This is part of a series of articles that walk families through the decision process of hiring a home care agency. Additional topics include how to evaluate home care agencies and caregivers, aligning expectations with home care agencies, and how to choose between residential options and at-home care. Click here for our full series of articles on home care.

Or, start from the previous article: Having a conversation with a loved one about home care 

When you just need a little bit of help

There are cases of minimal need that require less than a four-hour shift every day. This becomes quite challenging, because most home care agencies require a four-hour minimum daily shift (often expressed as a 20 hour/week minimum). Working for less than a four-hour minimum per day will correlate to a higher rate per hour, which makes care less affordable for the consumer.

Family, friends, neighbors, or community members who can offer support with responsibilities such as grocery shopping and light meal prep are an invaluable asset. This is not a realistic scenario for everyone. 

Usually fmilies will need to hire staff from a home care agency, and agree to the four-hour minimum. Look at ways in which this person can provide value for the hours that they are in the home, which may include tidying up, helping someone declutter an area of the home, or work together on various projects such as putting together a photo album.

Addressing sensitivities about the caregiver once they’re there

A person who was initially resistant to care may finally agree to have someone in the home to help with transferring safely from one place to the next. For example, to assist each time the client needs to use the bathroom. Yet when the client is settled, perhaps watching tv or reading, he or she may want to be left alone.

I have had a case in which the client rang a bell to let the caregivers know when he needed them. He was clear that he did not want to feel like he had “a babysitter.” The caregivers were instructed to stay in a different room in the home and he communicated his need for them by ringing the bell. Baby monitors are often used in the same way with older adults who want to feel independent yet have the security that someone is there when needed.

Another client became annoyed and agitated when her kids put a caregiver in the home with her after she had fallen several times. Despite her resistance to having help in her home, her kids understood the potentially grave consequences of another fall. They negotiated a few hours of the day for their mother to have her ‘alone time’ so that she felt less imposed upon when caregivers were present to assist with safe ambulation throughout the night.

When to consider a residential option

When continuous monitoring is required for someone’s safety, decisions get to be made about whether staying at home is reasonable, or if moving into an older adult community makes the most sense. A setting that offers 24/7 oversight is often needed when cognitive or physical decline renders someone to be a danger to oneself if left alone.

About the Author

Karen Faith Gordon specializes in providing support to individuals and families addressing issues of aging. Services provided include mental health counseling, grief counseling, patient advocacy, medical care coordination, real estate and placement guidance to address short and long term care needs, and adaptive yoga for optimal well being.

In a system fraught with bumpy rides, Karen provides guidance, direction, and reassurance to achieve optimal well-being for older adults and those caring for them.

Karen’s ideal client is someone who is facing the challenges of a spouse/parent/loved one who is experiencing cognitive or physical decline. This client seeks guidance and support from a knowledgeable expert to create a plan to address short- and long-term needs.

Her relationships with clients, colleagues, and providers of care reflect years of collaborative effort to achieve best outcomes. She has presented to audiences locally and nationally to educate on topics of care management, affordable health care, and the benefits of yoga and aging.