The baby boomer squeeze play
You are working six days a week in your business. Your children are in college, or soon will be. You see retirement on the horizon. And now, you find yourself financially and physically preoccupied with your aging parents, who are losing their ability to be independent.Sound familiar? If so, you are among a rapidly growing number of baby boomers squeezed from all sides. Increasingly, the tipping point may be the time and energy needed to manage your parents’ health and financial affairs.
This is especially the case if they are not ready – or willing – to consider an institutional option, and they insist on remaining in their home.
With that in mind, Cape Business invited three local companies – Home Instead Senior Care; TLC Home Health Care Services Inc.; and At Home Safe – that specialize in a spectrum of services to discuss options increasingly available as an alternative or precursor to assisted living or nursing home options.
How do I get started finding the right care?
Kathleen Catrambone, TLC Home Health Care: Don’t wait until you are in a crisis. Always be an active consumer of information. Call health-care agencies to inquire by phone or personal meeting. Determine if you need home care, a certified home health aide, a certified nurse assistant, an LPN or an RN. It may be that you simply need a licensed insured driver to transport your loved one to medical appointments, or allow them to get out of the house to go to the beach, lunch or hairdresser.
Who qualifies for home care, and at what point is this no longer an option?
Denise Dever, Home Instead Senior Care: The term “qualify” doesn’t really fit with home care. Anyone who needs assistance to help them stay at home and who has the ability to pay for these services privately or through long-term care insurance can hire a home care company. Medical issues and/or deterioration of client abilities – both physical and mental – may dictate whether it is advisable for the client to remain at home.
How can one begin to identify the right home-care option for a parent?
Dever: Start by contacting your town’s council on aging or senior center, Elder Services, Alzheimer’s Services of the Cape & Islands or the Alzheimers Association, or area hospitals or your doctor. Other avenues are local parish nurses, elder law attorneys and the Internet. A Google search on keywords such as home care, senior home care, care for mom and dad, elder care can provide a myriad of websites to guide you in the right direction.
Angela Dalpe, At Home Safe: Assess the needs of a loved one based on health status, family member and physician input, as well as a parents input. Identify a need and if possible start with the most basic of home care services, starting slowly can ease a parent or loved one’s sense of a loss of independence.
What are the financial issues involved in home care?
Dever: The advantages are generally for individuals who do not need full-time care – you only pay for the hours and services you need. Medical insurance does not pay for any non-medical home care.
Long-term-care insurance has now been designed to provide benefits across the full continuum of care. Unfortunately, baby boomers generally have more coverage than their parents, since it is a relatively new concept that is more expensive the older you are.
The most common type of long-term insurance now being sold is a comprehensive policy that provides a wide range of custodial, skilled and institutional care – including home care, adult day care, assisted living and traditional nursing home care. It’s really the future for us baby boomers.
Dalpe: Long-term-care insurance will pay for home care provided by a licensed agency that places licensed caregivers – for example, a nurse’s aide, home health aide, or skilled nursing care. Depending on the policy, most plans cover home health care equally when compared to institutional care. In addition, Medicare will pay for any medical equipment needed to assist an elder to stay at home.
What are other reasons people choose home care?
Catrambone: When medically feasible, home care addresses many psychological and emotional issues. People are attached to their homes and familiar surroundings. Especially after a spouse has passed, if you take the living parent out of the home, statistics show that often the surviving spouse will pass in three to six months if they lose the will to live.
Other reasons: consistency of care in the home, more independence and dignity for your parent. One key is to assure that the same caregiver is tending your parent on a regular basis. That contributes to the communication needed not only between the caregiver and parent, but between the caregiver and family members.
What are some of the best scenarios for home care?
Dalpe: My favorite scenario is a patient just home from surgery who is discharged from the hospital - with a variety of home care services working together as a team. It’s the patient, nurses, therapists and home health aides working throughout the healing process, watching the transition - from incapacitated to independently functioning and resuming activities of daily living without further assistance.
How do you stay in communication with the family?
Dever: Our client liaison is the first point of contact and is responsible for keeping all lines of communication open. We are a 24/7 operation that provides live responses by a staff member (not an answering service) immediately or within 10 minutes. Each client is provided with a daily journal that our caregivers use to log in what occurs during their time with the client for family members to read.
Catrambone: We ask that family members assign one person to be the advocate for the parent and represent every other relative. We ask permission to establish a communications log for all our caregivers to report details of their visits – what they did and how the patient felt that day. We encourage meetings with family members at the home or our office. We also have staff meetings with our caregivers to review care plans, receive their input and make any changes needed.
Dalpe: Family communication is very important, we can keep up communication via the telephone, Email or via a daily communication log book placed in the home of a client.
If the parent is nearby, what is expected of the children; and how do they partner with the home care staff?
Dalpe: Local and long-distance families have an equal daily responsibility, simply being available via telephone if a situation should arise, is all a home care agency could ask for. We are able to relay the issue at hand and all parties can discuss how to effectively troubleshoot any situation.
Denise Dever is president and owner of Home Instead Senior Care in Centerville. Kathleen Catrambone is president and founder of TLC Home Health Care Services in Hyannis. Angela Dalpe is president and owner of At Home Safe in Yarmouth Port.
Tips when seeking home care
• Have a family meeting to develop a strategy and develop consensus
• Designate one person to be the parent’s advocate
• Determine how many hours an agency will be needed
• Work with a locally owned and operated company – not a registry or independent contractor
• Make sure there is a thorough pre-employment screening of the company’s employees
• Ask if the company has an employee-training program in place
• Determine the responsiveness of staff. Can you speak to someone at any time?
• Is there a quality control program in place?
• Ask about the compatibility of caregivers, and how they are brought into your home
• Ask if the company can provide references from existing or past clients
• Ask the company if it can give you three reasons why you should choose it over another company
Source: Denise Dever, Home Instead Senior Care; Kathleen Catrambone, TLC Home Health Care Services
Published in Cape Business Health & Wealth July/August 2007
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