Insightful guidance about finding, hiring, and managing your caregiver from the experts at LeanOnWe. When a near-fatal bicycling accident left LeanOnWe founder Ron Gold a paraplegic, he learned first hand how difficult it was to find the right caregiver….and now you can too at www.leanonwe.com.
by Denise Kuhbier MS, RN, NHA, CCM, Senior Vice President of Care at LeanOnWe
One of the biggest misunderstandings about hiring a home aide circles around what type of coverage you are entitled to. Get ready for the bad news.
Most Americans are convinced that if they need a caregiver to help them with cooking, shopping, light housekeeping, or to be a companion, it will be paid for by their private health insurance, Medicare, or the supplement they purchased for Medicare.
In almost every circumstance, this is simply – and unfortunately – not true.
Knowing what home care coverage you’re entitled to BEFORE something happens, can help you prepare.
Medicare’s home health care benefit, like the benefit offered by most private health insurance coverage, pays for intermittent skilled nursing and therapy visits for people who are homebound and have a doctor-certified medical need for such services.
Here are three key things you need to know about who pays for what when it comes to help at home:
So what is someone in need of home help to do? Besides the typical options of going through a home care agency or advertising online or in a newspaper to try to find a caregiver, many are now turning to www.LeanOnWe.com, where they can find pre-screened and carefully vetted caregivers to hire privately, watch a professional video of each potential caregiver, avoid costly agencies, and have control over the type of care provided.
by Mike Lasday, Co-Founder & Chief Operating Officer of LeanOnWe
Few things test sibling relationships more than when the time comes to actively manage the lives of their aging parents. Irreparable damage to once-close relationships is too often the norm as brothers and sisters clash over what each believes to be best for mom and dad. The danger is only exacerbated by geographic reality, as in most cases not all siblings reside near their parents.
Yet this new family dynamic of becoming your parents’ decision maker need not result in fractured relationships! Done correctly, this new paradigm could bring already close siblings closer and even create a bridge to strengthen estranged relationships.
While there is no one-size-fits-all definitive roadmap for siblings to navigate that can guarantee family harmony, the following four steps can create the foundation for functional relationships as brothers and sisters take on the challenging roles of helping to manage their parents’ lives.
1) Create a Common Goal
The most common mistake siblings make when actively overseeing their parents is not taking the time to clearly articulate their objective. Or, they assume that everyone agrees that the goal is to act “in the best interest” of mom and dad without bothering to determine whether all agree on what “best interest” really means.
In most cases, when discussed openly, siblings can quickly agree on the objective. It could be as simple as enabling mom and dad to live safely in their home and maintain their current lifestyle.
In those cases where there is disagreement over the objective, it is far better to have that discussion early, when hopefully the parents can be part of the process rather than later when they no longer are able to weigh in. In other words, this process should begin prior to a catastrophic event after which the parents’ wishes cannot be solicited. It is nearly impossible to reconcile opposing objectives when each side’s position is based on the statement that “mom would have wanted….” Instead of hypothesizing, find out what your parents want prior to them becoming unable to tell you and make sure their perspective is a central part of the common goal. Parents, if your adult children have not initiated the conversation, you should do so now.
2) Divide and Conquer
There is an old management adage that says when everyone is in charge, nobody is in charge. While the superficially easy decision for siblings is to say everyone will share the work equally, the various responsibilities associated with elder care make the reality far less simple than that.
Let’s face it, in every family dynamic different people bring different things to the table. For the sake of your parents, responsibilities should be divided based upon who could best fill their needs for specific tasks. Start by identifying the tasks your parents need help with.
If financial management is one of the needs, the sibling with the most experience and aptitude in that area should be in charge of that component. This can be a tricky decision and the one who is selected for this role should set up a checks-and-balances system so the other siblings fully understand what is happening financially. Perhaps an annual or twice a year family meeting or conference call is a good forum for such a financial discussion.
If the family employs a caregiver, one sibling should be charged with the management and direction of that caregiver. At LeanOnWe, too often we hear from caregivers who receive contradictory directions from family members. Make a plan now to avoid such issues and avoid losing a great caregiver.
A third sibling could be in charge of overseeing medical care and treatment.
These are just a few examples of how to divvy up responsibilities, though of course, every family’s needs are different. That said, clearly delegating tasks and allowing the sibling in charge of each of those tasks to independently make daily decisions goes a long way to achieving the common goal to which everybody agreed in step one.
3) Respect Authority and Expertise
Directly related to “Divide and Conquer” is the need to respect the authority and expertise of siblings assigned to specific roles. If given the responsibility over certain matters to make decisions, that sibling must also have the authority to make decisions related to that area. Sometimes the other siblings will agree with those decisions, sometimes they will not. The critical measurement is not the decision itself, but rather the entire body of decisions the sibling makes in their defined area as it relates to the common goal.
This is not to suggest that once given authority to make decisions in a specific area that sibling now has carte blanche to do whatever he or she wants without comment from the others.
As an example, my brother is tasked with managing my mother’s finances. While I might be interested in knowing how much her cable bill is each month, it would be wildly counterproductive for me to insist to my brother that she change providers or service. It just isn’t that important in the grand scheme of things as long as mom is happy with the television channels she gets.
On the other hand, if over the course of a few months, my mother’s monthly expenditures as a whole signficantly change, it would be certainly appropriate to engage my brother in a conversation regarding why that was the case. At that point, if I felt that he wasn’t managing her finances appropriately we could discuss and revisit.
Which brings us to the last step…
Aside from setting the common goal, creating a system for communication between siblings is the single biggest determining factor of whether relationships will be strengthened during this phase of life or weakened.
Again, there is no single “best” communication strategy. Whether it is semi-weekly, weekly, bi-weekly or monthly, there should be a regular time in which the siblings can discuss progress towards the common goal, review whether the current division of responsibilities makes sense and share any and all information. It is truly remarkable what a regular communication schedule can achieve in terms of maintaining positive momentum and airing any potentially divisive issues that could arise.
Although these four steps are basic, they are not simple. The reality of becoming guardians for our parents creates a level of stress for all involved and each person reacts to that stress in a different manner (which in and of itself creates more stress). Yet, by following these guidelines, the stress can be mitigated and sibling relationships strengthened while simultaneously creating a support system for your parents that will meet their needs.
by Denise Kuhbier MS, RN, NHA, CCM, Senior Vice President of Care at LeanOnWe
Myth #1: Medicare covers the cost of home care.
Neither Medicare nor Medicare supplements or other private health insurance plans cover non-medical home care. Medicare will cover short-term, intermittent care services in the home through a licensed agency. For example, Medicare may pay for a physical therapist to come to your home 1-2 times per week after a change in your condition to help you regain mobility so that you can stand to make dinner, take a shower, etc. But Medicare will not pay for someone to prepare meals, give you medication, take you to the doctor, do laundry, or do light housekeeping when you cannot do these things yourself.
Myth #2: Home care costs too much.
In reality, home care is one of the most affordable care options, partly because of the flexibility of the number of hours or the rate of pay. When choosing care at home, as opposed to a nursing home or assisted living, you are able to hire a caregiver for any number of hours to meet your needs and your budget.
Myth #3: I have no say about who comes into my home
Reputable home care companies will try to match caregivers with seniors of similar interests, but more often than not, the caregiver sent to you is the caregiver who is available. You should make sure that a company’s caregivers are screened, skilled, and bonded, and that a background and reference check has been done. The company should also offer flexibility in setting up a schedule – and be sure they’ll provide back-up and replacement caregivers. With a unique service like LeanOnWe, you get all of that PLUS you view a caregiver’s professional video and online resume so the choice of which pre-screened and highly recommended caregiver to hire on your own is always yours.
Myth #4: A live-in caregiver works 24/7.
Nobody works around the clock, day in and day out without a break – nor could they function properly if they did. Each state has strict laws to protect household workers, and remember that any live-in caregiver you hire on your own or through an agency must be allowed at least 5-8 hours of uninterrupted sleep in most states or must be paid (often time-and-a-half) on days that does not happen. With recent changes to the laws regarding overtime payment, you must check to be sure the caregiver is properly paid.
Myth #5: A home care company with a license has met standards for quality of care, proof of liability coverage, and ethical business practices.
All licensed home-care businesses are different – some fully abide by the rules and regulations set out by their license while others simply pay their state or local business license fee and practice as they please. Be sure you know who you are trusting with your care or the care of a loved one.
Myth #6: I can hire a caregiver on my own and pay them as a 1099 independent contractor.
The IRS has ruled repeatedly that caregivers and other household employees who earn more than $1,900 a year (2015) are legally determined to be household employees who must be processed with a Form W-2 and not a 1099 form. (To qualify as a 1099 independent contractor, the worker must show they are truly independent based on such factors as whether they have a choice of what days and times to work, they bring their own supplies to work, and even a choice of where the work is done.) As the employer of a caregiver in the United States, you have a responsibility to follow all applicable federal and state labor laws and regulations including paying FICA taxes, accurately tracking hours worked, paying overtime, and securing worker’s compensation coverage for injuries on the job. Failure to do so results in back payment and civil penalties from both the federal government and state authorities.
by Betsy Gold, Co-Founder of LeanOnWe
Spend a little extra time this season to show your appreciation with a thoughtful gift to thank your caregiver for all they’ve done for you or your parents or your child. In addition to a traditional year-end cash bonus, a small (or large) “something extra” can go a long way to generate a big smile and a year full of good will. Take a look at our carefully cultivated list of considerate gifts and pick what’s best for your special caregiver.
A good book — Whether it’s the Bible she likes to read or he’s working his way through his favorite author’s latest trilogy, finding the right book or books is a personal way to show you’re paying attention to your caregiver’s interests.
A cleaner car — Does your caregiver have a car? Auto detailing is a real treat, taking care of everything from shampooing the car’s carpeting to cleaning out the glove compartment and shining the wheel rims.
The gift of you — What special talent can you gift to your caregiver? Some ideas: Preparing your caregiver’s taxes, teaching her to use a computer, giving him guitar lessons, knitting him a sweater, being a handyman for a day at her house, tutoring his child. Be creative — you’re sure to have something to offer!
Train, taxi, bus, subway fare — How does your caregiver travel locally? If they use public transportation, consider a monthly bus pass, train ticket, subway card, or even a taxi account. Free travel = freedom to travel.
Visit to the dentist — When was the last time your caregiver went to the dentist? Most caregivers don’t have dental insurance. This year, make an appointment with your dentist and cover the cost of preventive care, such as an exam, X-rays, filling, and cleaning. Make their smile even brighter this season.
Dinner & a movie — Help your caregiver spend time off with friends or loved ones. Dinner for 4 plus movie tickets makes for a fun package this holiday season.
Religious symbols — Wintertime is a religious and cultural season for celebrating everything from Christmas and Chanukah to Kwanzaa. What’s a nice way to enhance your caregiver’s celebration? Consider a custom ornament with a photo of you & your caregiver, a box of handmade specialty candles, or a homemade gift in the Kwanzaa tradition.
Driving Lessons — Sending your caregiver to driving school benefits her — and you — and adds another important skill to her resume. Even if he or she doesn’t buy a car, knowing how to drive is a surefire career booster.
Smartphone, tablet, or laptop — Keep your caregiver up to date with the latest electronics and they’re sure to stay connected to friends, family – and you.
Airline ticket home — If you’re able to financially manage a gift like this, what a treat for your caregiver, whether “home” is a few states away or in another country.
Membership to a warehouse club — Who doesn’t love to save money? Helping your caregiver buy in bulk and at a discount, will be a gift that’s appreciated all year ‘round.
Your caregiver’s favorite — This is something we can’t define for you, but you’ll know it if you think about! Does your caregiver love sweets? Put together a “tower” of chocolates and cakes. Is he a stamp collector? Does she cherish porcelain dolls? Does he have a favorite sports team? Is she a fan of black-and-white movies? Whatever it is, find a way to use your inside knowledge to give a specially tailored gift.