Question of the Day on ElderCareMatters.com: "My mother is 79 years old and suffers with Alzheimer’s Disease. She and my Dad, who is 81 years old, live by themselves with Dad now providing all of her elder care, which simply cannot continue because Dad is showing signs of “burning out” both mentally and physically. My question is: Can you please provide me with a series of questions that I could ask when interviewing home care agencies so that I will have a better chance of hiring the right home care company for my elderly parents? This hiring decision is simply too important to leave to chance. Thank you."

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: 

  1. 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.
  2. How long has the agency been in business? It is best to choose a well-established agency. They generally  offer more experienced, trained caregivers.
  3. 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.
  4. 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.
  5. How often is the caregiver supervised and by whom? Look for a RN supervision answer here. If not, that’s a concern.
  6. 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.
  7. Can I/we interview the caregiver(s)? If so, is there a charge? Either way take advantage of it.
  8. If we’re not satisfied with the current caregiver, what’s the agency policy on providing a replacement?
  9. Does the agency have a minimum amount of hours that are required? Although this varies agency by agency, most require a four hour minimum.
  10. What are the rates?
    1. Hourly
    2. 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.
    3. 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. 

  1. What LTC carriers do they accept?
  2. Do they accept Assignment of Benefits (AOB)? If so, this allows the agency to bill the LTC carrier directly.
  3. 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 

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