Massachusetts Elder Care Options

Home Care Agencies

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Many Seniors rely upon a combination of family or other informal Caregivers.  While this may work for a while, unless the pool of available people is large, eventually the stress level on the Caregivers builds to an unacceptable level. Home Care agencies can provide a solution to this problem.

 Home Care agencies fall into two broad groups.  The first group of Home Care agencies act strictly as recruiters and do not keep the Caregiver on their own payroll.  Instead, the Senior or family becomes the employer of record and, as such, is responsible for all insurance, payroll and benefits requirements.  The second group of Home Care agencies consider the Caregivers to be their employees.  They assume all the risk of managing, training and paying the Caregivers.  Home Instead Senior Care Caregivers are our employees. 

Among Home Care agencies that consider the Caregiver to be their employee, there are four subgroups.  The first group, which includes Home Instead Senior Care, provide Caregivers that do not offer medical services such as bathing or administration of medication.  Termed custodial care, these agencies are regulated by the State of Massachusetts and are required to perform background checks, insure, and bond their employees.  The second group of Home Care Agencies employ Certified Nurses Aides (CNA).  These agencies offer medical services and may or may not offer homemaker services.  The third group are medicare certified agencies.  These agencies offer very specific skilled care services and are generally paid for by medicare. The final group offer nurses that have completed a full course of study and are licensed by the State of Massachusetts.  It is unusual to contract with this type of agency except in exceptional circumstances.

 Picking the appropriate Home Care agency is driven by the level of services the senior requires.  A custodial care agency, such as Home Instead Senior Care, is the best solution when medical services such as bathing are not required. Caregivers from custodial care agencies tend to be much more willing to perform home maintenance tasks as compared to agencies that have medically trained Caregivers.  Conversely, a blend of Caregivers from a medical and custodial agency may be the best solution when some level of medical care is required.  Although this will tend to result in a better overall level of care, if two agencies are involved hiring of a Geriatric Care manager to coordinate services becomes important. 

 In all the above cases, it is unlikely any medical insurance will cover the cost of services, except for the period of time immediately following discharge from a hospital however read the medicare page regarding the possibility of having some of the costs covered.  Long Term Care policies will, on a case by case basis, often cover a portion or all of the costs incurred.


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