Finding Home Care for Elderly Family Members


A live-in aide could be a good option for your family. Around the clock care from an aide isn’t cheap, but it may be the best option for your family in certain situations, especially if you need live-in care for just a short period of time.

Whether you need long-term or short-term care for your ailing parents, though, here are six things you need to consider before you hire a live-in aide.

What type of aide do you need?

According to an article on the subject, there are several types of live-in aides that are available today. It’s essential that you choose the right type of aide, as choosing one that is overqualified for the job could leave your pocketbook unnecessarily slim, while choosing one that’s underqualified for the job could leave your parents in danger. Here’s a bit about the three basic types of aides:

  • Certified nursing assistants: These assistants work for registered nurses, or did at one time. They’re qualified to help with more intense activities like bathing, and they can monitor medications, do basic checks of your parents’ vitals, and care for wounds.
  • Home health aides: These individuals have slightly less qualifications than certified nursing assistants, but they’re able to take care of basic things like bathing and ensuring that your parents eat a healthy diet.
  • Personal care attendants: These individuals are also known as personal companions. They don’t take care of things like bathing or wound care as often, but they will help with household chores, including cleaning, cooking, and shopping.

While these are three separate categories of live-in aides, their responsibilities, in reality, often overlap. It’s not uncommon for a certified nursing assistant to take care of not only health care issues but also shopping or cleaning while acting as a live-in aide. However, the aides with more certifications are more expensive, so you will want to tailor the type of aide you choose to your parents’ actual needs.

 How much can you afford?

While the decision to hire a live-in aide is more about the well-being of the people who cared for you your entire life than about money, budget is definitely an issue when it comes to hiring an aide for your parents. The cost of a live-in aide will vary dramatically from one area of the country to the next. Just to give you an idea of potential costs, though, a New York Times article notes that round the clock care through Partners in Care, a New York based company, can cost from $1,000 to over $3,000 per week.
Your budget can help you determine what type of care you’re looking for, as well as how much care you can afford to pay for. If you really need someone to be awake the entire time they’re with your parents, you’ll probably pay for four separate aides who will alternate twelve-hour shifts. If you only need daytime care and can give the aide the nights off for personal time and sleep (even if they spend the night in your parents’ home), you can probably work with two different aides.
One thing to keep in mind with your budget is overtime. You’ll need to pay more for hours worked over forty hours a week, which is why Partners in Care suggests hiring multiple aides if you need around the clock care throughout the week.

How do you want to hire the aide?

There are two different ways to hire a live-in aide: individually or through an agency. Here’s a bit about what each experience could be like for you:

  • Hiring independently: Hiring an aide independently can save you some money, since their hourly rates tend to be lower, as you aren’t paying the middle-man, as well. However, independent aides tend to have a high turnover rate, so you may not be able to give your parents long-term stability. Also, you’ll have to take care of supervision as well as payroll taxes and other government paperwork on your own.
  • Hiring through an agency: On the surface, hiring through an agency is more expensive. However, the agency takes care of payroll taxes and supervision. Often times, CNAs are supervised by certified nurses who can give them advice on your parents’ healthcare, which is reassuring. Also, with an agency, you can usually try out several home aides before you decide which one to use, and agencies will often provide backup care if your regular aide is ill or takes a vacation.

Whether you hire independently or through an agency, make sure that you have a reference check, a background check for a criminal record, and a check for tuberculosis and other communicable diseases to ensure your parents will be as safe as possible.

Is the aide licensed, bonded, and insured?

Whether you hire individually or through an agency, you should make sure that your home health aide is licensed, bonded, and insured. Most aides who have worked for an agency at any point with at least have an old license, even if it’s out of date. If you’re hiring a freelancing aide, the up to date license may not be as important as long as the aide still has current knowledge on things like CPR and first aid.
Bonded and insured live-in aides are essential. Bonding and insurance basically let you know that if something happens in your parents’ home or if you find that something has been stolen, someone will reimburse your family.

Does the agency and/or the aide have a good reputation?

While you hear lots of horror stories on the news of live-in aides committing elder abuse or stealing cash, credit cards or jewelry from their clients, the truth is that there are just a few bad apples out there who ruin the reputation of the whole bunch. For the most part, people become live-in aides because they enjoy working with the elderly or disabled and because they really do care about their clients.
The best way to avoid a bad apple, besides running background checks and checking references, of course, is to ask for referrals and see who has a great reputation. Talk to local nursing homes, friends and relatives who have elderly parents, or even older people who have their own live-in or part time aides. You’ll be able to quickly see who has a great reputation and who you should steer clear of.

What are your expectations for a live-in aide?

One last thing to think about before hiring a live-in aide is what your expectations for the aide are. It’s helpful if your parents can form a bond with the aide over common interests, but at the very least, the aide should be polite, interested, and companionable. Talk about how many hours you expect an aide to work, whether the aide can sleep when your parents are asleep, and what types of daily tasks the aide will carry out. Talk with your parents about expectations, as well, since they may have some ideas of their own about what they would like in a live-in aide. While your aide may not be perfect, finding one who can meet a minimum standard of expectations is certainly not impossible.

Paying the Live-in Aide

Of course, paying your live-in aide can be the most complicated part.  The last thing you want to do is to get into deep credit card debt.  It’s usually wise to get a sense of where all your money goes.
There may be some government assistance available through Medicare or even the Housing Choice Voucher Program that will help pay for a live-in aide, although you’ll need to research these options for your family. However you decide to pay for a live-in aide, make sure you work through the hiring process carefully, thinking through each of these issues before you finally hire a live-in aide for your parents.

photo credit: Wunkai via photopin cc

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