insurance? Ask to see the Certificate(s) of Insurance for the agency. If they cannot / will not give you a copy, look elsewhere. As to dishonesty bonds, we believe that agencies should carry a $50,000 bond.
- Is there a charge for meeting with you to do an assessment or for signing with the agency for service? The answer absolutely needs to be “No.”
- Are the caregivers assigned by the agency certified (e.g., Certified Nurse Assistants) or proven to have comparable skills and experience? This is really important, especially if personal care is involved.
- Are caregivers thoroughly tested for attitudes, behaviors and personality, not just skills? For example, many of the better agencies use the Caregiver Quality Assurance tests from LeadingHomeCare.com.
- Are thorough background checks performed before the agency hires caregivers? Some private duty agencies point with pride to their use of governmental background checks, which, in reality can be quite limited in scope. California's Department of Justice check, for example, only gives state and local data for the last five (5) years. Agencies should include a nationwide felony/misdemeanor check, a Federal crimes check, DMV records, and Sex Offender Registry verification. The nationwide check includes running the social security number through a national database to retrieve address history. A check is then run wherever additional residences are found. Reference checks should be part of all background checks. Additionally, a negative TB test within the last year should be required and a ten point drug test.
- Is there a minimum number of hours or days required by the agency? The answer should be no, but shorter shifts will probably cost more than longer shifts, per hour, since they are harder to staff with good caregivers.
- Is a knowledgeable, empowered member of the agency’s management team assigned to answer the agency’s phone outside of office hours? The answer needs to be yes. Answering services and junior staff cannot help with your urgent needs at 2:00 AM.
This is not an exhaustive list, but it is a good place to start. One other question you should ask every agency you talk to is, “What other questions should I ask?”
Bert Cave, President
Support For Home
1333 Howe Avenue
Suite 206
Sacramento, California 95825
916-482-8484
Member of the national ElderCare Matters Alliance, California chapter
Answer: The short answer is “medical services”. Home health care is normally the result of hospitalization or time spent in rehabilitation in a skilled nursing facility. It is short-term care provided to help a patient transition back home. Normally, home health care will last four to eight weeks, and the typical services that will be included, as a result of a doctor’s order, are provided by one or more of the following:
- Registered Nurse. This may include wound care, for example, for someone suffering from a pressure ulcer (bed sore).
- Physical Therapist. A patient recovering from a fall or surgery may need guided physical exercise to regain some lost mobility.
- Speech Therapist. For example, a stroke victim may lose some ability to communicate verbally (aphasia).
- Occupational Therapist. The focus may or may not be on the ability to perform a job. Skills in this area are defined broadly (see below).
- Home Health Aide. This person is normally focused on assistance with bathing services, which may also be provided in non-medical home care.
Home care is typically non-medical in nature. It is focused on what are called Activities of Daily Living (ADLs) and Instrumental ADLs: More on Question of the Day: "What is the difference between home health care and home care?"…
