- Each day seven thousand Americans turn 65 years old, and 85% of these people will need some form of assistance during their lifetime.
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- 29% of the U.S. population (65 million+ people) provide care for a family member or friend who is struggling with the challenges of aging, chronic illness or disability.
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Source: Caregiving in the United States, National Alliance for Caregiving & AARP; Nov 2009
Many family members are taking on a wide range of caregiving tasks and responsibilities. We often find an adult child caring for an aging parent, a parent taking care of a child with a developmental disability, or a person who is assisting a spouse/partner struggling with a chronic illness,
One of the most stressful and emotionally charged decisions a person can make, is who should care for my loved one – me or a paid caregiver.
A recurrent theme that we hear from individuals is that they fear broaching the subject of whether or not a senior or person with special needs is capable of caring for themselves. In addition, once it’s clear that the person is in need of assistance, there’s often confusion as to what’s the best way to proceed. This is a delicate balancing act, to ensure a person’s health and safety, while maintaining their independence and dignity.
Assessment and Care Plan
As I shared in my previous article “Care Planning - How to Identify and Plan for a Person’s Care Needs” each human being is unique, and as a result each person has unique needs. Some people may experience mental and physical limitations that limit their level of functioning, while others will remain relatively high functioning. Evaluating a person’s care needs is like putting a jigsaw puzzle together. The more pieces of the puzzle you have the clearer the picture.
Once the client has undergone a comprehensive assessment, the information obtained will be used to outline a care plan (road map) that focuses on the individual's current needs (e.g. dementia, high blood pressure, unsteady balance and gait), required treatment (e.g. medical, psychiatric, physical therapy), housing requirements (home with assistance, short term rehabilitation), activities of daily living (e.g. bathing, dressing, meal preparation), socialization, and optimal utilization of community resources; to name a few.
Once a written care plan is developed for a client, the next step is to locate a caregiver who has the appropriate knowledge, skills, experience, and personality to help meet the client’s unique needs.
Know the Facts Before You Hire a Caregiver
In Connecticut, you have a variety of options to choose from, when hiring a caregiver.
1. Independent Contractor
Many seniors and family members think this is the best and cheapest way to go.
Keep in mind that when hired, an independent contractor becomes an employee of the client and or family.
If you decide to take this route, you will need to:
- locate potential candidates
- conduct interviews
- conduct background checks and driver license verification
- obtain and verify references
- pay payroll taxes & workers compensation for the caregiver
- provide your own supervision of the caregiver
- develop your own care plan, or hire a certified case manager to help
2. Registry
Usually a caregiver provided through a Registry is an independent contractor of the Registry, and not an employee of the Registry. When you hire a caregiver from a Registry, the caregiver becomes an employee of the client and or family.
For their assistance in locating a caregiver for you, the Registry will collect a monthly fee, for as long as you use their caregiver’s services
Keep in mind the Registry usually does not:
- provide any supervision of the caregiver
- develop a care plan
- pay payroll taxes & workers compensation for the caregiver
You will either need to hire a certified case manager to assist you in assessing the client’s needs, developing a care plan, and overseeing the caregiver; or you will need to take on this responsibility yourself.
3. Home Care Agency
Depending on the agency you decide to retain, the caregiver is most likely an employee of the agency. If this is the case, then the agency would:
- Interview perspective caregivers
- Conduct background checks
- Pay the caregiver’s payroll taxes & workers compensation
- Provide supervision of the caregiver
- Create a “caregiver plan of care” which relates to the caregiver’s specific job duties, but not a comprehensive care plan.
A care plan is a comprehensive document that is usually developed by a certified case manager in conjunction with all members of the client’s care team (e.g. client, family, physicians, therapists such as physical, occupational, speech; nutritionals, case manager, home care agency, etc.)
The care plan (road map) incorporates the information obtained from the client assessment and identifies the individual's current needs, goals, desired interventions, team members who are assigned to address and help with each identified need, and the target date for completion of a specific goal.
Medical vs. Non-Medical Home Care Agency in Connecticut
- Medical
A Home Healthcare Agency in in CT must be licensed by the State of Connecticut’s Department of Public Health.
Once licensed these agencies usually deal with acute care cases, and are authorized to provide home health care services such as nursing care, hospice services, social work services, physical therapy, occupational therapy, and speech therapy.
These agencies are Medicare approved.
A Home Healthcare Agency may also provide non-medical services.
- Non-Medical
In CT, non-medical agencies are required to be registered with the State of Connecticut Department of Consumer Protection.
These agencies are authorized to provide homemaker and companion services, and basic supervision services to ensure the well-being and safety of a person.
Be Proactive
Before you decide to retain any person or agency it’s important to ensure that you do your due diligence in checking their reputation, references, as well as any complaints that have been filed.
You may want to check with the CT Department of Public Health and the State of CT Department of Consumer Protection, to verify if an agency is either licensed or registered.
Once you have located several potential agencies, the next step is to set up interviews. It’s important to interview the agencies and the caregiver candidates, as well as to check all references.
Our next article will provide some information and questions that you may find helpful in interviewing an agency and caregiver candidates.
The Caregiver Resource Center
The Caregiver Resource Center assists seniors, people with special needs and their families in planning for and implementing ways to allow for the greatest degree of independence, safety and quality of life.
We are available 7 days a week by appointment, and 24/7 for emergencies. All of our services are individually designed to meet the unique needs of the client and their family.
For more information, or to request an initial consultation, please contact:
Linda Ziac, LPC, LADC, BCPC, CEAP, CCM, CDP
The Caregiver Resource Center
Greenwich, CT
203-861-9833
The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.
Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.
To learn more about health and mental topics and to become a more educated self advocate, please subscribe to this blog or visit us at www.CaregiverResourceCenter.com
