How to Select Elder Care 101

A Guide to Selecting Home Care in Arlington County and Fairfax County

Understanding The Stage of Care You May Need

There are three types of home care, or sometimes referred to as elder care, offered in Northern Virginia and they go from a fully independent older adult to one that is bed ridden. I am outlining in the first section the stages below and some guidance to understand where the needs for your parent may be.  In the second section, I outline the options for early stage care also known as companion care.

Companion Care: This is the stage where the older adult is fully capable of coming and going as they please.  Families are concerned that the older adult may be alone for too long but there is no concern of them not returning and they can cook for themselves, eat by themselves and in most cases they still drive.  This is the earliest stage of care and typically for older adults who live alone, this is the first form of care an older adult typically gets. There is a huge problem in home care these days with how this care is offered and used by families, I will discuss those issues below.

Full Time Care: In this stage, an older adult still lives in their home alone and family is more than a 30 minute drive away.  There is a concern whether the older adult is able to cook and clean for themselves and so often the service at this stage is preparing meals, cleaning and in the later cases this can include feeding and helping the senior in and out of bed and the shower.  The older adult can do well during the peak hours of the day by themselves in the early stages of needing this care.

Hospice Care: This is commonly known or referred to as end of life care.  It is an intensely in person, hands-on form of care, typically requiring the caregiver in the home throughout the day.  Falls are very common at this stage during the day, so leaving the older adult alone is a major concern.  In later cases, the older adult may be bed ridden.

 

Now, for the purpose of this article and because we have a very active senior community in Arlington County and Fairfax County, I will be focusing on the Companion Care stage, commonly known as early stage care or early elder care.  I focus on this because of its critical importance to the extension of the independence period for the senior and the cost savings impact it can have on the family in the long run. I will go into more detail on this in a later article.

 

Comparing My Options for Companion Care

The goal of my article is to help you keep your parents at home and out of the hospital.  I do this because I believe (and the research backs me up on this) that older adults want to stay in their home and age in place.  I believe this is beneficial for their physical health, mental health and financial long term health.

Home Care Companion Care

A home care agency employs caregivers and these caregivers drive out to the house of the senior or older adult.  The main thing you need to be aware of for this type of elder care is the hourly minimums here and reliability.  Let me explain.  Because they are using unskilled labor here, meaning there is no specific training required (I will talk about regulations in home care in a later article-a must know for everyone), they get paid relatively low, well until recently that worked ok.  Now with rising wages and rising gas prices (paid for by the agency), their margins are shrinking and fast.  So Home Care agencies charge hourly minimums, they have for the last 10 years and it is a 4 hour minimum in companion care, very common, and that costs $28.00/hour here in Virginia on average.  One day of service will cost you $112.00 and you will have to select morning or evening, the hours must be continuous, you cannot break them up (2 hours in the morning and 2 in the evening, it does not work that way).  Some families that can afford this type of care and typically select to do so on a part time basis, once or twice a week.

I have spent a lot of time with older adults and the way these blocks of time are used are not what you might typically think.  An older adult gets the care they need for about 15-30 minutes and the rest of the time, the caregiver may be there waiting to be utilized.  One important note here is that because the pay rate is so low and the all the driving, many do not want to take this job, this can affect quality of service and cancellations/no shows are a common occurrence.  Communication becomes a key problem here with the senior and the caregiver often times as well and not to mention once your parent finds a caregiver they like, there is a high turnover rate and that person may not last long. (You may be thinking that you will just hire them directly, and for now you cannot do that because agencies have contracts with their caregivers that forbid them from doing so, but that may change soon).

New Concepts

Technology has tried to fill the gap for years, many have come and gone and others have popped up that are simply a recreation of the same technology that failed a few years back.  It does not become apparent to those who buy the technology is that you are simply running an extension of providing the care yourself and this takes up your time in several ways.  If you buy monitoring technology, which seniors do not like in general as it diminishes their role as a parent, you will be doing the work of checking in constantly, it really just makes your job of providing the care to be remote and 24/7, so be aware of that.  You can buy stand alone technologies that they can talk to, but these are half measures and are always reactive.  If you want to address the core of the problem, you need frequent check-ins from a human, a technology seniors trust (seniors are very very wary of technology) and something that is not going to impact your account that heavily.

 

There is one solution that brings together the best of both worlds: great customer service and secure technology that is easy to use for older adults and values their privacy.  This option comes in at $200 a month, alleviates workload from family members and is an effective way to implement connectivity to the senior.  It is called the Virtual Concierge Service.  This is an option that addresses the gaps in care from traditional home care and helps alleviate workload from the family.  It provides oversight on progress, not seen anywhere else in home care, and it focuses on one goal, keeping your parent independent.

Provide the Home Care Yourself

Many families decided to offer the care for their parents themselves, and that is great.  It is very time consuming and often times can overwhelm you, the adult child.  In the companion level of care it is relatively easy, and by nature the task of checking in on the older adult inadvertently takes a back seat to work, family life, career, social life, house work and kids.  This is when something happens that directly affects their independence, such as a fall, a missed appointment, loneliness, not eating or not drinking.  Often times the early signs are missed and not addressed because there is alot going on in our lives and things move very fast these days.

 

Through home care agencies or in community centers, there is something called, respite care.   Respite care is basically a way for a family caregiver to take a break and have someone else watch, look after the older adult or senior for a few hours in a day.  In community centers they refer to this as Adult Day care, yes you are reading that correctly.  There is a cost in some cases or it can be offered at no cost by non-profits.

Now, assuming you are going it alone and you do not have family to back you up, there are resources through the county that can help you, I will include a few links to resources below.  The bottom line is that in this case, you will be the primary person and that is a full time job.

 

 

I hope this article helped you get a better understanding of home care in Arlington and Fairfax County, elder care is huge step and one many are not prepared for, so please pass this along so we can get people informed in Northern Virginia.  Thank you for reading.

 

 Some useful links:

AARP Family Caregiver support services in Virginia

If your family member belongs to the VA, Veterans Affairs, you can get paid to be a caregiver

Family caregiver support services

A full list of Adult Day Care Centers in Virginia