In a prior column, I wrote about the advantages of aging in place and how that sometimes requires the help of a home health aide to care for the elderly loved one. So how do you hire one?
The first question is whether to use an agency or find an aide on your own. While there may be financial benefits to going it alone, the risks don't always justify the savings. You will have to do all the vetting, often without any prior experience at it. You will have financial and accounting responsibilities for an employee in terms of withholding taxes and disability insurance. And, you will have to do this for a few different hires since you will likely need substitutes on hand when your regular aide is sick or needs time off. All this is labor intensive and can be extremely daunting, especially when you are under stress. That is why many people prefer to use a home healthcare agency that will relieve you entirely of these tasks.
But which agency do you choose? It is best to use one that is accredited and licensed in some way, so there is oversight of the agency while the agency oversees the aide in your home. In New York, licenses are obtained from the New York State Department of Health. Larger agencies often have accreditation from organizations such as the Joint Commission Home Care Accreditation. Note that for long term care insurance reimbursement, a certified aide from a licensed agency is required.The function of the agency is to be meticulous about checking each home health aide for:
- Certification: home health aides receive their certification from training institutes certified and licensed by the New York State Department of Education. Agencies check certificates are valid and current with the New York State Department of Health.
- Credentials: home health aides maintain certification by working for a licensed agency that provides the 12 hours of annual in-service instruction they need to keep it current.
- References: Past work experience must be verified.
- Criminal Background: Licensed agencies are prohibited by law from hiring convicted felons and check each hire's fingerprints with the FBI. They may hire someone convicted of a misdemeanor, but many will not hire someone with any criminal background at all as an extra precaution.
- Health Records: Each home health aide is required by law to pass a physical each year and get a flu shot and the agency must track this.
The more thoroughly you communicate with the agency, the better your chances of having your needs met or even exceeded. A really good agency will be eager to hear what you have to say and pass it along to the aide they send. Creating lists of needs will help you discuss your case more efficiently and intelligently with any agency you contact.
- Detail in-home daily care needs.
- List medical needs due to disease or medical incident.
- Personalize your loved one by providing past accomplishments, fond memories and facts that are consistently remembered by the patient (especially if they suffer from dementia) enabling a greater bond to form.
The agency's registered nurse will do an initial nursing assessment and provide ongoing assessment and supervision as part of the service.
You may also ask the agency the following questions about any aide they are thinking of sending to you.
- Does the certified home health aide have special training in patient care and safety?
- Do they have experience with dementia patients or any other condition relevant to your case?
- Are they able to manage your specific healthcare, household and behavioral care needs?
- What is their past work experience? How long were they at their last position? Why did they leave?
- Are they able to provide references to you if you wish?
Lastly, don't forget to check references of the home healthcare agency you plan to use. It is a good idea to talk to other clients of the agency to gauge their satisfaction with the service they received. Ultimately, the home healthcare agency that can satisfy all your questions and you feel comfortable with will be the right one for your family to trust.
Anita Kamiel, R.N, M.P.S. is the founder and owner of David York Home Healthcare Agency and is fully acquainted with all factors related to eldercare services and the latest guidelines for seniors. Thirty years ago, she realized the need for affordable, quality home health aide services provided and supervised by caring individuals. You can contact her at 718.376.7755 or through her website www.davidyorkagency.com. David York Agency is also on Facebook, Twitter, Google+ and LinkedIn.