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Keeping a Loved One at Home

by At Home Preferred on February 6, 2012

I talk with many families about our services and invariably, the first question asked of me is, “how do we know what we need?” Naturally, my response is “I don’t know,” that is, until we uncover the answers to a few basic questions.

The first consideration is the physical and mental state of the loved one (client). There is a big difference between a client who is physically capable of moving around, driving, preparing meals and bathing as opposed to a client who is challenged or incapable of performing those activities. Naturally, the caregiver support becomes more extreme based on the limitations of the client.

From there you can begin to put together a simple “plan of care” that addresses the needs of the client on a daily or weekly basis. For example, my mother-in-law is very independent — she can fix her own meals, bathe herself, read her mail and pay her own bills, but she has lost her confidence with driving. Yes, it would be nice if my wife or one of her three siblings could drive my mother-in-law around but unfortunately, they have jobs. So, three times a week for about 4 hours each visit, a caregiver drives her to CVS, the hair dresser, bank or wherever she wants or needs to go. That is the extent of her “plan of care” and it keeps everything in balance.

By contrast, if you are arranging care for a loved one who has physical constraints or memory issues, the “plan of care” becomes more demanding. Regardless, you can always devise a solution, but the very first step is to inventory the capabilities and limitations of the client. We like to have this done by a registered nurse because he or she can pick up on the subtleties of the client’s healthcare needs that may otherwise be overlooked or discounted.

Once you get a clear picture of what the needs entail, you then examine the available resources, people resources and financial resources. In terms of people resources, you should factor in the family support system, if there is one. Some clients have large families that live close by and can help with the plan of care; other clients may not have any family or family that lives out of town.

Therefore, if the plan of care involves, for example, a 30 hour a week of care, you must determine what portion of those 30 hours can be accommodated by the family or friends. Whatever remains will be handled by the caregiver or team of caregivers. Whenever possible, we like to see the family participate in some of the care. It’s good for the family, it’s good for the loved one, and it reduces costs.

Lastly, you must confront the financial consideration. The industry average for non-skilled or companion services is between $17 and $23 per hour. Let’s do the math. Fifteen hours a week at $17 is $255 per week or $13,260 per year. Since the cost is generally not covered by insurance, the individual or family needs to have a clear understanding of the potential expense associated with keeping a loved one in the home.

Private care in the home can be expensive, and I always like to point out to families that the real savings of care in the home is not in the hourly rate of let’s say $18 versus $17 , but rather, to take some of the careplan hours and fill those in with family and friends. In other words, reduce the hours of the paid caregivers.

There are many other considerations that I could talk about but these are just a few that are relative to every client engagement. We strongly believe in bringing together resources to allow people to age in place. This model can be achieved in most instances, but the upfront work of correctly evaluating the client’s condition, determining the level of family support, and discussing the feasibility of keeping a loved one at home will lay the foundation for a successful experience.