What You Should Consider

A caregiver provides assistance in meeting the daily needs of another person. Caregivers are referred to as either “formal” or “informal.” “Formal” caregivers are paid for their services and have had training and education in providing care. This may include services from home health agencies and other trained professionals.

“Informal” caregivers, also called family caregivers, are persons who provide care to family or friends, usually without payment. A caregiver provides care, generally in the home environment, for an aging parent, spouse, other relative, or unrelated person, or for an ill, or disabled person. These tasks may include transportation, grocery shopping, housework, preparing meals, as well as giving assistance with getting dressed, getting out of bed, help with eating, and incontinence.

If you fit the description of a family, or “informal” caregiver, you are not alone. According to the American Association of Retired Persons (AARP) and the National Alliance for Caregiving (NAC), estimates of 44.4 million Americans provide care as “informal” caregivers to people ages 18 years or older.

The majority of caregivers are women with the average age of 46; however, 39 percent or 4 in 10 men are also caregivers. It is also a myth that most of the elderly are cared for in nursing homes in the US; rather, most long-term care is provided by caregivers in the home.

Caring for an ill, aging, or disabled person can be a rewarding experience. However, depending on the level of care required and other demands on the caregiver's time and energy, it can also become an overwhelming responsibility. When this occurs, it may be time to explore other home health care options, such as hiring a private caregiver. Here are some questions to ask yourself when considering a private caregiver:

• How much time is required to help care for the individual at home? Is this likely to increase or decrease over time?
• What skill level is necessary to provide the best care for the individual at home?
• Are family members and friends capable of providing the necessary care without any one individual becoming overburdened?
• How does the ill, aging, or disabled individual feel about having a private caregiver assist with his/her care? Is he/she comfortable with the idea of a private caregiver? Does he/she understand the caregiver's need for care assistance?

If the decision is made to hire a private caregiver, you will want to explore many options. Also, it will be important to acknowledge and include the care recipient's preferences. Consider the following questions in your search for appropriate care:

• What services would be required of the caregiver? (Try writing a job description outlining exactly what would be expected of a caregiver.)
• Is the individual employed by an agency or organization licensed by the state?
• What specific services will the caregiver provide, and will these services match your job description?
• Will the same person or persons be always available, or will it be necessary to adjust to many caregivers?
• Does the agency or organization offer flexibility, making care available on weekends, at nights, and on holidays, for example?
• How does the agency or organization ensure that its employees treat their patients and patient families with respect?

Finding appropriate providers requires some research. When looking for a provider, consider the following:

• Quality of Care
• Availability of Services
• Personnel Training and Expertise

When evaluating the quality of a provider, you may encounter the following terms:

• Licensure: Some states require providers to have licenses to operate. Basic legal and operating requirements mandated by the state must be met to obtain a license.
• Bonding: A bond is a type of insurance policy for a provider. To become "bonded," a provider must pay a set amount. The bond protects the provider from bankruptcy in the event of a lawsuit by a consumer.
• Certification: State certification by state departments.
• Accreditation: Nationally recognized accrediting organizations evaluate and accredit quality health care services. A provider must voluntarily seek out this accreditation. Some organizations who accredit home health care include:
  • Accreditation Commission for Home Care
  • National Home Caring Council

When choosing a provider, consider asking the following questions:

• Does the provider have literature describing its services, cost, and funding?
• Is an evaluation of the patient's home healthcare needs required?
• Is there a written plan of care for the patient?
• When are caregivers available?
• Is there a supervisor on-call 24 hours a day?
• Can the provider ensure patient confidentiality?
• How is quality of care and services monitored?
• What types of payments are accepted?