As a kid, it’s hard to imagine life without adult care and guidance. It’s even harder to imagine providing care and guidance to adults. But as you age, the adults in your life grow older too. And eventually, you may find yourself taking on a parental role for parents of your own.
Acting as a caregiver for a parent or loved one can be a fulfilling experience, but it is also hard work. Just like your parents likely hired a babysitter once in a while, it’s OK for you to call in extra help too.
“Caregiving is both rewarding and demanding,” says Dr. Khaliq Siddiq, chief medical officer of Clever Care Health Plan, who practices in Seal Beach, California. “It’s vital to provide emotional support to both the individual being cared for and their family members, as caregiving can often be an emotional and physical strain.”
Depending on your unique circumstances, you may consider hiring a paid caregiver to take over your responsibilities or assist you in caring for your loved one. There are various types of in-home caregivers for hire who may be able to meet your and your loved one’s needs.
[SEE: Early Signs of Dementia.]
Types of In-Home Caregivers
The term in-home caregivers refers to a wide array of people who tend to and support others in their home — as opposed to in a hospital or a senior living facility — and may include paid workers and generous friends or family members. There are also various types of professional in-home caregivers you can hire.
Different types of professional in-home caregivers have different skill sets, some which may better suit your or your loved one’s needs than others. For instance, some in-home caregivers have medical training and can assist with checking your loved one’s vital signs or help them take medications; other caregivers may provide your loved one companionship and support their basic needs.
A few types of caregivers you may consider hiring include:
— Home health aides
— Certified nursing assistants
— Home care nurses
— In-home supportive services providers
[READ: What to Do When You Become the Family Caregiver]
What Exactly Does a Caregiver Do?
The level of care a caregiver provides and how this person tends to your loved one will vary based on their specific role and any medical training they have. Some services offered by different types of caregivers include:
Home health aides
HHAs are caregivers that offer your loved one essential health care services, which include duties like changing soiled sheets and helping your loved one perform activities of daily living (ADLs), including bathing or showering, dressing, preparing meals and some types of housekeeping.
In some places, HHAs will shop for groceries for your loved one, remind them about appointments and medications, do laundry, assist with health monitoring and escort them on outings too. Additionally, an HHA can act as a companion for your loved one.
They may also provide limited medical care such as taking vital signs, under a nurse’s supervision.
Dr. Esiquio Casillas, chief medical officer for the AltaMed Health Services Program of All-Inclusive Care for the Elderly, or PACE, in Los Angeles, explains that being under a nurse’s supervision doesn’t mean that an RN will be joining the rest of you at your loved one’s home, “they just need a nurse to be available and speak to — to guide if there are changes in condition that they note.”
Certified nursing assistants
Like HHAs, CNAs will provide your loved one with essential health care services including ADL assistance as well as limited medical services, such as taking vital signs under RN supervision.
Job duties of CNAs and HHAs have several similarities. But overall, CNAs are trained more broadly within the medical field while HHAs are focused more narrowly on home care and often elderly care.
With any worker, the extent of their services can vary based on the individual and their contract with you.
Home care nurses
Home care nurses, sometimes known as home health nurses, are registered nurses that come to your home to provide treatment or care. Home care nurses can provide services, such as:
— Administer medicine to your loved one
— Inspect their wounds and change bandages
— Help them with personal grooming and hygiene
— Monitor their well-being
— Work with doctors on personalized care plans for your loved one
In-home supportive services providers
If you are not a health care worker but are interested in becoming a paid caregiver, you can apply to become a type of caregiver called an in-home supportive services provider. Depending on where you live, becoming an IHSS provider can enable you to receive state payments for taking care of your loved one. Becoming an IHSS provider does not make you a health care worker, but enables you to care for your loved one’s well-being. As an IHSS provider, you assist with their ADLs and other nonmedical aspects of their care.
Casillas says that IHSS can at times act “much more autonomously” than other caregivers, as they are under the direction of an individual patient — or loved one — as opposed to an agency.
[READ Signs It’s Time for Memory Care]
In-Home Caregiving vs. Facility-Based Support
In-home caregivers may have different skills, but they all provide care in the home. This sets in-home caregivers apart from support staff in places such as hospitals, skilled nursing homes or assisted living facilities, as your loved one will not need to change their environment to receive support.
Corinne Eldridge, president and CEO of Center for Caregiver Advancement, a California-based organization that supports caregiver training, research, policy and advocacy, says that in-home caregiving can be an attractive option for many, as “people who are comfortable welcoming a caregiver into their home can enjoy a more individualized approach to care and greater autonomy.”
Still, there are benefits and drawbacks to both.
On the plus side, “both settings offer social advantages,” Eldridge says. “In-home care is conducive to socialization with family members, neighbors and established social networks, whereas caregiving facilities provide opportunities for daily interactions with other residents and multiple staff.”
As a drawback, she adds that people in a facility may be subject to “rigid policies, more formal processes for modifying care plans and fixed visiting hours,” which tend not to be issues with in-home caregiving. Still, she adds that “not all facilities are alike.”
With advanced research, patients can find senior communities that appeal to them and suit their needs.
If you are wrestling with the decision of hiring an in-home caregiver or moving your loved one into a caregiving facility, there are some questions you can ask yourself to gain clarity.
— What level of care is required?
— Can this level of care be provided at the home?
— If necessary, can the home be modified to ensure your loved one’s safety?
— What is the cost difference between in-home caregiving and a caregiving facility?
— What is the proximity — of either your loved one’s home or a potential facility — to their friends and family members, including you?
— What is your loved one’s preferred living environment?
— Do you or they have any other emotional or social considerations that may affect your decision?
[READ: Does Medicare Cover Home Health Care?]
Signs Your Loved One Needs an In-Home Caregiver
Eldridge says that “many people experience a gradual decline in their ability to care for themselves” — and may not recognize their need for a caregiver right away. Especially if your loved one cannot see or voice their caregiving needs, it can be important for you to look out for signs that they need extra help.
Some signs that your loved one may benefit from an in-home caregiver include:
— They have trouble managing their medications, or forget to take them.
— They frequently fall at home or are at risk for falling.
— They have challenges with bathing themselves.
— They struggle with cooking or do not cook for themselves.
— They struggle to or cannot dress themselves.
— They have noticeable changes in their cognitive function, such as displaying forgetfulness or confusion.
Perhaps you have already determined that your loved one needs in-home caregiving support, but — rather than hire a professional — you have been providing this care yourself. If you’re already acting as a caregiver for your loved one, consider if hiring a professional supports your needs too. For instance, ask yourself if the tasks you are providing for your loved one feel sustainable — or if these are taking a toll on other aspects of your life.
Additionally, consider if you are equipped to provide caregiving that meets their needs. Are you a health care professional who can assist with medical needs and medication intake? Or if you are not trained in this area, would you feel more comfortable passing this task to someone who is?
Calling in Help for Decision-Making
In some cases, you may feel that your loved one needs in-home caregiving support — and they may disagree with you. Such clashes could put a strain on your relationship and take a toll on both of you. To help separate your loved one’s health needs from both of your emotions around the decision, Eldridge says you may consider calling in a professional like a geriatric care manager who can conduct an assessment of your loved one’s health and safety in their home.
“It can be challenging to accept the judgment of a family member or loved one, so professional assessments are helpful and available at no cost upon the recommendation of a primary care provider,” Eldridge explains.
Depending on where you live and what services are close to you, you may be able to preview what these types of in-home assessments will look like online. For example, if you live in California, Disability Rights California provides an online worksheet that explains that service workers are looking for in an IHSS assessment.
[READ: Understanding the Different Eldercare Options]
Choose Your Caregiver Carefully
Whoever you choose to be your loved one’s caregiver will become a major presence in their life — and likely your life as well — so it’s in your best interest to be thoughtful about your selection.
Eldridge says, “It is extremely important to be selective about the type of caregiver hired for oneself or a loved one because they directly impact quality of life and well-being.” She adds that “caregivers who pay close attention to their consumer’s changes in health and behaviors can provide invaluable information to clinical teams and reduce the risk of medical complications,” which could be lifesaving.
Additionally, some but not all caregivers are specialized to work with people who have conditions like Alzheimer’s disease and related dementias. If your loved one has dementia, you’ll want to make sure their caregiver is equipped to care for their condition.
In addition to medical specialties, make sure your caregiver is a good emotional fit for you and your loved one.
Questions to ask a caregiver:
Some questions you may want to ask a caregiver before deciding if they are a good fit include:
— Can you tell me about your medical experience?
— Do you have experience caring for someone with dementia or another condition that my loved one has?
— How willing are you to learn about my loved one and their needs?
— How much do you prioritize emotional support and companionship among your services?
— How do you build trust with your patients?
— How will you communicate with me and my loved one?
— How have you demonstrated reliability with patients?
Caregivers may also provide references from former employers that can help you get a sense of their temperament, personality and work style, Eldridge says.
Prioritize Your Loved One’s Preference in Caregiving Discussions
If you are hiring an in-home caregiver for your loved one, chances are you are taking on a couple different roles for them already. And while it may be necessary to make some choices for your loved one, it’s important not to walk over them and ignore their preferences.
“The patient’s preferences should be prioritized, especially if they are mentally capable of making decisions,” Siddiq says. “Person-centered care is a priority, however, loved ones often have to make these decisions if the patient’s health condition impedes their ability to make informed choices.”
Above all, he adds that empathy and understanding the emotional and physical challenges faced by the individual receiving care is crucial to providing compassionate and effective support.
More from U.S. News
6 Surprising Things That Age You
What Makes a Good Doctor: Qualities to Look For
Hiring an In-Home Caregiver: What to Consider originally appeared on usnews.com
