Many families only look for help when something bad has happened, they fall, they get discharged from the hospital, they can no longer live safely and independently without help. Thus, the panic mode sets in, and people find the first home care company that answers their phone call or has the best website. There’s no time to make decisions about who will step foot into your home and care for your loved one.
But not all home care companies work in the same capacity. Some have decades of experience, well-trained caregivers, and good reputations. Others are simply matching services who connect you with whoever’s available. But in that panic mode, what are the good questions to even ask to determine which company is which?
Here’s what you should know when it comes time to choose someone with your family member’s safety and wellbeing in mind.
Who Comes to Your Door
The first question should be who. Are the caregivers employees or independent contractors? This distinction makes more of a difference than people realize. If caregivers are employees of the company, the caregivers have gone through their training and background checks, receive supervision, and if anything happens while they’re in your home, they have workers’ comp insurance.
They usually have additional staff who can step in if someone calls out sick that day.
For independent contractors, you’re stuck with what you’re given. It’s usually just a company that connects you with someone who passes a basic screening. Ask what kinds of background checks they’re run – only criminal, or also on abuse registries and past employers? Some companies check all. Some barely check anything.
Ask how trained they are, too. What kinds of things have they been trained in before they step foot into a client’s home? Is there continuing education or did they watch a video five years ago? For families with certain needs (especially dementia or other degenerative diseases), specialized training might be necessary.
What Happens When Something Goes Wrong
Ask this question before you need to know the answer. Should your caregiver be sick or quit unexpectedly, what’s the plan? Some companies have an extensive roster and can send someone new by that evening. Others let you scramble on your own.
Philadelphia families oftentimes turn to New Century Health Services for in-home care services in Philadelphia as such a company has an extensive team on staff at all hours so they can accommodate scheduling emergencies without leaving clients without help.
If something goes wrong with your loved one – chest pains, confusion, falls – what happens? Does the worker know how to respond? Will they call 911? Will they call you? Will they call the office? All should be on record as a company policy rather than addressing emergencies as they happen.
How Do They Communicate
Ask how communication occurs. Is there a caregiver who reports back to the office daily? Is there someone with whom your loved one communicates for issues or are you left to deal with whoever shows up?What’s the plan when you call at 9 PM with an issue?
Some companies have apps or a log that notes what happened each day; some rely on verbal updates, if at all. When you’re not there, sometimes having something consistent and reliable is the best option. You want to know if mom ate lunch today, if her meds got dispersed, if she was out of sorts.
How much flexibility do they have with scheduling changes? Many families will expand their needs as they realize what services they’ve understated. Extra hours one week or an additional day one week – how much advance notice do they require? Everyone would love a schedule to go according to plan but that’s not always possible when health is involved.
The Money Conversation
Money is not a fun topic to talk about. However, get it all out on the table ahead of time. How much does it cost per hour? Is there a minimum requirement per visit? What are the upcharges for weekends, holidays or overnight shifts? Some organizations charge differently based on what someone requires (companionship vs bathing vs medication management).
What is their payment policy? Do they bill every week? Every month? Do YOU pay them or do the caregivers get compensated directly? What payment systems do they have available (long-term care insurance/Medicaid)? All of this is crucial to know before care starts.
Are there hidden fees? Some companies add administrative fees, assessment fees and coordination fees on top of the hourly fee. Others bundle everything and have it all one price – and they’ll tell you up front. There shouldn’t be any surprises after caring starts.
What Do You Know of Their Reputation
It’s harder to gauge but worth it if you can. How long has this company been around? Can they provide references from active clients? What’s their retention rate – do they keep caregivers on staff for years or does everyone turnover after six months?
Where do online reviews rate them, if at all? Realistically, all companies are going to have a handful of bad reviews. But look for trends instead – is something noted repeatedly? Or is there scattershot complaints?
Check with the state licensing board as well – if any violations exist or complaints exist. Not everything shows up on a review but it’s documented in public records.
What Don’t People Usually Think to Ask?
There are always additional questions that don’t occur to people until they’re asked:
Do you have the ability to request a different caregiver if it doesn’t work out? Some companies act like you’re stuck with whoever shows up. Others will rotate until you find someone suitable.
What do these services include and exclude? In-home care basics typically include bathing help, dressing help, meal prep, light housekeeping and companionship – but there are limits. Caregivers cannot do heavy cleaning, medical needs (unless they’re nurses) or anything requiring a certification/degree they don’t possess.
If I need to put services on hold or discontinue need, how much notice do I need to give? Are you locked into a contract, month-to-month, more flexible?
Closing Thoughts and What Compounds Decision Making
Once you’ve collected all these questions, see how answering them makes you feel – are they vague but thorough about tons of questions? Or are answers evasive? Do they care about your personally tailored situation or do they seem like they’re trying to sell you on care?
If you don’t trust your gut now about a location that will support your family once things get complicated, get their information for reference down the road. Complications come up – care needs change; personalities don’t blend; things happen that were unexpected. You want someone who partners with you – and won’t drop off the map when it gets complicated.
No matter what, make sure this process is done before anyone enters your home or provides services. It’s far too difficult to shift gears while care has already been initiated, even more so if your family member gets used to someone coming by. Take the time even though it’s inconvenient because you’d rather take the time now than deal with two months down the line of frustrations over why you could’ve asked simple questions now instead of later.
