Tools for Your Caregiving Tool Belt – Navigating Care Facilities and In-Home Care

Yesterday, we added education to your caregiving tool belt (and I’d like to thank Denise Brown of Caregiving.com for coming up with the awesome concept of a “caregiver’s tool belt”). It’s reassuring to know when caring for your loved one you are not alone and there are resources out there to educate you about the particular disease or condition your loved one is living with. Knowing as much as possible about what you and your loved one is dealing with will help so much when talking to medical professionals – throw intimidation out the window!

The focus today is on resources available when searching for additional care for your loved one. This can include either in-home care or a care facility.

But first comes the decision . . .

The Decision.

The first decision to be made is the type of care needed at this time. It’s important to remember the phrase “at this time” because carees will have different needs as their disease or condition progresses and our ability to help may change over time as well. It’s okay to admit this. All you can do is manage what is happening “at this time.”

Family Support. Although you, as the primary caregiver, are the one making the decisions regarding care it is important to seek out others to help make the best possible decision. If feasible, enlist the support of other family members to help decide if additional in-home care is needed or if it’s time to move your parent (or sibling or grandparent or other caree) into a care facility.

Each family is different but keep in mind offers of help may not come streaming in. As the primary caregiver, it may be necessary to set forth specific tasks each family member can help with. Many people will make vague offers of assistance but unless given a specific task (“please call three care facilities by Wednesday”) it won’t get done.

Placement Counselors. If your loved one is currently in the hospital or a Skilled Nursing Facility, the placement counselors can help steer you in the right direction regarding permanent placement or provide information on in-home care. This is not a time to be shy as many of these counselors are doing their best trying to manage a heavy caseload which may result in subpar recommendations. Since I am inclined to avoid conflict and stepping on toes, it took me a while to get used to the squeaky wheel concept but found that it does help to be persistent. I do my pushing gently, yet relentlessly (most of the time). I’m getting used to a bit of conflict!

Medical Personnel. Talk with your loved one’s doctor to get his or her opinion (although I personally don’t think their opinion matters more than yours). Think of them as an additional source of information.

The initial decision can be the most excruciating one for you but you know your caree more than anyone so you get to decide what is for the best. Treat yourself gently during this process and remember you are making the best decision you can. (If you’re interested in reading about my own difficult decision in placing Robert, you can do so here).

Care Facilities.

If you are confused by the different care facility options, a previous post explains “Where to Start.” Before placement in the facility, I suggest checking them out using the various consumer advocacy websites. Although the information listed here is specific to California, a cursory search of a few other states reveals the Department of Health and Human Services in other states has similar information.  These sites allow you to search each home and will list complaints, citations and fines. This information doesn’t tell the whole picture of a home but can indicate patterns of problems.

The Health Facilities Consumer Information Center (http://hfcis.cdph.ca.gov/)
California Advocates for Nursing Home Reform (http://www.canhr.org/)

Other Care Facility resources to help in your search:

California Healthcare Foundation (http://www.chcf.org/)
California Quality Care (http://www.calqualitycare.org/)
Local Ombudsman Programs (www.aging.ca.gov/programs/ombudsman_contacts.asp)
The Consumer Voice (http://www.theconsumervoice.org/) (a national organization)

If you are looking for help in how to search for a home please visit my “Always with the Checklists!” post which outlines the steps needed to find your loved one a suitable home (and yes, it starts with a checklist).

In Home Care.

I don’t have personal experience with in-home care but can provide a few tips to help get you started. If you do have personal experience with in-home care, I’d love to hear about it in the comment section.

I’ve heard great (and not so great) stories about both options of using an agency or hiring a family friend (or other personal referral). Several reputable agencies can be found with a quick online search for “in-home care.” Regardless of which you choose an interview and background check is essential. I would approach the hiring process much like a business (because, really, it is) and would interview even a personal referral.

Questions. Create a list of questions covering topics such as work history, skills and experience (both length of experience as well as experience with the particular needs of your caree). Get a list of references (work related; not their dear ole mom).

Interview. Start with a screening interview with just you and the candidate. You can probably weed out a lot of candidates with your list of questions without taxing your loved one. After you have culled your pool of candidates, ask them back for a 2nd (or 3rd even) interview. Include your loved one so you can observe the interaction between the two. Deal breaker: if the candidate doesn’t engage with your loved one but instead talks only to you.

Feedback. Get feedback from your loved one if possible once the interview has concluded and the candidate has left. If conversation is difficult, trust your instincts in whether or not the candidate is the right fit.

Background check. It’s great to trust your instincts but don’t solely rely on them to make a final decision. Conduct a background check. No exceptions! Many of the agencies provide this service but please don’t take their word for it. Request a copy of the background check so you can review it for yourself.

I’d love to hear what resources helped you when searching for extra care. Please share in the comment section below so we can all give each other a little help during this journey.

Next, we will tackle government agencies (yikes!) and end with caregiving support resources.