4 Essential Tips for Finding the Best Home Care for Your Parents
The vast majority of frail older adults live at home — not in independent or assisted living and not in nursing homes. So, If you’re managing your parents’ care, sooner or later you’ll come up against the question of whether you should get them more help at home and how to go about it.
Hiring someone to help your parents can be expensive and awkward. It’s often hard to get your parents to accept a paid caregiver into their home and even harder to find a person you can trust. But, at the same time, it feels like doing so is the only way you can keep your parents where they are.
And, keeping them at home very often feels like the least heartbreaking way to proceed.
So, as is often the case with daughters, we try to perform miracles. We try to make our parents safe and happy in an environment that’s not really set up for their frailty or inability to get around.
And, then we feel guilty that we are failing…
But remember, you’re not failing! I promise. You’re up against a problem that’s too hard for any one daughter to solve by herself. Our typical homes and communities are not set up to support frail older adults.
So, when you are beating yourself up just remember that you’re trying to do BY YOURSELF something that whole senior housing communities and nursing homes are set up to do.
There are some real advantages to hiring someone to help if you can find the right person. It can reduce your parent’s social isolation, give you a break and at the same time provide a more neutral perspective on your parent’s situation – a paid helper without family baggage can be good for everyone.
Paid help at home is often referred to as “home care,” or “personal care.” Home care can help your parent with a wide variety of tasks ranging from the really personal activities such as bathing, dressing or eating, to the really practical like driving, shopping, food prep, and light housekeeping.
One point of clarification around something I find incredibly confusing: there is a difference between the terms, home care and home health. Medicare-covered home health refers to physician-ordered medical services at home delivered by medically skilled professionals like nurses and therapists. In contrast, home care is not medical and it isn’t a covered benefit under Medicare or other health insurance.
Most of the time families pay for home care out of their pockets. (Or, more rarely through long-term care insurance or Medicaid)
If you’re going to hire help for your parent, it pays to take the extra time to learn how the system works. Here are the four steps to follow that will increase your odds of success.
Step 1: Consider Going Through a Home Care Agency
Like Medicare-covered home health, home care is often provided by agencies (often the same agency will provide both). You can get a list of home care agencies in your area by visiting one of my favorite resources: the Alzheimer’s Association Community Resource Finder.
This same website has a great guide for interviewing home care agencies and the questions it provides are exactly the right ones to ask.
Here’s the problem though. When I put my zip code into the community finder, 66 DIFFERENT AGENCIES popped up. Am I supposed to interview all 66 agencies? Not likely. How do I whittle that 66 down to the 4 or 5 I should interview? Well, I wish I had an answer for that question. A friend of mine who has worked in this field for 30+ years said to me, “Even I wouldn’t know where to start.”
If you have any thoughts or views on this problem, let me know and I’ll investigate and get back to everyone. In the meantime, call every girlfriend you have and ask her if she has recommendations or knows someone who might. Check out reviews on Yelp and Angie’s List.
Our daughterhood team and advisors are working on ways that the daughterhood community can fill this gap!
Step 2: Be Realistic About Working With an Agency
Without question, one of the biggest frustrations I’ve heard voiced by friends, colleagues and readers is that working with an agency is really hard.
There’s too often a huge mismatch between what you want and what a typical agency can usually provide.
Understanding this mismatch and adjusting your expectations is key to getting the most out of an agency.
Because it’s our parents, of course we hope that the agency will send us a senior care version of Mary Poppins who is well paid and very happy to come in for just an hour or so to help out.
The reality, however, is that the agency is paying around $10 per hour for someone who relies on public transportation, is working for multiple agencies and/or multiple jobs, and may or may not be getting benefits, supervision, or training.
It’s just important to be realistic about what’s possible under the agency-model of home care, and to know what your absolute must-have needs are. The more home care hours you buy from the agency, the greater its flexibility in scheduling the times that are your highest priority. Plus you’ll also stand a better chance of getting the individual aide you prefer.
Step 3: Consider Avoiding an Agency
Because of the limitations of the home care agency model, many people prefer to avoid agencies and find a home care aide on their own. The reward of this approach can be high – in that you have a greater opportunity to choose someone who may, in fact, be very special and a great match for your parent — but the challenges are high too.
This option requires you to find the person without the benefit of an agency and to handle all the screening and scheduling yourself. In short, you have to be the employer with all that entails, and there’s no backstop on training or quality.
There are also internet-based companies that create marketplaces online with varying degrees of management and oversight. For example, Care.com allows you and prospective caregivers to meet online and then provides follow-up background checks and eventual bill payment.
If you live in the West or Southwest, check out Carelinx and Honor and let me know what you think. It appears they’re taking steps to pay aides more. Also, I like that Honor will create a care plan and provide care managers. And, Honor and Carelinx seem to be doing a good job of balancing the need for in-person communication and digital communication (something that traditional agencies are struggling with).
For the more routine tasks like driving, groceries, and home upkeep, consider using services that aren’t necessarily geared towards older adults — like internet grocery delivery, online transportation services (like Uber), unconventional service providers like TaskRabbit or Amazon Home Services. A friend of mine told me that his grandmother has a great relationship with an Uber driver in her community that’s worked out really well for them.
Step 4: Manage it All
In the end, the toughest thing about bringing in home care is that – most of the time — YOU still have to manage it. I was talking to someone recently who told me that his wife gave up a really good job just to “manage it all.”
Why? Well, it’s not just the day-to-day tasks and home-care workers you’re managing. It’s also the crazy medical care system, the legal complexities and many other logistics. And, you’re trying to do all of this while minimizing expenses and family conflicts. This is quite a lot to carry on your shoulders.
As best as I can tell at this point, there’s really only one solution and that’s to hire another daughter…and the closest thing to that is an Aging Life Care Professional, usually a social worker or nurse who will take on these more complex and multi-dimensional responsibilities.
Even if you can’t afford for one to be your full time manager, please pay for a few hours to at least get a consultation and care plan. Also, they can help you narrow those 66 agencies down to 4 or 5. To find one of these professionals, go here to the directory, type in your zip code into the “radius search” and then just hit “search” (ignore the confusing request for “member choices”).
Taking these foundational steps of care planning and professional recommendations will make a huge difference in the end and your sanity is worth it.
If you’ve tried to find help at home for your parents, we want to know what has worked and what hasn’t. Please join the conversation here at daughterhood!
I’m at the very beginning of finding home care for my parents. This article is very helpful. Please keep tips/information like this coming.
I don’t know if the following experiences are helpful, but I will share as I want to contribute to what you are doing:
– I got my parents to sign up for Meals on Wheels when I explained what it is/how it works as I volunteer once a month through work for this organization. This has led to my parents getting meals delivered 2 days per week and has worked out well.
– I signed up for a Medical Alert monitoring service where my Mom wears a pendant she presses if she falls and needs help. She has fallen once and the EMTs were there in about 10 minutes. This has worked well.
– My Mom now has a geriatrician and/or nurse practitioner come to the home to provide her medical care as she feels too fatigued to leave the house. These HCPs work for a division of a large, internationally known health system. This has not gone that well. The physician has not been able to diagnose why my mother has become increasingly fatigued over the past 18 months. And the physician doesn’t seem to realize how important this diagnosis is to my mother. She wants to get some of her energy back! Also, this care provider seems chaotic and is confusing to work with. It took me several months using the services of a Caregiver Support Service to arrange for this medical care at home. I think that the well known health system that this home care division belongs to would be appalled to know how poorly this division is run.
Hi Kathy — Thank you very much for sharing these very concrete tips. I am compiling tips to share back through social media — with the idea that we can get more systematic about providing this information to each other. One thing I am thinking about is how to create a private network through which women can get each other’s recommendations about narrowing that list from 66 to the 4 or 5 in their area that work well. It doesn’t seem like Angie’s List or Yelp are necessarily working well for that purpose — although I am not sure why not.
It’s alot of fun to have you as part of this community! You’ve got valuable expertise as both a daughter and someone who knows these systems well.
Your comments about taking care of your elderly parents, were interesting. I’ve watched my mom take care of her parents and her father and mother-in-law. It is really hard to take care of someone 24/7 and meet all of their needs. I liked your advice to get a home health nurse to help fulfill their needs. They are a great resource for help. Thanks for sharing your thoughts and ideas.
Hi Charlotte — Thank you very much! I so appreciate your support for the content. 24/7 is indeed really hard. Your mother must be a very devoted daughter and daughter-in-law.
As my parents get older there has been more and more to plan for. I think these tips are great, they will make moving them a lot easier. Planning ahead and considering an agency, like you mentioned, will make it a less stressful situation.
My siblings and I are going to begin the process of looking for the best home care for our mother. Because of this, I really appreciate this article about what I can do to find the best option. We are leaning towards home nursing care and believe that will help her the most at this point in her life. I hope others will be able to find the best option for their loved ones as well.
I’m glad that the article mentioned the difference between home care and home health, because I feel that they are often confused with each other. Both can be very important for elderly people living at home, but they are certainly not the exact same thing. An elderly person who is in need of home care is not necessarily in need of home healthcare.
I like what you said about hiring someone. I need to start exploring options for my parents, but I never seem to find the time because I’m very busy. After reading this, I’m starting to think hiring someone I trust would be the best way to go.
We started with Care.com and found an excellent caregiver. Over time, we also got to know her sister and the sister became a caregiver as well. We also use HomeInstead but because we live in a rural area, they have a limited number of caregivers in our area so we are using a combination of private pay and their agency. It’s working but it’s a lot to manage. My Mom, fortunately, still has the mental wherewith-all to keep up with who is coming on which day. A drawback to not using an agency is one we have also dealt with…what happens with the caregiver just doesn’t work out? We’ve had to “let go” more than one person for a variety of reasons. It’s also concerning to have that many complete strangers in and out of your home; I’m away at work and they are in my home caring for my Mom. While the agency has a lot of rules, well intentioned as they may be, at least you have a case manager you can call to discuss issues. And if the caregiver is away on vacation, they can often send you a substitute which is more difficult to find on your own. I just found this website but have found myself and my situation in nearly every blog post and comment. Thank you so much.
I really appreciated this post, especially because my wife and I are trying to help out my mother right now. I liked the tip to be realistic about working with an agency. I actually would love to have a senior care version of Mary Poppins! Thanks for sharing this post.
I think it is important to work with an agency so you don’t have any confusion with what is going on. I also think that working with an agency will help you find the right type of home care that is fit for the person you need the care for. It would also be smart because they would have really good prices.
My siblings and I have decided that it is time to put our parents in a nursing home because they are getting so dependent on us and we all have busy families. I really appreciate your point about how managing that search could mean carrying on our shoulders the medical care system, legal complexities and logistics, because it has made me realize how much work there will be in this process. After reading this post, I am definitely going to tell my siblings that we should consider going through an agency to get our parents into the right place.
I never thought about going through an agency; are they easy to find? My mom is going to be moving into a nursing home in the next few months and we are still trying to find a great place for her. I’ll have to do some research and see if we can get some help for our search.
I thought it was interesting that you would have some real advantages to hiring someone to help if you can find the right person. This is so important since your parent should feel comfortable with their caretaker. It would be quite uncomfortable if you would end up having to keep company with a worker that you don’t necessarily like. I would hope that through hard work and perseverance you would be able to find someone that would work well with your relative.
Thank you for explaining what home care is. I think it can really come in handy for people that need help. We all get to that point that we just can function the same and need a little bit of help.
Thanks for this helpful post on some tips for hiring the best home care for your parents. My father is getting to the point where he might need some in-home health care. Thanks for including some of the different ways to hire an in-home health care professional. I will have to study more on using a care agency. Thanks for the help!
I like how you said that at the end of the day you still have to manage the home care for your senior. My mom has been taking care of her mom for a long time and sometimes grandma needs to go to a home. Even when she’s away my mother is always checking in on things and making sure everything is going smoothly. Great advice!
I really appreciated this article. Managing a home health care agency, I found so many family members that had struggled far too long before contacting us. There is help out there!
K. Thiessen, BS
Thank you for explaining what home care is.I really appreciated this post, especially because my wife and I are trying to help out my mother right now. I need a home care system for my old mom. Do anybody knows about home care system agency , so please tell me about this. I need it hardly.
I love that you point out that when we are trying to give full care to parents on our own, we are attempting to fulfill the role that is filled by a full staff in nursing facilities. It really sounds a little crazy when you look at it that way! Although you may be able to give your parents the basic care they need, the nice thing about senior living homes is that they also provide entertainment and activities to give residents things to do on top of receiving the health care they need. It really is such a blessing to know that my family members are receiving such great care in the independent living center they’re in!
Good Information sharing tips for best home care services places.
I like your idea of looking for an agency to help you find an assisted living home. I would imagine that doing some work with experienced professionals would allow you to find the right place for your loved one to live. I’m looking for assisted living care for my mom now that she’s getting older so I’ll have to consider working with an agency to find the right place for her.
Because home caregivers are going to be in the homes of your parents it is important to make sure that they are trusted. I agree that a home care agency would be a good place to start when looking for a caregiver. Because agencies do background checks you will be able to have the surety that the person is honest and that they have the training needed.
Nice to read. Great article and very well explained. I believe in professionals so this is a very useful article for everyone. Many thanks for your share.
As my mother is getting older in her years, I am wanting to make sure that she is being looked after even if I can’t be there to do so. A friend that was in a similar situation, suggested that I look into getting help with an in home care service. It’s good to know that when I start looking that I need to be realistic about what the service can provide for my mom. I’ll have to remember that if I want a more flexible schedule with them then I may want to pay for more hours. That seems crazy but it will all be worth it for my mom. Thanks for the information!
This is very good information to know, as a homecare provider myself I find myself explaining the different between homecare and home health to clients who insist that you care for their love ones on a medical basis and we have to tell them this is what we can do and can not do and it’s also a liability to perform duties that we are not qualify to perform. So I make sure that we advertise we are non-medical and when clients call for services we quickly ask is this a medical issue or non medical? We create a “care plan or plan of care” , client assessments and body audits/pictures and home safety inspections to make sure we give the best care possible as a Non-Medical homecare provider.
I am living your article and have written about our experience on my blog: http://www.advocateformomanddad.com One thing your article did not cover, but is part of my mother’s health care cost to keep her at home, is the upkeep on a 60 year old home.
I invite you to read about why we choose to go with an agency instead of employing someone ourselves:
In this article I deconstruct what I learned about hiring a home care agency:
This article describes home health agencies, when they come into play and how they get paid.
I hope these article help you in your research and your readers
Advocate for Mom and Dad
Thank you Anne! For me this is the absolute biggest most confusing, vague, blech issue. I have now bookmarked the care management link for my mom’s zip code. You’re the best. Thank you Thank you Thank you.
It was interesting to learn that you still need to manage things when you hire an in-home care specialist for your parents. I think that is definitely fair because you are the one that can help out the most. In-home care agencies could be very useful if you live far away and cannot be near your parents, though. We’ll have to remember all of this when we start looking for the best in-home care specialists for my parents.
My wife and I have been looking at some different in home care services that we could use to help take care of her mother, and I think that getting some tips would be helpful. I’m glad that you talked about being able to be realistic about working with an agency, and how there can be a big mismatch between what you want and what they provide. I’m going to have to make sure that we know what a in home care service is providing, so we can either make up the difference, or find someone who will provide that extra help! Thanks for the tips!
Thanks for the tip that we hire a professional that will be able to help us with setting up a home care plan and help find the best agency to use. Now that my grandparents are getting pretty old, we’ve all decided that we should hire some kind of professional to help take care of them full time. So I will definitely start by talking to a service of some kind who can help us find the best home care agency to work with and set up a plan as well.
I like that you provided some tips on how to find the best home care for your parents such as asking for recommendations from people you know. Your friends and colleagues may be able to recommend one whom they probably worked with before. It’s possible that they have hired the services of this facility for their loved ones and were very satisfied with the treatment. You may also want to check for online reviews. This should give you an idea if the caregivers are indeed reliable and trustworthy. If I were to hire the services of a 24-hour live-in caregiver, I would make sure to keep this in mind. Thanks.
I always thought that getting a home care service would slowly move us out of the picture and that was something that I almost couldn’t stand the idea of. I am actually kind of glad to hear that we will still have to manage it all. It lets me know that we will still be a big part of my parent’s lives.
These tips are very helpful to find the best home care for aged parents. Thanks for sharing this information!
Very helpful tips to take care of elderly people and I had to note down these tips.
There really are a lot of complications that you have to take into consideration when choosing home care assistance. That is why it could be helpful to take the article’s advice and work with an agency. By doing that you will at least have someone that you can collaborate with when choosing assistance for your elderly loved one.
I loved your tip to manage everything about your home healthcare, and not leave the managing to the provider. I will be sure to be the best I can at managing everything. My mom deserves the best of care, and I will be sure to get it to her.
I like how the article explains that when you are looking for home care for your parents, you should think about hiring someone through an agency as they will be able to find one in your area and can help you to ask the right questions when interviewing someone. My parents are starting to age and aren’t able to do much on their own but they are refusing to leave their home but I am unable to stay at their home and help them as I have work. I will look into hiring an agency to help me find home care for my parents and find the right person for them.
I am glad that you mentioned that elderly people can receive help with shopping, preparing food, bathing, dressing, eating, housekeeping, etc when they have home caregivers. My grandparents are getting to the point where they can’t really get much done on their own. My mom always helps them but she also works and doesn’t always have the time. I will talk with my mom and my grandparents about hiring a home care service to help. Thank you for the advice and the benefits of using caregivers.
It is helpful for me to know that if we were to hire a home care service, that it will reduce the social isolation for our parents. We need to find someone to take care of my parents, and it is going to be important for us to know that we could find the right options for them. While I look for a service, I will remember that it is going to help them with their social lives.
I like how you mentioned that hiring an in-home care provider for your elder parent can help reduce their social isolation and give you a break. My wife is thinking of looking for a home health care agency because she’s thinking of returning to work full-time and would be unable to watch her mother every day. I think it’s a good idea for us to consider hiring a reputable professional that can help us watch and tent to my mother-in-law as best as possible while we’re at work.
I’m glad to hear that elderly people can receive help with bathing and preparing food from home caregivers. My mom is getting to the point where she can’t do a lot on her own. I’ll have to talk with the rest of my siblings about hiring a home care service or a health care facility that can help her with her day.
Those are great tips you have listed. I was searching for home care service for my parents in West Bloomfield Township and it was overall great experience with M&Y Home Care LLC.
I appreciate your reminder that hiring someone to take care of our parents can be expensive and awkward. However, I don’t have anyone else to ask for help and I have my own family to look after. Going for in-home care options would probably be the best choice for my parents’ current situation.
Practical and essential tips for home care for parents. Thanks for writing and sharing this post with us.
As our age is growing and we are busy in satisfying our family needs, our parents are also growing older and they need somebody 24 hours a day. At such times hiring a home care agency would be very beneficial as it will reduce the social isolation for our parents.
Thanks so much for this post. Finding the best home care for an aging loved one isn’t easy. It’s challenging to even know when to start home care. I found this blog post that may help others who struggle with that: https://www.nursingplusbroward.com/blog/aging-parents-home-health-care/
I completely agree with your suggestion to research and gather information about different home care agencies. It’s crucial to ensure that the agency we choose has a good reputation, reliable caregivers, and appropriate licenses and certifications. Taking the time to read reviews and testimonials can provide valuable insights into the quality of their services.