A place for your parents

Helping seniors stay at home

Photo courtesy Visiting Angels

Becoming an empty-nester, retiring and caring for aging parents are life stages familiar to many. Springfield has numerous agencies that help seniors stay in their own home. Determining what's best for your loved one can be daunting. Senior Services of Central Illinois (SSCI) is a good place to start. SSCI is a nonprofit organization that specializes in providing solutions to everyday problems so seniors can continue to live independently and maintain a high quality of life.

Rod Lane, owner of Visiting Angels, says there is a strong senior care community in Springfield and a lot of great agencies. The Illinois Department of Public Health licenses both Home Services Agencies and Home Health Agencies.

Home Services Agencies provide assistance with daily living, dressing and bathing, companionship, light housekeeping, transportation, menu planning and other non-medical care that allows someone to remain at home safely. Care plans are tailored to individual needs and can range from a few hours of assistance weekly to round-the-clock care.

In contrast to Home Services Agencies, Home Health Agencies are licensed to provide skilled nursing services, and they employ certified LPNs and RNs. Wound care, infusions, drawing blood, administering medications and injections are examples of skilled nursing care.

The distinction can be confusing to the layperson. Lane explains there is often a fine line. For example, Home Services Agencies may remind patients to take their medications but can't administer medications. Caregivers may empty a catheter bag but not insert a catheter.

Visiting Angels and Home Instead are two of the many Home Services Agencies serving the Springfield area. Both are locally owned franchises of nationwide businesses.

Memorial Home Services is a licensed, Medicare-certified Home Health Agency, which provides skilled care and helps patients recover from injuries, surgeries and illness. Memorial Home Services also provides Home Hospice and helps people get medical equipment they need at home.

It's not uncommon for individuals to need both skilled and non-skilled care. Home Services Agencies often work in tandem with Home Health Agencies. Most agencies that provide skilled nursing don't provide assistance with daily living, which is the primary role of Home Services Agencies.

BrightStar Care is the only local agency that provides both, offering a full range of services from assistance with daily living to nursing care by CNAs, LPNs and RNs. Care plans are individualized, and not every client needs both skilled and non-skilled care. The BrightStar Care local franchise is accredited by the Joint Commission, a nationally recognized health care quality standards organization that also accredits hospitals. Memorial Home Services is also accredited by the Joint Commission.

Cost is certainly one factor when arranging in-home care. Medicare does not cover Home Services. Long-term care insurance can be used, and veterans may be able to use VA benefits. Some assistance is available for low-income individuals through the Illinois Department on Aging Community Care Program. Senior Services of Central Illinois has certified care coordinators who assist qualifying individuals to access the Community Care Program. Care coordinators provide in-home assessments and develop care plans designed to promote independence and prevent premature institutionalization.

Photo courtesy Visiting Angels

Although agencies are in competition with each other, all are committed to providing the best possible care that meets the client's needs. "Those of us in the field work with each other informally to try and get people the services they need," says Amy Best, owner of Home Instead. Lane says it is critical to interview multiple agencies.

"Don't be afraid to ask hard questions," says Della Thomas, BrightStar Care office manager. She advises asking about staff training and retraining, the hiring screening process and if the agency guarantees compatibility between the client and caregiver. For example, compatibility can be an issue if a client thinks the caregiver talks too much or too little. Thomas also recommends asking about consistency of care. She emphasizes the importance of having a consistent caregiver and regular routine, especially for people with dementia. "It can be very confusing and frustrating for clients if there is a different person every day," says Thomas.

Lane recommends inquiring about the relationship with the office in addition to the caregiver. Clients should ask if there is a required minimum number of hours. Many agencies have minimums, although Visiting Angels does not. Hourly rates are often higher for shorter shifts.

Staffing is a challenge, and there is a high staff turnover in the industry. COVID-19 has also taken its toll, as caregivers have their own challenges. Visiting Angels has gone from 100 caregivers to 70. Lane says he hires people who have experience caring for elderly or disabled individuals, are dependable and flexible and enjoy taking care of people. "You can't teach people to care," he says. Best says Home Instead is always looking for great caregivers and that being a caregiver can be a rewarding part-time job for people in their 60s and 70s who have experience taking care of someone, have some time and are looking for a way to give back. "First and foremost, we look for people who have the heart for this business," says Best. "We can teach the rest." Although certifications aren't required for caregivers, Best says many staff are CNAs, and some are retired RNs and LPNs.

Home Services Agencies provide care for people in their home, wherever their home may be. Amy Best estimates 20 to 30 percent of Home Instead's clients live in some type of facility. Many senior living centers provide a continuum of care, from independent living apartments to assisted living and skilled care. Individuals often hire Home Services Agencies for assistance in their independent living apartments, which helps them avoid moving into assisted living. In some situations, Home Services and Home Health Agencies assist patients in skilled care or assisted living. These arrangements vary by facility and are influenced by a myriad of rules and regulations.

Selecting an agency to help aging parents stay as independent as possible is challenging. Do your homework, talk to a variety of agencies, ask a lot of questions and make an informed decision about the best fit for your situation.

Karen Ackerman Witter is a frequent contributor to Illinois Times. Her parents have used both Home Services and Home Health Agencies in order to remain as independent as possible.

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