How to Make the Best Choices in Selecting a Care Provider

Your loved one’s comfort and safety are your primary concerns. If the care plan you’ve designed with the physician includes engaging a care provider, you’ll want to make sure you choose the right person.

“How do we know dad will be taken care of?”

Federal and state regulations go a long way to protect elderly person from abuse, from being taken advantage of, and from neglect. Through inspections and licensing, your state government prevents egregious violations and punishes violators. Online and community watch organizations can provide advice and recourse for minor violations.

Choosing to trust someone with care of your loved one is a big decision. Your loved one is particularly vulnerable because of AD. He may not be able to stand up for himself; he may accept unpleasant conditions because he feels confused or alone. These risks should weigh into the decision you make about the level of engagement you will pursue with a care provider.

Once you decide upon the level of care you plan to arrange for your loved one, there are several pertinent questions to help you interview providers.

In-Home Care Interviews

Hiring in-home care providers can be a great way to alleviate the stress for your full-time family caregiver. But inviting strangers into your loved one’s house creates a number of opportunities for mistrust, misgivings, and mistakes.

Whether it is the local church sending a youth member over to play cards with your dad, or the civic club’s elderly outreach team coming by to tidy up, your loved one may feel vulnerable to the arrival of strangers. Preparing your loved one for company will make the first visit more successful. You should insist volunteers call-ahead and plan their visits. Talk to your loved one about the reason for the visit, be honest about needing a break, and assure your loved one that if the visitor makes him uncomfortable, you will ask the visitor to leave.

You may not know the visitor personally and might feel uncomfortable asking volunteers for references. If so, it may be a good idea to supervise the first few visits to ensure your loved one is comfortable with this new friend before leaving them alone. Some of the things to look for during supervised visits are:

  • How interested is the volunteer in your loved one?
  • Is the volunteer preoccupied by his phone or the TV?
  • What kinds of topics of conversation does the visitor offer?
  • Is your loved one comfortable with the conversation?
  • What reasons does the visitor give for wanting to help?
  • How does the visitor suggest handling emergencies if one should arise?

If you have an immediate need for a substitute, you will not have a chance to supervise introductory meetings. So it is very important you line up volunteers early in your in-home care experience so that when the need arises, especially if it is sudden, you can ask a number of already-established volunteers.

What to Ask an In-Home Provider

Paid care providers can usually provide references, licenses, and other legal documentation to recommend them. It is a good idea to review those documents to ensure you are remitting payment to a legitimate organization.

  • Is the agency licensed by the state?
  • Is the agency certified by Medicare to meet health and safety regulations?
  • What type of employee screening is done? Are references available?
  • Is the agency accredited by The Joint Commission or other regulating body?
  • What are the credentials of the home-health aide you provide?
  • Does the individual aide provide references?
  • How does the agency find, hire, and train its home health aides?
  • Are the home health aides licensed and insured?
  • Does the agency have a quality improvement program?
  • How does the agency handle expenses and billing?
  • Will the agency accept Medicare payments?
  • What will the agency (or individual care provider) do to accommodate on sick days or vacation?
  • Will you receive a written care plan?
  • What services are included?
  • Will the loved one be referred to dieticians, physical therapists, or nutritionists as needed?
  • What emergency procedures does the provider have in place?
  • How are problems addressed?

Adult Day Services

There are two distinct models for adult day service providers. One offers social services such as activities, meals, and entertainment. The other provides medical services, too, including therapy and physician attendance. It is important to know which service you are investigating and also which one is the best choice for your loved one.

What to ask adult day service provider:

  • What kind of services do you provide?
  • What are your emergency procedures?
  • What are the operating hours?
  • Is the provider insured?
  • What are the credentials of employees and activities directors?

Residential Care Interviews

Choosing a residential care facility is a big decision. Working with your family, your loved one, and your loved one’s physician, you should develop a list of the requirements you have for the facility.

Each patient’s needs are different. For example, if your loved one has difficulty climbing stairs, you may want a facility constructed on a single level. If your loved one has trouble with darkness, you may want to ensure there is adequate lighting in his room, his bathroom, and the hallway.

You’ll also want to know what role you will be expected to play in your loved one’s care. You’ll want to know how the provider’s care plan will be written and how it will change as your loved one’s condition advances.

Some questions to ask a residential care provider:

  • Are families encouraged to participate in care planning?
  • How are families notified when care plans change?
  • How can we discuss the level of care our loved one receives with providers?
  • What medical care is provided?
  • What personal care is provided?
  • What special provisions are made for persons suffering from memory loss?
  • Is the staff trained in memory care?
  • Are there services available for memory patients?
  • What security measures are in place?
  • How is the food preparation planned?
  • How much assistance does the staff provide during meal times?
  • What are visiting hours for family members?
  • How are visitors recognized and accounted for?

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