Here is a handy checklist that will help you with your selection and judgment of the quality and scope of services provided when you contact an agency in your community.
Pre-screen In Home Care Agencies for the basic scope of services
You'll save time if you know what type of care services you're looking for. Some home care agencies provide primarily nursing and medical services, some provide hospice care for the terminally ill, others specialize in non-medical care only. Find out up front if their services will be right for you. Use the following points to help you get a handle on your basic level of need. Check which service your loved one requires:
Medical Care (wound care, injections, monitoring health conditions like diabetes or blood pressure or heart disease, assistance with medical equipment like dialysis, indwelling catheter, naso-gastric (NG) tube feeding or a ventilator)
Rehabilitation to improve or retain function (e.g., range of motion, physical therapy following an injury), speech therapy or help swallowing (e.g., due to a stroke, Parkinson's disease or ALS) respiratory therapy, or help getting around the house or using assistive equipment.
Personal Care (help with bathing, toileting or incontinence, eating, dressing, getting out of bed or out of a chair, or being lifted)
Chore Work (shopping, errands, minor home repair -- like clearing the front path -- or making phone calls)
Nighttime Care Make sure you know what hours you will need care for (bedtime, evening, all-night, etc.)
Transportation Assistance Will the worker be expected to transport your loved one to activities, shopping, medical appointments, etc.? If so, will the worker drive her own car? Your car? A special wheelchair accessible van?
Companionship Is it important for the person to provide good company? or to provide supervision to someone who is confused/has memory loss?
Comfort Care (for a terminal illness) Some home care agencies also provide hospice services for terminally-ill individuals. This may entail a range of needs from nurses and mental health professionals to spiritual advisors.
Get the basics on their business practice
How long has your agency been in business?
Do workers provide nursing care, non-medical care (personal care, chore or companionship) or both?
Can your agency accommodate my loved one's needs? Note: describe person's diagnosis, age, special needs (e.g., administering medications, using home medical equipment).
What are your fees (per hour, per day or per visit)? Note: this may vary significantly depending on the level of care needed.
It is advisable to request written documentation of fees and services.
How many hours in a minimum shift? What about a maximum shift? Can a shift be split (e.g., two hours in the morning and two in the evening)?
Must the client have a doctor's authorization to receive home health care?
Is a nurse or a therapist required to evaluate the client's needs? If so, what does this entail? Will they consult with the person's physician or with family members?
Are there any restrictions against accompanying the client outside the home or driving a car?
Does your agency carry malpractice insurance?
Is your agency bonded (insured against theft)? Are workers bonded?
Is your agency insured for on the job injuries?
Ask about worker qualifications and training
Are all your home care workers licensed or certified? If not, what minimum qualifications do workers have?
Do you screen your workers? If so, what type of background checking is done?
Are workers trained? If so, does the training include:
Safe bending and lifting practices
CPR/first aid?
Managing incontinence?
Catheter care?
Communicating with someone who is confused or forgetful?
Managing difficult behaviors (e.g., wandering, paranoia, or memory loss?)
Bathing someone in the tub/shower or in bed?
Can you furnish references for your workers that I can check? If not, do you have any client satisfaction survey results you can share with me?
See how their service quality measures up
Are workers supervised? If so, by whom?
Is there a written care plan specifying the home care worker's routine duties? If so, can the family have a copy? How often is the plan updated?
Does the elder (and involved family members) have input into the client service plan? Do you arrange regular conversations with the family about the client's case?
Will a supervisor visit or call the client's home? To whom can the client or family ask questions or make complaints?
How do you ensure your clients' confidentiality?
How does the agency follow-up on/resolve problems or complaints?
Can a known agency worker be requested by name?
Can a different worker be requested, if there was a problem with the first one?
How fast can your agency respond to an emergency need? Are workers available 24 hours, seven days a week? Is there always someone available at your office to take a call?
Can a replacement worker be called if the worker does not come or cannot complete a shift? If so, how long does it usually take to get a replacement?
Learn about financing and payment
Do you accept private health care or long term care insurance?
Does the agency pay the worker's social security and taxes? If not, do I need to pay this?
What is the cost for overtime, if the worker stays late?
When is payment due? (e.g., at the end of each visit? weekly? monthly?)
Does payment go to the agency? Or the home care worker directly?
Are there any additional costs for travel time or extra services (e.g., doing laundry or errands)?
