Home health agencies

Hiring a certified home health agency to supply and manage your mom’s care is the easiest but most expensive option of the two. Costs run anywhere from $12 up to $40 an hour depending on where you live and the qualification of the aide. This is also usually a better way to go if your mom requires a lot of in-home health care.

You pay the agency, and they handle everything including an assessment of your mom’s needs, assigning appropriately trained and pre-screened staff to care for her and finding a fill-in on days her aide cannot come.

Some of the drawbacks, however, are that you may not have much input into the selection of the caregiver, and the caregivers may change or alternate, which can cause a disruption in care and confusion.

You also need to know that while Medicare does cover some in-home health care services if it’s ordered by a doctor, they don’t cover homemaker services, nor will they cover personal care services, such as bathing and dressing, provided by a home health aide if that is the only care required. But, if your mom is low-income and qualifies for Medicaid, some services are covered.

To locate and compare Medicare-approved home health agencies visit www.medicare.gov/hhcompare, and call 800-633-4227 and request a free copy of the “Medicare and Home Health Care” publication (#10969) that explains coverage and how to choose an agency.

Hiring directly 

Hiring an independent caregiver on your own is the other option, and it’s less expensive. Costs typically range between $10 and $20 per hour. Hiring directly also gives you more control over who you hire, so you can choose someone who you feel is right for your mom.

But be aware, if you do hire someone on your own, you become the employer so there’s no agency support to fall back on if a problem occurs or if the aide doesn’t show up. You’re also responsible for paying payroll taxes and any worker-related injuries that may happen. If you choose this option, make sure you check the aide’s references thoroughly, and do a criminal background check.

To find someone, ask for referrals through friends, doctor’s offices or hospital discharge planners, check online job boards like carelinx.com or carescout.com. Some states even offer registries (PHImatchingservicesmap.org) to help you locate good caregivers. Or, for a fee, a geriatric care manager (caremanager.org) can help find someone.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.