Navigating the Elder Care Journey

How to find a trustworthy caregiver for your loved one

Ric Edelman: It's Wednesday, June 7th. I want to talk with you today about finding a caregiver that you can trust. How do you do that and what does it cost? Well, you can hire someone on your own. You have to run an ad on a website or you can ask family and friends or you can go through a home care agency. Your choice. Let's talk about how to start. First, identify your needs. Who is it that needs care and what do they need care for? Do they have mental issues? Do they have physical issues.?

So figure out first, what are your needs? For example, are you looking for a caregiver for your spouse or parent? Do they need help just with housekeeping and running errands, cooking? Or do they need more help, like making sure they take their meds or helping them with bathing? Remember, what we're talking about are these things called the ADLs. There are five of them, ADLs, the activities of daily living: dressing, bathing, eating, toileting and help getting from bed to chair. If somebody needs help with these activities of daily living, that's different than helping somebody with a housekeeping or running errands. The more care the patient needs, the higher the cost, because you need somebody with more and more skill or you need them for more and more hours. You also have to think about the soft skills, language, culture, religion. 

You want a caregiver who the patient - frankly, I hate to say it this way, but I'll put it bluntly - the patient has to be willing to tolerate them. I can't begin to tell you how many times I remember my grandfather literally throwing his caregiver out of the house because he didn't like him. He was, of course, not really liking anybody at that point. But you catch my drift. The patient has to be comfortable with who is by their bed or in their home for hours at a time.

Now, you might not find every attribute you want in a single individual, so you've got to either prioritize. You are going to hire someone because they can do X even though they aren't able to do Z. Or you may end up having to hire more than one person. This person can handle the errands and the chores and the housekeeping, but this other person can provide more of the nursing skills. So you might need to hire more than one individual or choose. I'm going to have someone who does this and not that. Also, you need to think about how many hours of care is needed to be provided. Are we talking just a few hours a day or maybe just a few days a week? Or are we talking about 24/seven care?

The median cost for a home health aide is $27 an hour. Now, where do you come up with $27 an hour? Well, it could come from the benefits you get from your long-term care insurance policy or from Medicare Advantage or from Medicaid or from the VA. So you need to examine once you've identified the kind of care you need and how often during the week you need that care to determining the total cost of the care and then looking for the sources of income to provide for it. And while you're at it, I'll layer this in.

What if you're doing all of this evaluation for a loved one who lives a thousand miles away from you? Not at all uncommon for us to be living far from our elders. So that means you might have to hire a geriatric care manager that's a licensed nurse or social worker who oversees the caregiver. And these folks, these geriatric care managers, they charge 150 bucks an hour. Now, instead of trying to hire these people all on your own, as I mentioned, you might go instead through a home care agency. The agency handles the payroll. They provide background checks of the worker's insurance and training and also backups. So if your caregiver calls in sick, they can provide somebody else. Maybe you'll want to install cameras to keep an eye on what's going on in the house. 

And if you're dealing with a patient who has Alzheimer's or dementia, then you need people skilled in serving those patients. Everything needs to be in writing so that you have best protective opportunity. And I'll add one final element. If they're going to be driving the patient around, you need to look at their driving record and make sure they have proof of insurance as well. It is a huge emotional burden when you discover that you are dealing with the needs of caregiving. You're either going to provide those services yourself, giving them up among family members, or you're going to pay someone to provide that care. The sooner you begin to deal with the issues associated with caregiving, the easier it can be to deal with.

You know Jean's podcast, Self-Care with Jean Edelman is now her own independent podcast, and her new podcast premieres each week every Thursday. Jean's really passionate about sharing her knowledge and insights with you on self-care, mindfulness and overall wellness. I know she wants to hear from you. You can sign up for her free email updates. Just ask Jean your questions. Jean's topic this week: Our Inner World. You can listen to Jean's podcast anytime you like, everywhere that you get your podcasts. Subscribe at Self Care with Jean.com.

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