Should I Hire a Home Care Assistant Privately or through a Home Care Agency?

by Clare Absher

If you are a family caregiver and realize that you can't do it alone and help is needed, then congratulations are in order! This is undoubtedly a big step in the right direction and probably not a minute too soon. The wise decision to hire outside help is definitely not a sign of weakness or 'giving up', but instead just using good common sense, realizing your limitations, and having a little foresight. Most families usually need some type of home care assistant to help with their loved one's personal care and activities of daily living. This might include assistance with bathing, grooming, dressing, meal preparation, feeding, medication assistance, walking and exercising, shopping and running errands, housekeeping, laundry, and offering companionship. Perhaps your loved one can't be left alone and needs supervision for safety reasons to allow time for yourself or to get away for a while.

Besides the usual arrangements that go in to planning any trip, you need to consider some additional factors. When setting up a travel itinerary, if air travel is necessary try to make every effort to set up a direct flight for your folks. Also be sure to notify the airline in advance if special arrangements are needed such as wheelchair availability and/or accompaniment. When traveling by car, plan to allow for a few extra rest stops and have drinks, snacks, medications and other supplies readily accessible. I need to stress the importance of not only bringing all their medications, but that they are labeled with current dosages and times. Frequently I have seen older folks arrive loaded down with bags of outdated medication bottles that creates the need for time-consuming long distance verification with physicians. Should medications be forgotten, contact their physician immediately upon your destination arrival to request prescriptions be called in to a local pharmacy in order to avoid unsafe dosage lapses.

Most heavy and bulky durable equipment such as wheelchairs, lifts, transfer/tub seats, and backup oxygen tanks can be rented at local suppliers when space is limited. Bring along whatever you can of course, however often times traveling lighter is preferable. Save yourself valuable time by searching on-line for these medical companies whenever possible. Many company listings and contact information in your vacation area can be found at www.cmrg.com/cmrg_cfmfiles/sm.cfm

Your accommodations might require handicap access, and although growing in popularity, are still very limited and in great demand. You can book such accommodations at most hotels, however if your preference is to stay in a rental home or cottage you must call a travel agent or contact a rental company yourself well in advance. In some popular resorts such as where I reside it's not unusual to book a handicap accessible home 6-9 months in advance. Keep in mind that stairs are usually the biggest concern for older persons to negotiate along with their requirements for widened doorways, and large bathrooms with safety rails for easy walker/wheelchair access.

Depending upon how much help they are accustomed to having at home or in an assisted living facility will determine the type of arrangements for care during your vacation. Simply put, arrange for at least the same amount of care they already have and whenever possible get extra help on vacation. Remember, this is a vacation for everyone to enjoy and not the time to take on additional responsibility. I have witnessed many families with the best intentions end up bitterly disappointed and resentful towards one another after a week of sharing what turns out to be an exhausting vacation together.

If fortunate enough to have a private caregiver available and the space to accommodate them, by all means BRING THEM. Many families however do not have this luxury and need to arrange care with a local home care company. Search our Home Care Agencies directory for home care agency listings and contact information in your desired location. This is usually not too difficult speaking from first-hand experience as a home care nursing manager, but again, call in advance by a month or two to set up this care. In most cases a home care assistant or nurses aide will attend to your parent's personal care needs such as bathing, dressing, and general hygiene. However for special treatments, dressing changes, injections, glucose monitoring, ostomy changes, catheterizations or other skilled care, request that scheduled nursing visits be made by an RN or LPN. Nursing visits to monitor an older relative's unstable health status when he or she is at risk for pending medical problems is also a good idea to consider while away. I found the process of setting up home care assistance hastened by having families fax or mail medical records, physician orders, current care plans and signed consent/insurance forms in advance to the home care agency. Getting some or most of the preliminary paperwork out of the way also reduces demands on your precious vacation time.

When working with a home care agency, take advantage of their staff's knowledge of other resources needed such as reliable home equipment/supply companies, pharmacies, and nearby medical facilities. They cannot only provide referrals, but are frequently willing to make some of the arrangements for you when doing business with them. My role outside of the nursing field often includes suggesting sites to see, restaurants to eat at, and even fun places for the kids to visit. Tap into the expertise and experience that the local staff can offer for health care resources as well as area recreational highlights.

Lastly, if you find that time restraints and a busy schedule are a problem, then consider hiring a Geriatric Care Manager to help you make travel arrangements for your older loved ones. Let them make the tedious calls, do the extensive legwork, and basically be available to assist you along the way or even during your stay. This will add some to your trip's overall expenses (fees range from $40-$100/hr) but is money well spent to reduce burdens and alleviate the stress involved with vacation planning. Limited vacation time for working families as well as limited vacation budgets is all the more reason to plan ahead and get professional care manager help to make the most of your vacation.

© Clare Absher


Clare Absher - is RN Care Manager and Content Evaluator for CarePathways.com, a community dedicated to optimizing a family's access to valid web information and creditable services about senior care and housing options. She has been an RN for over 20 years in geriatric fields including home care, independent living and assisted living and has a lot of experience with the care of Alzheimer's patients and the care of their caregivers. Visit the author's web site at http://www.carepathways.com.