10 Things your Home Health Care Provider Won't tell you
 

1) “Our service could bankrupt you.” Choosing to stay home is the easy part. Paying for it is another question. Full time home health care can cost more than twice as much as standard hourly rates. This means you are on the hook for the hours when your parents have no aide. The fees, however, are just the beginning. Don't forget that if your parents live in their own home, you still have to pay to take care of it. Also, tipping is also considered part of the compensation. For example, some family members tip aides when an incontinent parent has an accident.

2) “The home modifications alone could bleed you dry.” Unfortunately, the typical house isn't built for the elderly. The hallways and bathrooms are often too small to accommodate their special needs. How much can this cost? Get ready. If someone is relatively mobile, you may get by with spending $500-$1000 for a few properly installed grab bars in the bathroom and at the top of the main stairwells. But the wheelchair bound can require structural changes that could total $50,000.

3) “Don't expect Medicare to Pay for This.” If you thought the government might help out, think again. The government has started paying agencies a flat fee for treatment. Consequently, it's in an agency's best interest to keep costs down and provide your loved one with as few home health care visits a week. Since a nursing home is cheaper, the government payout will stretch a lot further there.

4) “You may be better off in a nursing home.” If a love one needs 24-hour supervision, sometimes home health care is not best option. An agency may even tell you your parents that their needs are too great for their service. If it's necessary that every shift be covered, problems can arise. After all, like any employee, a home health-care aide can catch a cold and call in sick. Another thing to think about is how long your parent’s' money will last. If you plan to move them into nursing home eventually, it's crucial that you do so before their income is depleted. The reason: If you want to get a bed at one of the nicer residences, you'll need to be able to convince management that you'll be able to pay its fees for at least a year or two. That's because once your Mom or Dad is in, the facility has to keep them until they die. Consequently, those facilities are very choosy about whom they admit.

5) “Nobody wants to work for us.” Given all of the horror stories about nursing homes, most people figure that while home health care is expensive, you're definitely getting better quality service. Well, it doesn't always work out that way. Most agencies are operating with temps from the Manpower pools. Part of the problem is that in most cases, at least half of the fee you're paying goes back to the agency. That means that the person tending to your parents is likely to be making less than $20,000 per year. Nothing like relying on someone who is both overworked and underpaid.

6) “Our turnover rate is astounding." Not surprisingly given the low pay and long hours-home care agencies have a terrible time hanging onto their employees. The turnover rate in the industry is tremendous, meaning that once your parent develops a good relationship with his or her daily caregiver, there's a good chance that person may soon quit.

7) "Our staff steals." Theft is another big problem for the home health-care industry. And because less than one in ten cases gets reported, it's very hard to track. There has been an increase in the number of cases, but since the elderly are often skittish about making accusations, the problems are probably bigger than the numbers indicate. Older people with failing senses, sometimes worry that they might have simple misplaced something. And if they like their caregiver, they might be afraid to alienate him or her. Sometimes, the victims are simply unaware that anything has been stolen. Indeed, that's what many of these aides are hoping for.

8) "We will neglect your parents." Most experts agree that your loved one is less likely to suffer neglect from a home aide than in a nursing facility. Still, it's tough to find aides who'll give your loved ones the same level of care you would provide.

9) "Good luck trying to monitor us." One of the toughest aspects of hiring a home health aide is trying to monitor the care. This is especially difficult if the patient isn't cognizant. In these cases, it's important that someone else be involved. You should treat home health care as your would childcare. No one would just drop their kid off at the front door and never walk in. Also, while interviewing agencies, ask how they monitor their employees. Some agencies have no supervision and act like a temp agency for an office. The aides need to know that they're not the only one taking care of this elderly person. Aides are mostly good, kind people, but it can get discouraging for them if they think they are the only ones who care.

10) "You'd better have a back-up plan." Depending on your home health-care aide to show up everyday on time is a gamble. So you'd better be prepared for the times when he or she is late, can't get a ride or has the flu. If you have an agency, the agency should be able to send a replacement. But you can't be sure that there won't be some sort of interruption in care. The responsibility, of course, is ultimately up to you.