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Considering Home Care Staff
Evaluate a Home Care Agency and the Staff

Demand for aides and caregivers is increasing in the home care and home health care industries. Mix that with a shortage of health care workers, and it makes for rude awakenings in the health care labor.

Health care reform makes staffing shortages worse, because it's focus is value-based; prevention and team-based care, led by primary care practitioners.

Who will take care of our growing (and growing more) aging seniors who don't have the privilege of prevention?

Medicare covers the entire population age 65 and up, an estimated 32 million people who need more healthcare services. Yet, with the Affordable Care Act, the focus is on prevention and primary care, which doesn't help older adults very much since many (but not all) find it's too late for preventative measures.

Here are the Facts:

- 26.9% of people 65+ have diabetes - American Diabetes Association,

- 5.2 million have Alzheimer's disease (200,000 less than 65) Alzheimer's Association,

- 9% have Osteoporosis - CDC,

- 40% of 70+ have a form of heart disease - National Academy on Aging Society,

- 80% of older adults have one chronic condition - CDC

Sound critical?

As career paths of experienced health and medical professionals move towards an emphasis on primary care. who will care for the older adults living with chronic illnesses?

There are many home care and home health care agencies who provide well-qualified aides and professional caregivers. Continue reading to learn how to select the best service that matches your needs. As you research senior care agencies, be sure to check out our home care directory.

Considering Home Care Staff

Hiring a Home Health AideHiring a Home Health Aide

The Joint Commission, an independent, not-for-profit organization, accredit and certifies more than 20,000 health care organizations and programs in the United States. Joint Commission accreditation and certification recognized nationwide as a symbol of quality that reflects an organization's commitment to meeting certain performance standards.

The Private Duty Home care Association (PDHCA) established by the National Association for Home Care & Hospice (NAHC), is a trade association of home care providers dedicated to helping the ill and disabled remain at home.

When hiring a home care agency, consider if they're accredited and certified by either the Joint Commission or the Private Duty Home Care Association. Both recognized nationwide as a symbol of quality that reflects commitment to certain performance standards.

These standards imply that home care organizations directly employ home care aide staff, been in operation for at least one year, and handled a minimum of 25 cases at the time of application. All home care aide services in an organization must apply for accreditation at the same time.

The home care organization must have qualified professionals on staff to give assessment, care planning, and supervision and maintain compliance with the standards and procedures and pay accreditation fees annually.

Core Standards for Accreditation of Home Care Aide Services:

  • Ensures that the organization is legitimate, accountable and can deliver safeguards to consumers, if something go wrong.
  • Assures consumers that the organization complies with employment laws and regulations.
  • Makes certain the consumer is dealing a fiscally sound organization.
  • Assures that employees are prepared and capable before entering the home and able to perform the needed tasks and level of care.
  • Declares the service meets the needs of the consumer, is appropriate, and that the consumer remains informed and treated fairly.
  • Ensures that the service delivered is safe, that problems resolve quickly, employees supported, and service meets the changing needs of the recipient.
  • Assures that the home care agency strives to give quality of care, deliver more effective service and maintain positive service outcomes.
  • Ensures that the organization has capacity to deliver services promised.
  • Inform the consumer of the rights and responsibilities they have as recipients of home care services.
  • Makes certain the consumer understands the risks in home care, to ensure the safety of the recipient and employee, to minimize accidents and improve the delivery of service.
  • Assures that the organization complies with the law and program regulations and that the organization maintains a high level of integrity.

Read more on the Joint Commission's Standards and the Private Duty Home care Standards.

Home Health Care and Caregiver Aide Education and Training

Home health aides and professional caregivers help people with a disability, chronically ill, or cognitively impaired. They assist older adults who need help, at home or in another care setting.

In a few states, home health aides give patients medication or check their vital signs under with direction from a nurse or another health care practitioner.

It's important that aides receive training and skills that apply to the job.

Orientation Topics include:

  • Care setting
    Certified and TrainedCertified and Trained
  • Job responsibilities
  • Care plan and care team
  • Client rights
  • Documentation and reporting
  • Mandatory reporting
  • Basic communication methods and techniques

Safety Topics include:

  • Body mechanics
  • Employee safety
  • Accident prevention
  • Emergency, disaster, and evacuation preparedness
  • Hand washing and gloves
  • Infection control and standard precautions
  • Fire safety prevention
  • Fall prevention

Other Training

  • Housekeeping tasks
  • ADLs: Bathing, toileting, transferring, medication reminders, dressing.
  • Nutrition and special diets
  • Checking vital signs
  • Administering prescribed medication at scheduled times

Home Health Aide Duties

  • Help clients in their daily personal tasks, such as bathing or dressing
  • Provide basic health-related services - check vital signs or administer prescribed medication at scheduled times
  • Do light housekeeping, such as laundry, washing dishes, and vacuuming in a client's home
  • Organize a client's schedule and plan appointments
  • Arrange transportation to doctors' offices or for other kinds of outings
  • Shop for groceries and prepare meals to a client's dietary specifications
  • Provide companionship

How to Select the Right Home Care and Home Health Care Provider

Here's a checklist of questions to ask providers. Plan to ask family, friends, and your medical health staff for references.

Choose Right Home CareChoose Right Home Care

  • How long has the home care or home health care agency been in business?
  • Did they give literature on the services, eligibility requirements, fees, and funding sources?
  • Did you receive a copy of the Patient Bill of Rights; the rights and responsibilities of the providers, patients, and caregivers?
  • How do they select and train the employees? Do they offer benefits packages and have malpractice insurance?
  • Do nurses evaluate and assess patient's home care needs?
  • Will they consult the your physician and include family members in the care planning?
  • Who's included in developing the care plan of patient? Are they also involved in making care plan changes?
  • Is the patient's treatment documented, detailing the specific tasks needed by the home health aide or professional caregiver?
  • Will the family receive education on the care given by them?
  • Are home health care aides supervised? How often do the supervisors make visits?
  • Who does the family or patient contact, if there's a question, concern, or complaint?
  • How do they follow-up and resolve issues, concerns or problems?
  • How do they bill? Will you receive statements explaining costs and payment plan options?
  • How do they handle emergencies?
  • Are its caregivers available 24 hours a day, seven days a week?
  • Do they actively follow a patient confidentiality procedure?

Ask for References

Get a list of references from the provider:

  • Doctors
  • Discharge planners
  • Current and former patients and their family members
  • Community health care leaders and professionals

Contact references and ask:

  • Do you frequently refer clients to this provider?
  • Do you have a contractual relationship with this provider? If so, do you require the provider to meet special standards for quality care?
  • What sort of feedback have you gotten from patients receiving care from this provider?
  • Do you know of any clients similar to your care needs? If so, can you put me in touch with these individuals?



Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.