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When Should You Hire Home Care for Your Parent?

Watch for signs that your loved one, or you, need an extra hand

Benjamin Rose Institute on Aging

Editor’s note: This is the tenth in the Next Avenue “When Should You…” series on aging milestones for parents or loved ones. With our partners at the Benjamin Rose Institute on Aging, we address common caregiving concerns.

No matter where loved ones call “home” – the house they’ve lived in for 40 years, the seniors-only apartment building they moved into last year, the mother-in-law suite you added to your house a couple of years ago – there’s probably going to come a time when home care can help them stay “at home.”

There are two kinds of home care, explains Christine Foley, the manager of home care at Benjamin Rose Institute on Aging.

Personal vs. Medical Care

Many seniors just need some help with personal care. This might include assistance with bathing and grooming; light housekeeping and laundry; shopping and cooking; transportation to medical and other appointments; or even just companionship.

Personal care is provided by a home care aide (often supervised by a care manager) and may be long-term. It enables an older adult to live safely and independently at home for as long as possible. It also provides family caregivers with peace of mind knowing their loved one is well cared for.

“This is the kind of home care that most people are seeking,” says Foley, who has been a home care administrator for 25 years.

Other seniors require services involving skilled medical help, such as wound care, infusions, or physical therapy. This level of care is often needed during a critical illness or after hospitalization or rehab, and is provided by licensed, registered and/or certified health care professionals. Skilled home care is usually provided for a shorter time period.

When to Say Yes to Home Care

There are two major — and often overlapping — indicators that loved ones, and their caregivers, could benefit from home care.

What the caregiver sees: If loved ones aren’t taking care of themselves; if their homes aren’t not kept up the way they had been; if there are unexplained bruises; if they aren’t eating; if their mental status has changed or if they are wandering, it may be time for home care.

If their house is not kept up the way it was; if there are unexplained bruises... it might be time for home care.

What the caregiver feels: If the caregiver is worried and anxious all the time about the loved one; feels a need to do so much for the loved one that the rest of his or her life has been put on hold or if the caregiver is asking other family members for help and getting no response; those feelings are red flags, Foley says. “Home care could benefit them and the person they are caring for,” she notes.

The first step to getting the kind of in-home care both parties need isn’t to rush out and hire a home care aide. Rather it is getting a referral from the loved one’s physician for an in-home assessment. Some physicians may also provide a list of local home care agencies that can do this evaluation.

“Usually the assessment is done by a social worker or nurse,” Foley says, “though sometimes a physical therapist will come in to evaluate for safety and mobility issues.”

Assessments, she adds, don’t just measure a loved one’s needs. “They also look at a caregiver’s needs…and can help them find resources and support services they can benefit from, too,” says Foley.

Getting the Right Fit

In some instances, the person doing the evaluation can match caregivers with the home care agencies and home care aides who will meet both their needs.

Talking to friends who are using home care can also be helpful. The human resources or Employee Assistance Program folks at work may have recommendations as well. Or call the local Area Agency on Aging. Or search online at ElderCare Locator.

Whatever the method used to navigate to an agency, be sure the staff is thoroughly screened before allowing anyone from there into your loved one’s home.

And even though the caregiver may believe they have found the ideal home care aide, the older adult in their care may think otherwise.

“Chemistry matters — especially if there is dementia — between the person providing the in-home care and the person receiving it,” Foley says. “Start slow. Introduce the home care aide into the person’s life for a couple of hours once or twice a week — and progress from there.”


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