Insider Tips for Families Considering In-Home Care
By Jeffrey Grossman, CEO Commonwise Home Care
In 2013, I co-founded Commonwise with the hope of offering a quality service for families seeking personal care in their homes. Before doing so, I hosted numerous conversations with consumers who were purchasing care. Most were dissatisfied, their frustration centering on “bad caregivers” and “poor agency management”. In response, our thesis was that paying higher wages, selecting front-line staff more thoughtfully, and deeper investment into operations infrastructure would address some of these problems.
That was nine years and one global pandemic ago. Since that time, I have learned a good deal that I believe can be valuable to any family considering in-home care. Here are a few of those insights:
Timing is everything.
Many families call our firm from “the bedside” in an acute care setting. The story often goes something like “my father fell, and we are being told he needs in-home care to be safely discharged”. The challenge is, there is a vast disparity in the quality and reliability of home care providers, and it is incredibly difficult to make an informed choice during an emergent situation. If you can, ask around or do some Google searching before a major incident takes place. Know who you might call, should you ever need help. Otherwise, talk to as many of the nurses and social workers as possible, and press them for their opinion (which can often differ from a list of “preferred vendors” at the facility).
Caregivers are in very high demand.
The competition for nurse aides (colloquially referred to as caregivers) is fierce. Hospital systems, clinics, physicians’ practices, skilled nursing facilities, assisted living communities, dementia care communities, home health agencies, hospices, and home care providers are all vying for the same talent. And, good caregivers know their worth. Ask your prospective agency what their starting wage is for caregivers. Note, turnover is exceptionally high in this industry, so it does little good to know what a tenured employee earns. If the agency underpays new hires, the likelihood of receiving quality care is much lower.
The hiring philosophy, or lack thereof, matters.
Most licensed agencies do little more than run background checks and confirm basic personal care skills before hiring caregivers. These steps provide no information about an applicant’s alignment with the difficult work of caregiving. Ask your agency what they believe makes a successful caregiver and then ask them how they attract and select those candidates. Without a thoughtful interview and selection process, an agency may place a caregiver who has technical skills, but lacks the essential and equally important bedside manner to offer caring support to your loved one.
The importance of relationship management.
Home care organizations share a common challenge: they manage a workforce that goes to clients’ homes to provide care with little central oversight or on-the-job support. It’s critical to have management staff to train and engage with the caregivers so that they know they have the support they need on a regular basis. Caregivers who are managed from a home office, not where they work, are less likely to stay for the long term. Ask how often a team member will be out to check on your loved one and their caregiver. Bonus points for agencies actively overseeing care week-to-week.
Scheduling Care.
I could write a book about this topic alone. Consistently scheduling the right caregivers (appropriate availability, skills, personality, proximity to client’s home, etc.) is exceptionally challenging. It takes a very knowledgeable, motivated team to leverage up-to-date software. Before selecting a company, you should ask not only how they manage the scheduling process, but also how they respond to the inevitable “call-outs”. What mechanisms are in place to help solve scheduling challenges so that they do not consistently fall back on your family?
True or False: I will not need home care because I live in a senior living community?
FALSE. It may come as a surprise that many older adults living in senior living communities find their day-to-day living is enhanced greatly by having in-home care to assist with daily chores, errands, cooking, etc. Additionally, they may find that in-home assistance is the key to being able to remain in the independent community they have come to love; or that they need to have ongoing in-home care to be able to return to their home following an acute medical situation.
Often, independent living communities wish to approve the use of home care agencies, so families should check about that before hiring an agency.
Choosing a care agency.
In every town, there are excellent organizations working hard to hire great caregivers and deliver quality service. A little due diligence goes a long way to identifying these organizations and avoiding others.
A great strategy for identifying quality in-home care partners is to speak with a Geriatric Care Manager (GCM) in your area. GCMs serve as consultants for issues in aging and often have experience with various agencies that they can draw from in making a recommendation. Find a local GCM at www.aginglifecare.org
Contact Us.
If you are interested in learning more about the unique approach Commonwise takes to providing in home care, please contact us!
Charlottesville: 434-202-8565
Richmond: 804-401-8326
