Montrose Herald Journal, Montrose, MN
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published 2009

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In-home services give seniors an alternative to nursing home care

By Linda Scherer
Staff Writer

There is no place like home, and many aging seniors are choosing to remain there longer with the help of in-home services to assist them.

Just a few of the advantages of the elderly remaining at home – using in-home care as an alternative to nursing home care – would be the one-on-one attention the senior receives from the caregiver, the senior can choose a daily routine, pets are allowed, and the senior is able to choose a caregiver he/she likes.

Because insurance companies have sought ways to trim the cost of hospitalization and therapy services, it has opened the door for service providers who concentrate on supporting individuals at home. This reduces health care costs and allows an older adult to remain in the home, according to

Whether it is for a few hours a day or 24-hour-a-day assistance, a wide range of community-based services are available to suit the senior’s needs.

Access to home-care personnel with all levels of knowledge and skill, include registered nurses, who help with medical care; therapists, who work with patients to restore or maintain motor, speech, and cognitive skills; home care aides, who provide personal services; and companion/homemakers, who help with chores around the house and transportation.

Some home care agencies charge flat fees, according to the National Family Caregivers Association, ranging from $100 to $120 a visit. Others have a minimum two- to four-hour fee. The actual hourly rate will vary depending on services required and the part of the country assistance is provided. The rate can be as low as $13 up to $35 per hour or higher.

The number of service options on in-home care is staggering. The following sources are available by county to simplify the search:

• If you live in Carver or Hennepin counties, call the Senior LinkAge Line toll-free at 800-333-2433 for answers to questions relating to aging or to finding in-home services available in your area.

An online search can be done by ZIP Code to find in-home service available in both counties at – go to Senior Link and the topic: Help with Care and Chores in Your Home.

• For McLeod County, the above resources for Carver and Hennepin counties are available and, in addition, seniors can call the McLeod County Public Health Nursing Service for a list of agencies available in McLeod County at (320) 864-3185 or toll-free at 800-450-3185.

• Wright County Public Health at (763) 682-7456 or toll-free at 800-360-3667 ext. 7717 can be called to get a list of home health care agencies within Wright County. Also check the resources available for Carver and Hennepin counties, which cover some areas in Wright County as well.

What to look for in in-home health services

The following are questions to ask an agency being considered for in-home care. The questions are provided by the National Family Caregivers Association.

• Is the agency certified for participation in Medicare and Medicaid programs (where applicable)?

• How long has the agency been serving the community?

• Is the agency accredited by the Joint Commission On Accreditation of Healthcare Organization (JCAHO) or Community Health Accreditation Program (CHAP), or other recognized accrediting body?

• Does the agency provide an initial assessment to determine if the patient would be appropriate for home care and what those services might be?

• Does the agency provide all of the services you need? Can it provide flexibility to meet the patient’s changing health care needs?

• How does the agency choose and train its employees? Are background checks made? Does it protect its caregivers within written personnel policies, benefit packages, and mal-practice insurance?

• Does the agency provide literature explaining its services, eligibility requirements, fees, and funding?

• Does the agency have arrangements in place for emergencies? Are the agency’s caregivers available 24 hours a day, seven days a week? How quickly can they start service?

Informal caregivers becoming more common

“Informal caregivers” provide another source of assistance for seniors living at home.

A recent estimate by reported 19 million Americans are informal caregivers to someone over age 75.

The senior they care for is typically a parent or a grandparent who may or may not live with them. They provide 75 to 80 percent of all long-term care in the United States.

The average family caregiver is a 46-year-old woman caring for a parent who does not live with her. She is married and employed, according to the National Alliance for Caregiving and the American Association of Retired Persons (AARP): Caregiving in the US (2004).

A personal example of an informal caregiver was given during an interview for an article titled “When Your Aging Parents Need You” written by Sally Wadyka for MSN Health and Fitness. The caregiver (daughter) lived one hour away from her parents.

Her mother, 90, had advanced Alzheimer’s and her father, 92, was bedridden for the past year because of some broken bones.

The daughter, 63, made the drive routinely to take charge of her parents’ shopping, finances, and getting them to the doctor.

Her parents were able to stay in their own home because they had a revolving schedule of around the clock caregivers. Although the daughter’s task was physically, emotionally, and mentally difficult, she tried to focus on the positive aspects of her situation, according to MSN Health and Fitness.

“In a way, it’s a gift to me to be able to take care of them in the last years of their lives” she said. “They were good, loving parents. I had no children by choice, but now I’ve been given the responsibility of caring for my parents, and I can feel good about that.”

Trying to manage two lifestyles can prove to be overwhelming at times. The National Family Caregivers Association has offered the following 10 tips for the family caregiver.

Tips for the family caregiver

1. Caregiving is a job and respite is your earned right. Reward yourself with respite breaks often.

2. Watch out for signs of depression, and don’t delay in getting professional help when you need it.

3. When people offer to help, accept the offer and suggest specific things they can do.

4. Educate yourself about your loved one’s condition and how to communicate effectively with doctors.

5. There’s a difference between caring and doing. Be open to technologies and ideas that promote your loved one’s independence.

6. Trust your instincts. Most of the time, they’ll lead you in the right direction.

7. Caregivers often do a lot of lifting, pushing, and pulling. Be good to your back.

8. Grieve for your losses, and then allow yourself to dream new dreams.

9. Seek support from other caregivers. There is great strength in knowing you are not alone.

10. Stand up for your rights as a caregiver and a citizen.