Tips for Choosing Care for an Aging or Ailing Family Member

UNLIKE other areas of health care, the cost of hiring someone to help tend to an aging family member 

at home has been relatively stable.

You’ll now pay a median rate of $19 per hour for a hired homemaker, who does household tasks like cooking and cleaning, according to the latest report on the cost of care from Genworth Financial, which sells long-term care insurance. You’ll pay a bit more, about $20 per hour, for a home health aide, who helps with personal care like dressing and bathing but not medical care.

The cost of home caregiving has gone up only about 1 percent annually over the last five years, compared with an increase of about 4 percent a year for institutional care, the report said. The report reflects the cost of hiring a home caregiver through an agency, which typically costs more than directly hiring a caregiver.

The difference is partly because home care providers don’t have to maintain large facilities and generally have fewer regulations to follow, said Thomas J. McInerney, chief executive of Genworth. And, for now, there is an ample supply of workers to serve as at-home caregivers.

That may change in the longer term. As baby boomers age, demand for caregivers is likely to increase, since most people want to remain at home as long as possible, said Mr. McInerney. It’s also possible the cost of hiring a caregiver may be affected by new rules, which kick in next January, extending federal minimum-wage and overtime protection to many home care workers.

Extended care at home generally isn’t covered by Medicare, the federal health plan for those 65 and older. So families using such services generally pay for it out of pocket, unless they have long-term care insurance or qualify for Medicaid. Medicaid eligibility varies by state and is based on your income; you generally must have very little in the way of financial resources to qualify.

Here are some questions about hiring a home caregiver:

■ How do I know what kind of caregiver my family member needs?

You can assess needs, like his or her ability to handle activities of daily living such as dressing, eating and bathing, using a checklist, like one provided by the National Caregivers Library.

Or, you can have a professional conduct the evaluation, which is advisable, said Amy Goyer, a specialist in home and aging with AARP. To find someone qualified to do the assessment, you can contact your local office of the National Association of Area Agencies on Aging for a referral. You can find the one nearest you on the federal government’s Eldercare Locator site.

■ How do I go about finding a home caregiver?

One option is to use a home care agency, which will screen and train caregivers to make sure they can provide the level of care needed. Since the agency employs the caregiver, it also handles payroll tasks. An agency can also schedule alternative caregivers if your primary caregiver is ill or unable to work. Because the agency offers these services, its hourly rates may be higher.

■ What if I prefer to hire someone myself?

You may be able to obtain a lower rate by hiring someone directly. But if you hire a caregiver yourself, you’ll have to handle payroll and possibly taxes, said Leah Eskenazi, director of operations for the Family Caregiver Alliance, a nonprofit that helps people caring for relatives.

Ms. Eskenazi advises that word of mouth is often a good way to start your search; friends or family members who can vouch for a caregiver’s skill and reliability can be good first references. The AARP website offers a tool to search for an agency by ZIP code.

Sites like Care.com also help find independent candidates in a given geographic area. You post a job at no initial charge, and interested applicants respond with their credentials and experience; if any of their profiles look promising, you may register to obtain contact information and purchase background checks. You will have to pay a monthly, quarterly or annual fee to subscribe to the service ($35, $70 and $140). The site also offers payroll and tax services, for an additional fee.

■ Where can I find more information about home caregiving?

In addition to your local Area Agency on Aging, the Family Caregiver Alliance offers an online tool that provides links to resources in your state.

 

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