Caregiving Case Studies: When In-Home Care is a Good Fit

A sailboat underway on the ocean

One of the challenging aspects of senior caregiving is that every situation is unique. As a result, it’s impossible to prescribe a “one size fits all” approach. Caregiving Case Study posts are designed to give readers insight into how different families have approached eldercare and the lessons they’ve learned. I recently interviewed Mary Anglade, CEO and Founder of sparqGEN Marketing, about her caregiving experiences with her dad.

A few years ago, Mary and her siblings recognized that their father who was in his 80s needed help. Mary’s Dad was a lifelong resident of Rhode Island and an accomplished sailor. He completed 11 Newport to Bermuda Races and was an active member of the sailing community in his town. As Mary’s Dad entered his mid- to late 80s, however, his eyesight began to fail. This made it difficult for him to move around in his home with confidence and he fell a couple of times, resulting in brief hospitalizations. Although Mary and her siblings lived out of state, they were close enough to visit frequently and knew he thrived in his own community.

The family began researching home healthcare agencies. Her family decided to work with an agency who provided home health aides to come for a few hours each day to help their father with a variety of tasks, ranging from meal preparation to transportation to doctor’s appointments. “Home health aides enabled my Dad to stay in his home. He was able to maintain an active social life, and the aides were like family in some cases,” Mary noted.

Reflecting on the experience with home healthcare, Mary offered the following pros and cons of home health aides, family considerations to keep in mind, and tips for success.

The Pros and Cons of Home Health Agencies

  • Dependability. If an aide calls in sick or can’t work for any reason, the agency will provide a replacement. This gives families peace of mind that their parent will still receive care.

  •  Experience. Often aides are certified nursing assistants (CNAs). Many have worked in nursing homes and understand the needs of seniors.

Families should also be aware of the downsides associated with home health aides:

  • Service Limitations. For example, CNAs are not permitted to administer medications to clients. They may be able to hand pills to clients at a particular time, but they cannot assist in any other way. If your parent has complex needs related to medication management, in-home aides may not be the right path.  Some agencies do offer skilled nursing care which may be an important option to consider.

  • Turnover. High turnover is common among agency CNAs. Sometimes this can make it difficult for clients to develop long-term relationships with aides. When a replacement shows up, some seniors may be resistant to what they perceive as “strangers” in their homes. High turnover rates among aides can be problematic for some families.

Family Considerations When Hiring Home Health Aides

Your family situation will play a major role in determining whether home health aides are the right solution for your elderly parent’s care. Mary made the following observations:

  • A strong network of friends has value. If your parent has a rich social life in his or her town, home health aides can help them remain at home and continue those interactions. On the flip side, if your parent is more introverted, staying at home with a few hours of care per week may result in isolation.

  • Aides are a practical solution if you live far from your parents or your work isn’t flexible. Mary explained, “Sometimes I would meet the aide and my Dad at his doctor’s appointments in Providence. This enabled me to go to the appointment where I could advocate for my Dad, while minimizing the amount of time I had to spend driving my Dad to and from the office.”

  • Aides may not be the right option if your parent has cognitive issues and lives alone. If your mother or father has Alzheimer’s or dementia and lives alone, a few hours of aide care per day may not be enough. In most cases, home health aides are not a financially viable solution for people who require care or supervision around the clock although most agencies do provide care 24/7.

Some Parting Tips for Elder Care and Home Health Aides

After reflecting on her family’s experience, Mary recommended three tips for adult children of seniors:

  1. Recognize that there’s only so much that you can do. “As your parents age, you’re no longer the child. That means that you must engage in hard conversations and say what you think needs to be done. If your parents still have their cognitive abilities, you also have to accept if your parents don’t want to follow your advice,” she commented.

  2. Present different alternatives. Most seniors would prefer to stay in their homes as long as possible. “We explained to my Dad that he could stay in his home with aides. However, if he didn’t want to take that path, the other choice was moving.”

  3. Be prepared to manage the aides. Mary noted, “It’s kind of like child care. You must be very clear with the aides about your expectations. Outline what you want them to do while they are with your parent.”

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