This is one in a ….

This is one in a series of monthly columns to familiarize LW residents with the vast array of resources available to them. Each article will focus on a topic of interest as researched by Member Resource Liaison Robann Arshat. The goal is to help residents better manage the challenges often associated with aging and to keep people at home and healthy for as long as possible.

by Robann Arshat

member resource liaison

A family caregiver is a person who provides any type of physical and/or emotional care for an ill or disabled loved one at home.

Loved ones in need of care include those suffering from a physical or mental illness, disability, substance misuse or other condition.

In many cases, the primary caregiver is a spouse, partner, parent or adult child. Caregivers often take on the responsibilities of the patient while still providing for themselves and other family members.

Types of In-Home Care Providers

1. Companion Care: a form of home care offering non-medical services to older adults, which is primarily social and emotional support, and companionship for seniors who are generally healthy and want to remain independent at home.

2. In-Home Health Care: personal care that may provide not only the same services as companion care, but also help with tasks such as bathing, dressing, meals and medication management. They can also clean clients’ homes, do laundry, change bed linens, aid with planning meals, shop for food and cook, and accompany the client to their doctors’ appointments. These caregivers can be contracted by the hour, day, week or month.

Generally, in-home care agencies charge from $28-$60 per hour for a caregiver’s service. Some agencies will require a minimum of four hours of service for each day care is provided. The more hours you book, the more competitive the price. 3. Live-in Health Care: usually signifies a caregiver who stays 24 hours, offering the client services for 18 hours with six hours devoted to uninterrupted rest. They provide the same services as companion care and in-home health care.

Who Pays for Caregivers

Home care services are generally paid for directly by the patient and/or the family as an out-of-pocket expense, but there are some ways to cover costs.

• A long-term insurance policy will pay only for long term care. It can cover a portion or all of the cost for an in-home healthcare worker or an assisted living, or board and care facility, depending on the policy you have chosen.

• If you are eligible and are a Medi-Cal recipient, you can apply for the In-Home Supportive Services (IHSS) program. This program can help to pay for caregiver services provided to you so that you can remain safely in your own home. To be eligible, you must be over 65 years of age or disabled or blind. To learn how to apply for services, go to www.cdss.ca.gov/ in-home-supportive-services.

• Medicare will pay for a caregiver only when the Medicare recipient meets the requirements. It can cover part-time or intermittent in-home health services for people who are under the care of a doctor, homebound, and have been recommended for home services by their doctor. In other words, Medicare pays for a couple of hours of irregular inhome health care after surgery or after an extended stay in the hospital and ordered by a doctor. Further, the caregiver must be Medicare-certified.

• VA Benefits will cover a caregiver. There are two different programs. You need to contact your VA benefits coordinator for more information and eligibility: Veterans Home Care Vet Assist Program, (562) 208-1883; or VA Caregiver Support Homemaker Program, (562) 826-8000, ext. 4985. (This program offers three-five hours per day or threeseven hours per week of free VA paid for caregiver services.)

When Choosing a Caregiver for an Elder 1. Assess your needs in the areas of health, personal and household care. Decide if you need minimal or full assistance with bathing, dressing, toileting, walking, eating, medication management, transportation, shopping, meal preparation, laundry and house cleaning. A caregiver can only be a success if you clearly state your needs and expectations. Write out a job description based on the help that is needed 2. Decide if you want a private caregiver or an agency to provide the caregiver.

If you decide to hire a private individual, make sure to:

• check their references and do a background check.

• verify that the person is insured and bonded.

• consult your insurance company to see if your policy will cover in-home injuries.

• have a back-up to cover your caregiver if they are sick.

• follow local and state laws in regard to taxes, hours worked and overtime.

• ask yourself, “Am I comfortable with this person?”

• pay legally. When hiring caregivers, people often don’t realize that paying taxes are part of their responsibilities as an employer. You could try to save money by paying your hired caregiver cash “under the table” and skipping the employment taxes. But if you or your caregiver gets audited by the IRS, the ramifications could far outweigh any potential savings. Creating your own W-2s and tax forms isn’t too difficult, or you can get help from an accountant, use an online payroll service or use a caregiver agency. For more information, visit https:// www.care.com/hp/how-to-startpaying- your-caregiver-on-thebooks.

• develop a job contract based on the job description, start date, worksite address and work schedule. Include wages and terms for ending the contact. For more information about caregiver contracts, visit https://www.care.com/ homepay/sample-senior-carecontract- 20180306163750.

If you choose to use an agency, remember:

• a good agency will screen and generally bond its caregivers, and you can also ask to interview the potential caregiver. These caregivers have already been screened with background checks and bonding or liability insurance is covered. All taxes, labor laws and insurances are included in the cost of your service.

• the agency should do a home visit and put together a plan of care that meets your needs and does not overwhelm you. The agency should advise you of charges per hour, minimum hours required, hours billed for 24-hour service, services and mileage costs (if any).

• be sure to ask how to reach the agency after business hours and on weekends.

For more information, visit https:// eldercareanswers. com/ when-hiring-a-caregiver/ or https:// www. payingforseniorcare. com/homecare/hiring-independent- caregivers.

Monitor Your Caregiver

Caregiving is about meeting the non-medical needs of the client, and supporting the emotional and intellectual needs of the senior. When assessing the quality of care, consider if the caregiver is:

• attentive and engaged and has a meaningful connection and quality of life care.

• serving as ears and eyes and in consistent communication with the family, if need be.

• clean, professional and reliable.

• properly trained.

• accomplishing tasks properly and professionally.

Watch for:

• signs of abuse: physical, emotional, sexual or financial.

• unexplained or frequent injuries.

• furtive or secretive behavior from the senior; is he or she hiding instead of spending time openly in the home?

• consistent complaints by the senior. It could be that the caregiver is not interacting with them.

• limited access to the senior. Does the caregiver make it tough for you to reach the senior over the phone or tell you that the senior is always unavailable to talk to you? Is the caregiver always in the room when you talk on the phone or visit? If you are concerned about not being able to communicate with your senior family/friend, find out why. Make sure the caregiver isn’t trying to keep you apart so that you won’t find out what goes on when you aren’t there.

• an overly close relationship. Is the senior loaning money, the car and other items to the caregiver or otherwise being taken advantage of emotionally or financially? Caregivers provide a good service. Most are kind and caring people who want to help. Unfortunately, there are occasions in which caregivers have ulterior motives or issues that result in bad behavior. Remaining close to your senior family/friend can help you catch inappropriate behavior before it gets out of hand.

Once you have decided to employ services for yourself or family member, it is your responsibility to make sure that your caregiver is registered with the Stock Transfer office, per your Mutual policy. This allows your caregiver to receive a pass into the community and identifies them as an employee of your unit.

Caregiver Resources

For more information on choosing a caregiver, visit www. tn-elderlaw.com/free-resources/ resources/ten-tips-for-choosinga- caregiver-for-an-elder.

Other resources include:

• Caregiver Counseling: Help and Support to Family Caregivers of those with Dementia through the Alzheimer’s Family Care Center, (714) 593-9630, www.AFSCenter.org.

• Caregiver Resource Center OC offers consultants who can provide specialized referrals to various community resources for caregivers, fact sheets and general information related to caregiving, 1(800) 543-8312 or (714) 446-5030, www. caregiveroc. org.

• IHSS Medi-Cal Caregiver Program for Low Income, (714) 825-3000, www.cdss.ca.gov/inhome- supportive-services.

Residents are invited to visit the brochure display in Building 5 for more information. To book an appointment to learn more about the information here, call Robann Arshat at (562) 431-6586, ext. 317.

The next Senior Resource Focus will run in the May 5 edition.