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March 4, 2005/Adar I 23 5765, Volume 57, No. 27
The right fit: choosing a home care provider
LINDA L. ESRICK
Special to Jewish News
America is aging, and people are living longer than ever before. According to a U.S. Census Bureau 2000 report, 35 million people in the United States are age 65 and older. That represents a 12 percent increase since 1990. By 2011, the Baby Boom generation will begin to turn 65, and by 2030, 70 million Americans will be age 65 or older. In fact, an estimated 82,000 people are 100 and older in the United States and the number is projected to grow to 381,000 by 2030. In the larger picture, the world's population age 65 and older is growing by an unprecedented 800,000 people a month.
In a recent survey, more than 83 percent of seniors said they are very or somewhat likely to remain in their homes rather than move into a care facility. This is certainly true in the Valley, which is home to a large senior population.
With the senior explosion, the Valley has seen literally hundreds of new private-duty home care companies open up. New ones are popping up almost weekly. With so many new companies to choose from, when the time comes that you or a loved one needs assistance, how do you choose the right company?
Some quick facts:
- There are more than 300 companies in the Valley offering private-duty home care.
- On average, Valley home care companies pay their caregivers as little as $6 per hour on the low end to about $10 per hour on the high end.
- On average, the top Valley home care companies charge from about $16 per hour to more than $20 per hour.
- There are three major caregiver skill levels in the Valley - Certified Nursing Assistants (CNA), who are licensed through the Arizona State Nursing Board; certified caregivers, who must complete a training course to become certified; and caregivers or companions, who hold no license or certification, and who may or may not have any training or hands-on experience.
- Be careful shopping for the lowest price in care giving. One company may be sending you a $6 per-hour companion while another company may be sending you a $10-per-hour CNA. You get what you pay for.
- Know what type of caregiver you are getting for your money no matter what the rate is. This is your right. Different medical conditions call for different levels of trained home care staff.
- Arizona does not regulate private-duty home care companies, and therefore there are no rules or regulations to be enforced.
- Valley companies are not required to perform background checks.
- Valley companies are not required to hire people with any experience.
- Valley companies are not required to perform driving record checks.
- Valley companies are not required to call references and verify work history.
As incredible as it sounds, Valley companies can hire and send to your home any person, with or without experience, a clean background, felony convictions or drunk driving convictions. The lack of regulations for private-duty home care companies means it is up to the discretion of each individual company who they hire and send to client homes.
If this information scares you, it should. A total stranger will have access to your private possessions, money, jewelry, and most importantly, access to you or a loved one. You should seek someone honest, someone professional who speaks your chosen language, someone with experience who knows what she is doing. You deserve a professional who shows up on time, dresses professionally and is well groomed, and who carries the proper insurance coverage.
To find a home care company that can provide you with these things, you will have to do some homework, make some calls, check with the Better Business Bureau and hope the company you are speaking with is being honest with you.
Referrals from Valley health care professionals can also be a good starting point toward finding a good home care company. It would also be prudent to call a few of the company's current clients for references.
Make a few photocopies of the following questions before you begin making calls to home care companies:
- Name of company.
- Number of years in business.
- Are your caregivers "employees" or "independent contractors?"
- Do you carry workers' compensation insurance?
- Are your employees bonded and do you carry general liability insurance?
- What are your rates?
- Do you bill "add-on" or "extra" charges on top of your quoted rates?
- How much do you pay your average caregivers?
- What is the skill level range of your caregivers?
- What are your caregiver hiring guidelines?
- How do you check out applicants before hiring them?
- What are your owners' and managers' backgrounds?
- Do you require your caregivers to have current fingerprint clearance cards?
- Do you have a skilled nurse on staff?
- Does your company provide individual client care plans?
- Do you have case supervisors who perform regular supervisory visits?
- What is their skill level?
- What is your company's after-hours accessibility?
- Does your company require a deposit, and if so, how much?
- How often do you bill?
- What if I don't like the person you send to me?
- What happens if your caregiver doesn't show up?
- Does your company have a Web site?
- If I choose your company, what happens next?
After interviewing several companies over the telephone and asking them these questions, you will be able to make a more informed decision about the company that best suits your needs and comfort level.
Choosing the right company is important and certainly worth an hour of research.
Running an ad in the paper and hiring a caregiver direct to try and save money is an option some people pursue. If you hire someone direct, please remember most caregivers who work direct carry no liability or workers' compensation insurance and are not bonded. If they get sick or have an accident, there will not be a backup caregiver to fill in.
Speak with your attorney and know your liability and exposure before you hire someone direct.
Linda L. Esrick RN, BSN, is the owner and president of Affordable Home Care Solutions. Call 480-451-8183.
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