A recent article in The Atlantic discussed the question of the difficulty of finding adequate care for America’s senior citizens as more of them are choosing to remain in their own homes as they age. In the article, published April 27, 2015 by Alana Samuels, the author relates the story of her grandmother’s plight to find adequate, affordable home care near the college town of Amherst, Massachusetts.
A shortage of qualified Certified Nursing Assistants (CNAs) coupled with outrageous hourly fees made the task of caring for her Parkinson’s ridden spouse that much more difficult. The author’s grandmother eventually gave up on agencies and a friend helped out until her husband’s death a couple of years later. It’s a story becoming all too common today.
By the year 2030, more than one quarter of all Americans will be over the age of 65. More than ever, those people are choosing to remain in their homes as long as possible, relying on home health care and the assistance of family for everything from grocery shopping to bathing.
Over the last few years, a host of “non-medical” in-home care agencies have sprung up all around the country, spread by franchise. Most offer no skilled health care services and little more than baby-sitting. They can help with things like shopping, cleaning and some companionship for homebound seniors.
But, these home care workers are not permitted to help in medical matters, not even to distribute medications, as would a CNA or other state-registered, skilled health care worker. One published estimate by Genworth puts the cost of non-medical home at a range of $10 to $36 per hour. The extreme discrepancy is attributed to variations in region and the type of care required.
One question families should be asking is exactly what could an unskilled worker possibly do that’s worth $36 per hour? Still, most have few options available; it’s either a nursing facility or home care.
Plus, the home itself can be more hazardous than the disabilities suffered by the senior. It may be necessary to modify the home to accommodate “aging in place,” with zero-clearance shower stalls, raised toilets, grab bars, and much more. This also carries added expense and attention to which families might be unaware.
The fact is that it’s much better, psychologically, and far cheaper for seniors to remain in their own home. But most people caring for an elderly family member cannot be with them all hours – people have to work and care for their own homes and families – and still need outside support.
The first place to start is with the local agencies on aging. Most counties or regions have a non-profit organization such as this to help put families and seniors in touch with needed services such as meals on wheels, in-home healthcare, and more.
Be aware, however, that most services referred by these agencies are self-pay and are not covered by Medicare or insurance. The advantage, however, is that they can generally offer a discounted rate on certain services based on the income of the senior. Contact the local agency for details.
For support on in-home modifications, consult the local builders association for referrals to certified aging in place specialists. Most can provide design and construction information for everything from a simple grab bar installation to more complex additions such as elevators.
Additionally, financial and insurance companies out there might be missing the boat on a potentially golden profit center – “in-home care insurance.” Separate from long-term care or other types of health insurance, this could be a specific product that addresses the far less-expensive options of keeping a senior at home rather than in a skilled care facility. Give it a slightly lower premium and the ability to purchase later in life, and it would likely be less difficult to sell.
Before hiring anyone, caregivers should do their homework. Get at least three references from previous clients and do a thorough Google search on the agency you choose.
Whatever the overall solutions to the home health care problem, it’s clear something has to be done in a hurry. With incidents of elder abuse on the rise in nursing facilities, it’s imperative that families have alternate care options.