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Choosing the Right Home Care for Your Parent

There are basically three different levels of care that come under the heading of home health care: homemaker services, home health care, and skilled care. The first thing you'll need to do is determine what your parent needs, and then search for the level of care that fits Mom or Dad's needs.

Homemaker Care

Perhaps Dad needs help with what geriatricians call the instrumental activities of daily living, such as …

  • Meal preparation
  • Heavy housework
  • Doing the laundry
  • Grocery shopping
  • Managing money
  • Keeping track of medications
  • Getting around in the community via personal or public transportation
Senior Alert

When it comes to managing money, keep as much of this responsibility in your hands as possible. Even if you have to do this from a distance, have Dad's Social Security and pension checks electronically deposited into his bank account. Use a bill payer service with a bank to have all of his routine bills paid electronically. If you live far away, have the home care aide mail you any nonroutine bills so that you can pay them. Be extremely careful handing off money matters to strangers or friends.

If Dad needs this kind of help, it might make sense to hire a homemaker or chore worker to prepare meals, to remind Dad to take his medicines properly (the worker is not permitted to administer medications, however), to handle the grocery shopping, to keep up with the laundry, and perhaps to take him to doctor appointments or to social events. For these kinds of things, Dad doesn't need anyone with a nursing background to care for him. The focus here is on providing care for your dad so that he can live at home; in other words, home care.

This level of care can prevent your dad from needing more extensive care down the line. Getting someone in, even two days a week, can prevent Dad from eating poorly, forgetting to take his medicine, and not attending to his physical hygiene. It doesn't always take a catastrophic event to send Dad down a fast descent. Malnutrition can lead to dementia, mixing up medicines can easily land him in the hospital, and poor hygiene can lead to infections.

Home Health Care Aide

If your mom needs help with activities of daily living that are more physical in nature, then you need to move up a level on the home health care ladder. Perhaps your mom needs help with the following:

  • Eating
  • Dressing
  • Bathing
  • Using the toilet
  • Getting in and out of bed
  • Taking medications
  • Getting around inside of the home
Senior Alert

Giving a bath to an older person is no easy matter. Knowing how to move someone without you or the other person falling is a trained skill. If you hire someone to give Mom or Dad a bath, ask that person about his or her training, particularly how he or she avoids falls in the bathroom.

If Mom needs help doing these things, a home health care aide who has some training in health care (such as a certified nurse's aide) would be the best bet. You might hear the term custodial care or personal care being used to describe the kind of services your mom needs.

The certified nurse's aide would do well to be supervised by a nurse on a periodic basis. The nurse's role would be to set up a care plan, monitor the plan and Mom's condition, and identify any other potential problems that may arise. A nurse is best prepared to pick up symptoms that warrant further examination by a physician. If you're working with an agency, most will have a nurse oversee the care provided by a nurse's aide.

Skilled Care

The level of home care requires skilled nursing care. In this instance, registered nurses (RNs) or licensed practical nurses (LPNs) provide direct, hands-on nursing care to your mom or dad. This is usually needed following surgery or recuperation from a stroke. Besides needing most of the custodial care just discussed, Mom or Dad may need dressings changed, medications administered, and various therapies provided.

At this level, a doctor prescribes the kind of care that your parent should receive. The doctor might also order physical therapy, occupational therapy, speech therapy, or respiratory therapy. A nurse will oversee the care being provided by all of these therapists and nurse's aides.

More on: Aging Parents

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Excerpted from The Complete Idiot's Guide to Caring for Aging Parents © 2001 by Linda Colvin Rhodes, Ed.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

To order this book visit the Idiot's Guide web site or call 1-800-253-6476.


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