Home Safety for Seniors

Ensuring home safety for the elderly is crucial to prevent accidents and promote their well-being. Here are some important tips to create a safe living environment:

1. Remove tripping hazards: Keep the floors free from clutter, loose rugs, or any other items that may cause the elderly to trip and fall. Secure loose cables and cords to the wall or use cord covers.

2. Install grab bars and handrails: Install grab bars in the bathroom, especially near the toilet and shower area, and handrails on stairways to provide stability and support.

3. Improve lighting: Adequate lighting is essential to prevent falls. Install bright lights in hallways, staircases, and entrance areas. Consider using motion sensor lights to ensure good visibility during nighttime.

4. Non-slip surfaces: Use non-slip mats or rugs with rubber backing in the bathroom and near entrances. Apply non-slip strips or decals to slippery surfaces such as bathtubs and showers.

5. Secure rugs and carpets: Ensure that rugs and carpets are properly secured to the floor to prevent slipping. Consider using double-sided tape or rug grippers.

6. Organize belongings: Keep commonly used items within reach to avoid the need for climbing or overreaching. Rearrange kitchen cabinets and storage areas accordingly.

7. Smoke and carbon monoxide detectors: Install smoke detectors and carbon monoxide detectors throughout the home. Test them regularly to ensure they are functioning correctly.

8. Medication management: Set up a system to help the elderly manage their medications safely. Use pill organizers or automatic medication dispensers to prevent errors or missed doses.

9. Bathroom safety: Use a raised toilet seat to make it easier for the elderly to sit and stand. Place a non-slip mat or adhesive strips in the bathtub or shower to prevent slips.

10. Emergency response system: Consider installing an emergency response system that the elderly person can use to call for help in case of a fall or other emergencies.

11. Clear pathways: Ensure that all pathways in the home are clear and easy to navigate. Remove any obstacles, excess furniture, or clutter that may obstruct movement.

12. Adequate heating and cooling: Maintain a comfortable and safe temperature inside the home. Ensure that heating and cooling systems are functioning correctly and have regular maintenance.

13. Fire safety: Place fire extinguishers on each floor of the house and near the kitchen. Educate the elderly on fire safety procedures and how to use fire extinguishers.

14. Stair safety: Install handrails on both sides of the staircase for stability. Consider adding stair gates at the top and bottom to prevent accidental falls.

15. Regular home maintenance: Keep the home well-maintained by checking for any potential hazards such as loose handrails, broken steps, or faulty electrical outlets. Address these issues promptly.

Remember, every individual's needs may vary, so it's essential to assess the specific requirements of the elderly person in question and make appropriate adjustments to ensure their safety and comfort.

Caring For Someone With Dementia

What Family Caregivers Need To Know About

Caring For Someone With Dementia

Dementia is a general term used to describe a group of symptoms affecting cognitive functions such as memory, thinking, and reasoning. It is not a specific disease itself but rather a syndrome caused by various underlying conditions or diseases. Dementia is characterized by a decline in cognitive abilities that is severe enough to interfere with a person's daily life and activities.

The most common cause of dementia is Alzheimer's disease, accounting for about 60-80% of cases. Other causes include vascular dementia, which occurs due to impaired blood flow to the brain, and Lewy body dementia, which is associated with abnormal protein deposits in the brain.

The symptoms of dementia can vary depending on the cause and stage of the disease, but they often include memory loss, difficulty with language and communication, impaired judgment, confusion, personality changes, and problems with performing familiar tasks. As the condition progresses, individuals with dementia may experience difficulties with self-care, mobility, and coordination.

Dementia is typically a progressive condition, meaning it worsens over time. However, the rate of progression can vary among individuals. Currently, there is no known cure for most types of dementia, but certain medications and interventions may help manage symptoms and slow down the progression of the disease. Supportive care, including creating a safe and supportive environment, providing emotional support, and assisting with daily activities, is crucial in improving the quality of life for individuals with dementia and their caregivers.

 There Are Many Types of Dementia

• Alzheimer’s Disease

• Vascular Dementia

• Lewy Body Dementia

• Parkinson’s Disease

• Krosakoff Syndrome

• Huntington’s Disease

• Frontotemporal Dementia

There are many challenges when caring for someone with dementia. Here are some tips to overcome these challenges.

 Communication

When communicating with someone who has dementia, it's important to remember that their cognitive abilities may be impaired, making it necessary to adjust your approach. Here are some tips to effectively communicate with someone who has dementia:

1. Maintain a calm and reassuring demeanor: Approach the person with a friendly and calm attitude. Speak in a gentle tone and use a relaxed body language. Your non-verbal cues can help create a positive and comfortable environment.

2. Use simple and concise language: Keep your sentences short and simple. Avoid using complex or ambiguous words that may confuse the person. Speak slowly and clearly, allowing them enough time to process what you're saying.

3. Be patient and allow extra time: People with dementia may take longer to understand and respond to conversations. Give them ample time to process the information and express themselves. Avoid rushing or interrupting them. Patience is key to effective communication.

4. Ask one question at a time: Present questions or information in a clear and straightforward manner. Asking multiple questions at once can overwhelm and confuse the person. Give them time to respond before moving on to the next topic.

5. Use visual aids and gestures: Visual aids, such as photographs or simple drawings, can help enhance understanding and memory. Pointing or using gestures can also assist in conveying your message. Visual cues often complement verbal communication effectively.

6. Maintain eye contact and show interest: Establishing eye contact helps to engage the person and shows that you are interested in what they have to say. Be attentive, actively listen, and respond with empathy. This can help build trust and create a positive connection.

7. Avoid correcting or arguing: It's common for people with dementia to have memory lapses or difficulties with reality. Correcting or arguing with them can lead to frustration and agitation. Instead, focus on the emotions behind their words and respond with empathy and understanding.

8. Use positive body language: Your body language should be warm, open, and inviting. Smile, nod, and use gentle touches if appropriate, as these can help convey a sense of comfort and reassurance.

9. Limit distractions: Choose a quiet and comfortable environment for your conversation, free from excessive noise or distractions. Minimize background distractions such as television or loud music, as they can interfere with communication.

10. Be flexible and adapt: Communication needs may vary from person to person, so be prepared to adapt your approach based on the individual's preferences and abilities. What works for one person with dementia may not work for another, so remain flexible and patient.

Remember, effective communication with someone with dementia requires understanding, empathy, and patience. By using these tips, you can help create a positive and meaningful connection with the person you're communicating with.

 Aggression

When dealing with aggression in a person with dementia, it's important to remember that their behavior is not intentional but rather a manifestation of the underlying condition. Here are some steps you can take to manage the situation:

1. Stay calm: It's crucial to remain calm and composed. Agitation can escalate if you respond with anger or frustration.

2. Ensure safety: Make sure that you and the person with dementia are safe. If necessary, remove any objects that may cause harm or create a potentially dangerous environment.

3. Identify triggers: Try to identify the factors that may be triggering the aggression. It could be pain, discomfort, fear, frustration, or an unmet need. Understanding the triggers can help you address the root cause of the aggression.

4. Redirect attention: Gently redirect the person's attention to something positive or engaging. This could involve changing the subject, introducing a favorite activity, or providing a sensory stimulus like calming music or a familiar object.

5. Validate emotions: Acknowledge the person's feelings without arguing or contradicting them. Use empathetic statements like, "I can see that you're upset. I'm here to help you."

6. Maintain structure and routine: A structured environment with consistent routines can help reduce confusion and anxiety, which may contribute to aggression. Stick to a regular schedule for meals, activities, and rest.

7. Modify the environment: Create a calm and soothing environment by minimizing noise, clutter, and excessive stimulation. Soft lighting, familiar objects, and comfortable seating can help create a more peaceful atmosphere.

8. Seek professional help: If aggression becomes a persistent problem or if you feel overwhelmed, it's important to seek guidance from healthcare professionals who specialize in dementia care. They can provide personalized strategies and may suggest medication if necessary.

Remember, each person with dementia is unique, so it may take some trial and error to find the most effective approaches to manage their aggression. Patience, empathy, and understanding are key to providing the best care possible.

 Confusion

If a person with dementia becomes confused, there are several strategies you can employ to help them:

1. Stay calm: It's important to remain calm and composed when interacting with someone who is confused. Your calm demeanor can help reduce their anxiety and agitation.

2. Reassure and comfort: Speak in a gentle and reassuring tone. Let the person know that they are safe and that you are there to help them. Use simple and clear language to convey your message.

3. Maintain a familiar environment: Keep the surroundings as familiar and predictable as possible. Avoid sudden changes or introducing unfamiliar objects or people that might add to their confusion.

4. Provide orientation cues: Remind the person of their location, time, and other relevant information. Use visual cues, such as calendars or clocks, to help them orient themselves.

5. Offer simple choices: Present limited and clear options when appropriate. For instance, if they are having trouble deciding what to wear, you can show them two outfits to choose from rather than overwhelming them with too many choices.

6. Break tasks into smaller steps: If the person is struggling with a task, break it down into smaller, manageable steps. Guide them through each step patiently and provide assistance when needed.

7. Use visual aids: Visual aids, such as written instructions or labeled objects, can be helpful in providing cues and reminders. For instance, you can place a sign on the bathroom door to indicate its location.

8. Maintain a routine: Establishing and sticking to a consistent daily routine can provide a sense of structure and familiarity, which may help reduce confusion and anxiety.

9. Involve familiar people: Encourage the involvement of family members, close friends, or caregivers who the person with dementia knows well. Familiar faces and voices can help provide comfort and reassurance.

10. Consult a healthcare professional: If confusion becomes a persistent or worsening issue, it's advisable to consult a healthcare professional specializing in dementia or geriatric care. They can provide a proper diagnosis, offer guidance, and suggest appropriate interventions.

Remember, each person with dementia is unique, so it's important to observe and understand their individual needs and preferences. By providing a supportive and understanding environment, you can help manage their confusion and improve their overall well-being.

 Agitation

When a person with dementia becomes agitated, it's important to respond calmly and try to identify and address the underlying cause of their distress. Here are some steps you can take to help manage agitation in someone with dementia:

1. Stay calm: It's important to remain calm yourself, as your demeanor can influence the person's emotional state. Speak in a soothing and reassuring tone.

2. Create a safe environment: Ensure that the immediate surroundings are safe and free from any potential hazards. Reduce noise and other stimuli that might be causing agitation, such as loud music or excessive activity.

3. Validate their feelings: Acknowledge the person's feelings and empathize with their frustration or anxiety, even if you don't fully understand the cause. Let them know you are there to help and support them.

4. Identify triggers: Try to identify any potential triggers for the agitation. It could be physical discomfort, hunger, thirst, fatigue, noise, or unfamiliar surroundings. Understanding the trigger can help you address the root cause.

5. Maintain a routine: People with dementia often benefit from having a regular routine. Familiarity and predictability can help reduce agitation. Stick to a consistent schedule for daily activities, meals, and rest.

6. Offer reassurance: Provide reassurance and comfort to the person with dementia. Use gentle touch, if appropriate, to convey care and support. Reassure them that they are safe and that you are there to help.

7. Redirect their attention: If the person is fixated on a particular topic or is upset about something, try to redirect their attention to a different activity or subject. Engage them in a calming activity they enjoy or reminisce about positive memories.

8. Use calming techniques: Techniques such as deep breathing exercises, gentle music, aromatherapy, or a comforting object can help promote relaxation. Experiment with different approaches to see what works best for the individual.

9. Consult a healthcare professional: If agitation becomes a persistent or escalating issue, it may be beneficial to seek guidance from a healthcare professional who specializes in dementia care. They can provide additional strategies and, if necessary, evaluate the person's medication regimen.

Remember, each person with dementia is unique, and what works for one individual may not work for another. It's important to be patient and understanding while trying different approaches to manage agitation

NEW YEAR….NEW YOU, Thoughts for Caregivers

Whether you're a caregiver for a family member or an in home care provider, New Years is a perfect time to reassess. Here's some thoughts from one of our senior care providers.

2016 silently tiptoed out for many people who were not into the blowing-horns-saluting-the-New Year-with-bubbly mode.  On tiny cat feet, 2016 quietly walked out the door, and gave a hug to 2017 while whispering in its ear, “treat every day with kindness and love”.  Those who greeted the New Year with reflections of the past year and a cup of hot cocoa or Earl Grey tea may be thinking of new ways to journey along the path of 2017.  Resolutions may include getting more exercise, cutting down on nibbling junk food while watching tv or get started on that endless honey-do list.

I’ve thought about “New Year Resolutions” and realize that despite my good intentions, my resolves to do this or that fall by the wayside a few weeks after the New Year begins. This realization triggered some thought about making an effort to “do better” in small but significant ways.  Making changes that would put smiles on the faces of those who are in your little corner of the world would be a good starting point. 

POSITIVE THOUGHTS

When waking up in the morning, focus on the power of positive thinking.  Instead of lamenting “Oh, great!  My plate is over-filled today. How can I get it all done?” Think, instead, “I should prioritize what I have to do today.  I know I’ll be able to do this because, first-off, I like to do these things and secondly, hey, I’m good at doing them!” That kind of thinking will get your creative juices flowing and also make you feel good about yourself. Giving yourself a pat on the back is a gentle push to get moving in a positive direction, not a negative one. This resolution will make your inner self ready to meet the day and give it your best efforts.

KIND WORDS

Brushing your teeth is part of your morning routine.  Why not add another must-do?  Make a conscious decision, each morning, to speak kindly to your family as they gear up for their day – whatever it may be. Too often the hustle-bustle of getting breakfast, grabbing important paperwork, feeding the pets, throwing on a load of laundry or figuring out what else needs to be done before you head out the door…result in unkind words being thrown at family members.  Criticism spews from a mouth like an angry volcano.  Those in the path of such words become defensive and then, in turn, ready to speak unkindly to others.  Remember, once spoken, words cannot ever be retrieved!  Sure, you can follow up with “what I meant was” or “sorry”, but the damage has been done.  The target of your ire just had a chunk taken out of their heart.  Now there is a dead spot on that heart where once was a smile. I speak from experience of being on the receiving end of words that went right to my heart and did damage – it hurts!  Yes, this will take big-time effort on your part but what a life-changer it will become when you make it routine.  Sending your family (and yourself) off to meet the day with smiles is awesome!  A great resolution!

SINCERE CARING

Too often we know someone who is experiencing a huge bump in their road and their day is falling apart. We may tell them we are sorry or off-handedly say “let me know if I can help” and then hope they won’t really ask us to do this or that.  After all, aren’t we all busy with our own lives? Or so we tell ourselves. Reach out to friends, family or acquaintances when they need help.  Put aside some time in your day to check in on them and, again, remind them you really want to help.  Caring about others does not have a time limit – it is endless!  And rightly so.  Sincerity is caring with you going the extra mile. Think about it. After all, when someone reaches out to us and then follows up with a phone call or knock on the door, isn’t our load somewhat lightened knowing that someone really cares enough to want to help – that it just wasn’t an off-hand gesture?  Sincere caring is a resolution that will bless them and your own heart, too.

LOVE YOURSELF

This may sound weird but it’s not! Do you feel unworthy/unable to be loved?  Then you need to take a good look at yourself in the mirror and tell that person staring back that they are a good person -- talented, caring, and worthy of love and respect. Don’t be bashful. Don’t think you are being egotistic. You aren’t. Do you know that the hardest person to love is yourself?  You know everything about you – what you perceive to be your good and bad points. But - to be able to give love to others, to care about them and to give the best you can whatever the situation -- you need to be coming from a place of inner strength, self-approval and knowing that you are valued.  Resolve to take stock of the person who wears your shoes. By doing this frequently, you will be reminded to smile at that reflection in the mirror.

DON’T JUMP TO CONCLUSIONS

How many of us form an opinion about a person or situation only to find out our idea of so and so or some event was totally off track? Rather than being patient, or listening intently or getting the whole story, we jumped the gun, thus putting a negative slant on a certain situation. How often have we hurt a person through word or action because we had formed a wrong conclusion? Make a New Year’s resolution to get all the facts. If you need to ask questions, then do so. 

BE BRAVE

It takes bravery to speak up about a situation that bothers you.  It is an injustice to a person if you don’t tell them if something they said or did is always on your mind.  I’ve always held to the premise that not saying anything when you need to means you really don’t care.  Having something eating at your heart and not talking about it is like an invisible rock hung on a chain around your heart – always heavy and wearing away at you.  I am not a person to make waves and I hate confrontation. But, there are times when I’ve had to take that very hard step to let someone know that something is wrong. I tell them that something they did or said is weighing heavy on my heart and we need to talk. When the air has been cleared, I can breathe easier and my heart steps lightly.  Resolve to clear the air and the sun will shine brighter for you!

WHAT DO THESE QUALITIES MAKE?

You may be asking how can these resolutions:  Positive Thoughts, Kind Words, Sincere Caring, Loving Yourself, Not Jumping to Conclusions and Be Brave have a connection with being a Caregiver?  Well, think about it. A Caregiver who starts their day with negative thoughts, biting words, off-handed offers to help, not being able to look in the mirror, making assumptions, or being too timid to clear the air walks into a client’s home dragging any of this name-it, claim-it baggage. Poof! Today’s road starts out rocky, not smooth. Adopting even one of these resolutions into your everyday life will put a spring into your step and a sincere smile on your face.  Your head will be ready to think, your hands will be ready to offer assistance and your heart will be ready to truly care about the person who needs you.  A Caregiver who is walking their New Year’s Resolution journey will bring sunshine and not gray skies to someone who needs to know they, too, are valued. Unlike winter’s sniffles, spreading these life-changing resolutions around would be awesome!

Whether you're a family caregiver or a homecare provider, what resolutions have you made which might help in your role as a caregiver?

Elder Abuse, Neglect, and Exploitation

Protect yourself or your loved one

The elderly often rely on others to meet their most basic needs. Statistics tell us that about 9.5% of the elderly population is abused every year. Elder abuse includes neglect, physical abuse, financial exploitation, emotional abuse, and sexual abuse. One out of every 14 cases occurs domestically, usually within the victims homes. Abuse also occurs in nursing homes and other facilities. Physical Abuse is defined as the use of physical force that may result in bodily injury, physical pain, or impairment. This can happen even if the motives are good. For example we have seen family members who force there elderly mother into the tub, because she has dementia and would not cooperate. This forcing caused minor injuries. When confronted the family stated they were just doing what the nursing home did.  This is a shocking story, and often how physical abuse occurs. Psychological Abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. What is often just family conflict and strife can easily get out of control and lead to psychological abuse. Financial Abuse or exploitation is defined as the illegal or improper use of an elder’s funds, property, or assets. A family member, neighbor, friend, even a hired caregiver, anyone who is close to the person can manipulate and abuse them for personal selfish gain. Neglect is defined as the refusal or failure to fulfill any part of a person’s obligations or duties to an elder, or the failure on the part of an in-home service provider to provide necessary care. This can easily happen just by family members conveniently forgetting about their elderly parent. Caregiving is a hard stressful job, rather than properly finding the help that is needed. Ignoring the problem is abuse.

We all have the right to be free from abuse, neglect, and exploitation. If you suspect any form of abuse to an elderly person, it is important for you to report it. The types of abuse discussed above could happen to any of our community’s elders. Without intervention, abuse almost always escalates. Because victims are often reluctant to report abuse, a person’s safety may depend on you to recognize and report suspected abuse. It would be far safer for you to report a suspicion and be wrong, then remaining quiet while abuse occurs. It is important to know that more than two-thirds of elder abuse perpetrators are family members of the victims or close family friends, typically serving in a caregiving role. When elder abuse occurs, it can be addressed – if it comes to the attention of authorities.

If you need to hire homecare assistance, we recommend using a licensed agency rather than hiring privately. Homecare agencies must conduct criminal background checks, and BEAS registry checks. The BEAS registry (bureau of elderly and adult services) is a database containing information on founded reports of abuse, neglect or exploitation of incapacitated adults by a paid or volunteer caregiver, guardian or agent. There are individuals with a clear criminal background check who in in the BEAS registry. The NH BEAS registry can be reached at (603) 271-3269. Also, keep in mind; only criminals who get reported and charged have criminal records. Some homecare agencies and nursing facilities conduct pre-hire personality tests. These tests help determine if an applicant has a tendency toward certain types of crime or questionable behavior. 

Questions to Ask When Hiring Homecare Services

Providing care for a loved one can be stressful. Hiring homecare services should help relieve stress, not add to it. We made the following list to help make hiring a homecare service easier. 

Things to consider:

1.  Reputation:  Ask around. Ask your hospital discharge planner about any agency you are considering.  Rehabs or Nursing homes will usually provide you a list of agencies to consider. Senior centers and government services such as Service Link in New Hampshire are also great place to get information. Ask specifically about more than one agency for comparison purposes. 

2. Check out their website: The agency’s website should be thorough, informative and professional.

3. Ask to have a free in-home assessment. Any reputable agency should be willing and able to provide an assessment of your loved one’s needs. This meeting should be one that is not only for admission purposes, but also to answer the family’s questions or concerns. The homecare representative should be willing and able to answer and help guide the family toward the options they have, without pressure. They should be willing to be a resource for you whether you use their services or not. 

Questions to ask an agency:

1. Is your agency licensed by the state?

The states of Maine and New Hampshire require homecare agencies to be state licensed. New Hampshire also requires a state license for independent caregivers. If your family is considering hiring privately for care for your loved one please read our article on this topic "Use Caution When Hiring Independent Caregivers".

2. Will you take care of all required payroll paperwork for my loved one’s caregiver? Are your caregivers all employed by the agency?

The states of Maine and New Hampshire consider you an employer if you independently hire someone to work in your home. There is a large amount of paperwork involved in being an employer. This paperwork covers such matters as taxes, Social Security, workers compensation, disability, and liability insurance. One benefit of hiring an agency is that the agency normally does this for you. Even so, it is good to ask, as some agencies do use independent contractors as caregivers.

3. What kind of training do you provide for your caregivers?

To expect experienced and trained caregivers to work in homecare should be the minimum. However, it is important to ask if the hiring agency is training the caregiver themselves in addition to any formal training or schooling which the caregiver has had. What do they require for continuing education? Abundant Blessings Homecare’s new hire training and continuing education exceeds the state requirements in every area. Our RN is continuously adding and improving our training. We believe providing the very best training and continuing education will assure that our caregivers are the very best caregivers!

4. Do you conduct drug testing on your caregivers?

The states of Maine and New Hampshire do not require drug testing for home healthcare workers. Many homes in which home healthcare services are provided contain controlled substances, therefore we believe drug testing should be a vital part of the hiring process for any home care agency.

5. What kind of background check do you conduct on your caregivers?

Having peace of mind that your loved ones are in good hands is vital when hiring homecare services. The state of NH requires that homecare agencies in New Hampshire conduct only a State of New Hampshire criminal background check, not a Federal background check. They also do not require a motor vehicle driving record check. At Abundant Blessings Homecare we believe that State, Federal and Motor vehicle record checks are all essential when hiring homecare for a loved one. We run all three checks on all our caregivers. These additional checks are an added expense during the hiring process but we feel they are essential for peace of mind for your family. It is possible for someone to have a criminal record in another state which would show up on a Federal check and yet their New Hampshire background check would return "clear". We also believe motor vehicle background checks are imperative because often times home healthcare workers provide transportation for their clients.

6. Are your employees insured and bonded? 

The state of New Hampshire requires insurance of homecare agencies, but not bonding. However, insurance does not cover theft; bonding does. Also, not all liability insurance is the same. You could ask the agency for a copy of their policy or ask what their liability insurance covers. 

7. If at any time my loved one needs more hours of care (eg: 24 hour a day), or if a caregiver should call in sick, do you have the staff for coverage? 

Any agency you hire should have enough staff to cover these situations should they arise.

8. What is your policy regarding sending a caregiver to my loved one’s home whom my loved one has never met?  

It is not safe for an elderly person to be answering the door to total strangers. An agency should have a policy in place regarding the meeting of new caregivers. Abundant Blessings Homecare never sends new caregivers to a home blindly; we always conduct a “meet and greet”.

9. What kind of supervision do you provide? 

Once a caregiver is placed in the home of your loved one, ongoing supervision of that caregiver needs to be provided. How often can you expect a Care Manager/Supervisor to be available? Your family is assigned a Care Manager who you will get to know and trust as your go to person. At Abundant Blessings Homecare our phone number is always answered 24/7 by a real person and if your Care Manager is off when you call, you will be connected with whomever is providing coverage. In addition, we conduct drop in visits just to see how things are going on a regular basis. 

10. What kind of service agreement is required? What are your minimum number of hours?

All agencies have different policies. Find out what is required to be sure it will work for the needs of your loved one.

11. What is your method for tracking a caregiver’s arrival and departure from a clients home?

The agency should have a system in place for this that works for you and your family.

12. What are your hours of operation, and how are phone calls handled during odd hours? 

Abundant Blessings Homecare is available by phone 24/7, and is always answered by a real person!

13. Do you provide a written plan of care which clearly describes any rates and fees?

The state of New Hampshire has requirements which must be on the plan of care. The plan of care should be thorough and well    explained to your family.

14. How soon can you start services?

Your family may need homecare right away, yet the homecare agency may be too busy or too small to handle a quick start. They may need time to schedule services. This is a very important question to ask.

Questions to Ask Before Hiring a Homecare Agency

To obtain a license, a homecare agency must meet certain requirements for the state.

These requirements include:

• Criminal Background Checks

• BEAS registry check

• TB Testing

• Physical

• Training

• Liability Insurance

In addition to the above, we recommend asking your potential agency questions pertaining to things the state does not require of an agency, yet are important when considering care for a loved one.

These include:

• · How long has the agency been in business?

• · Are all caregivers employees or are they subcontracted?

• · What are their hiring standards?

• · What are the qualifications

• · What is the company dress code?

• · How much experience do the employees have?

• · What is the training and continuing education program for the employees?

• · Does the agency provide drug abuse testing for employees?

• · What is the range of pay provided to employees?

• · Does the agency conduct motor vehicle background checks? (this is especially important if the caregiver will be providing transportation)

• · Are your caregivers insured and bonded?

• ·Is there enough staff if at any time my loved one needs more hours of care (ie: 24 hour a day), or if a caregiver should call in sick do you have the staff for coverage?

• ·What are your hours of operation, how are phone calls handled during odd hours?

• ·What types of pre-hire screening do you conduct on your employees.

 Click Here for a PDF of Questions to Ask Before Hiring a Homecare Agency.

When Hiring In-Home Care - Be Informed

We often have people tell us they are considering hiring an independent caregiver for their homecare needs. Sometimes the person they are considering is a neighbor or a friend who has worked with the elderly or disabled at some point. All situations are unique and every need for homecare will have a slightly different solution, whether it be hours of need or type of services. We believe each family seeking homecare solutions should have the best care for their situation whether it be an agency or an individual, but we also believe each family in order to protect themselves and their loved one should be thoroughly informed when they hire. 

Here are a few things you should be aware of when weighing your homecare options. 

1.  Many families are not aware there are certain things which are required by law of any individual or any agency who performs home care / personal care services. For example: the state of New Hampshire requires all homecare agencies to be licensed but many are not aware that any individual performing personal care / homecare services must also be licensed. This state licensing was established to protect the individual. An agency must go through a thorough licensing process in order to obtain a state license, an independent caregiver must go through a similar process. This license is different than having an LNA certificate. An individual can have their LNA certificate and still not be state licensed. 

2.  Many families are not aware that when they hire a caregiver independently, the IRS then considers them an employer. We have had families call us who have hired caregivers independently and when the family no longer needs as many hours of coverage they let a caregiver go. The caregiver then goes to the unemployement office and the family receives a bill for back employee taxes. Taxes which must be paid by an employer include Federal, Social Security, Meidcare, and state taxes if you are outside of NH.

3. There is a state registry called the BEAS registry, we find there are many people who are not even aware this exists. This registry of the Bureau of Elderly and Adult Services is maintained to keep a registry of those who have abused, exploited or neglected elderly or disabled adults. Running a check of this registry is not the same as running a criminal background check. We have seen situations where someone is on this registry yet has a clean criminal background check. 

4.  Many families are not aware that a negative TB test is required of all home care employees employed by an agency or working independently. TB can be carried by an individual for years without signs or symptoms. Any caregiver you are considering hiring independently should also be tested for TB.

5.  Drug Testingfor illegal drug abuse or prescription drug abuse. Many of the homes in which homecare services are performed have prescription medications in them. In fact, medication reminders is often one of the primary needs of homecare clients. Yet when seeking homecare services, many families often are not aware of this potential problem. All homecare providers should be drug tested. 

6. Any homecare agency must provide, as required by law, Workers Compensation Insurance. In addition an agency provides Liability Insurance and Bonding. If you are considering hiring independently, your homeowners policy may not cover such things. Talk with your insurance agent and make sure your homeowners policy is going to cover any incidents which may occur. This is not the time to think "oh, nothing will happen", we live in a society which loves lawsuits and you put at risk your home and anything else you have worked hard for if there is an accident.

7. Other considerations.

• Sick Days: If homecare is something which you can not be without day in and day out, make certain you will have replacement if the caregiver should call out sick.

• Qualifications and Training. Be certain the individual you hire has experience and training in the skills you are asking them to perform. For example; just because someone has worked in a nursing home does not necessarily mean they have done transfer assistance. Transfering an individual to their bed or in and out of the shower requires specific skills and techniques and must be done correctly to avoid injury to both the caregiver and the client/patient.

• Transportation: If your caregiver will be providing transportation it is important that a motor vehicle background check be conducted prior to hire. Also, make certain your motor vehicle insurance will cover this situation or the caregiver is carrying their own motor vehicle liability policy. Our agency has a policy which will cover transportation of a client whether in the employees vehicle or the clients vehicle.

• Physical: All state licensed agencies and individuals must have a physical from their doctor stating they are medically cleared to do such work. You should make certain you obtain the same if you are hiring independently.

These above considerations are just a few of the things we believe every family hiring homecare services should consider. For more considerations you can download the following PDF document. 

When Hiring In Home Care - Be Informed