For many elderly people, the availability of someone to help them a few hours a day with personal care or household chores can mean the difference between continuing to live at home or moving into a nursing home.

Home-based care is a new and growing field and many of the services are unregulated. Here are some tips on finding an appropriate care provider and paying for that care:

Consider community resources first. Contact your local Area Agency on Aging, often listed in the phone directory under "senior services" or "human services." Almost every county has one to help seniors remain independent in their own homes. Explain the need for home care and seek recommendations of service providers. A social worker usually will visit to assess the elderly person's needs.
Some services provided by local aging agencies, such as transportation, home-delivered meals and help with household chores, may be available for free or at modest cost, depending on the person's income.

Long-distance caregivers can call the Eldercare Locator at 800-677-1116 to find the appropriate state or local agency to arrange service for an older person in need of assistance.

Private home-care services. Some people may not qualify for government programs or may require more help than local aging agencies offer. They, or their family members, may have to look for private home care services providers. Check your phone directory under "personal care services" or "home care services."
Home care aides run the gamut from companions and housekeeping aides to those who help with personal care such as bathing, dressing and grooming. Fees usually run from $10 to $16 an hour. People with specific health problems may require a visiting nurse.

In exploring home-based care, check whether the service you contact is an agency, which screens, trains and supervises its employees, or merely a registry of independent caregivers. Also ask if the service is licensed - if required in your state - and accredited by a professional association, indicating a higher standard of quality.

"Usually, the people who are referred instead of being employed are cheaper," said Margaret Terry, executive director of Homemaker Health Aide Services of the National Capital Area, a home care agency in Washington, D.C.
"But the less costly person comes with a potentially big price," she said. Terry explained that if one of her employees is unable to visit a client on a particular day, a replacement is found. And if an aide is injured on the job, such as hurting her back when trying to lift an elderly person out of bed, the agency - not the client - is liable.

When you hire an independent caregiver, you become the employer. That means you are liable for injuries, for withholding Social Security taxes, and for filing the proper tax documents. (To learn more about tax responsibilities of employers of household help, call the IRS toll free at 800-829-3676 and request Publication 907.)

Some people find, however, that less expensive independent caregivers are the only way they can afford home-based care. An excellent book on the subject, "Home Care for Older People," discusses the advantages and disadvantages of various home care options and how to find needed help. For a copy, send $12 ot United Senior Health Cooperative, 1331 H. Street, N.W., Suite 500, Washington, D.C. 20005.

Paying for care. Once you find the home-based care you need, the next challenge is paying for it. Medicare, the government's health care program for those 65 and over, does not cover long-term care or help with personal or household services. However, Medicare will pay for home care services related to acute, short-term health problems if a person is homebound, under a physician's care, and needs part-time or intermittent skilled nursing services or physical or speech therapy.
Private insurance pays very few home care costs. Some newer supplemental medical insurance policies, known as medigap, offer limited coverage for home care, but only when a patient is also receiving Medicare.

Private long-term care insurance policies often cover home-based care. But these policies are still so new and relatively expensive that only a small percentage of the elderly have them. The bottom line is that if you need private home care services, you're probably going to have to pay for it yourself. That may mean liquidating assets or engaging in some creative financing, such as applying for a reverse mortgage where the lender pays the homeowner.
By Mary Beth Franklin
Maturity News Service
































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For your convenience, we have also included links to the websites of many home health agencies. Click on the link for the agency about which you want more information.

Active Alliance Home Care (Columbus, OH) With more than 16 years of experience, our caregivers are able to provide the most comprehensive and compassionate services with personalized attention.

Free Comprehensive ElderCare Referral Service - ElderCarelink This free online referral service helps you find everything from Adult Day Care, Home Care and Assisted Living to Financial Planning and Personal Emergency Responses.

Comfort Keepers Provides non-medical in-home care to thousands of people, one person at a time.

Home Care (Australia) Kinder Caring specialises in personalised, flexible home care so that families can keep their loved ones at home. Kinder Caring offers a range of services to help you with your in-home care needs.

Home Companion Services (Fort Jefferson Station, NY and Boynton Beach, FL) Provides a wide variety of non-medical and daily living services that enable the elderly and physically challenged to remain active and live in the comfort of their own homes.

Home Health Care (Fort Lauderdale) Visiting Angels provides the following services: Hourly up to 24 hour care per day, Personal Care, Light Housekeeping, Joyful Companionship, Day/Night Live-In/Live-Out Care and Respite for Family Caregivers.

Home Health Works (Florida) Excellent home health care services for Florida's Tampa Bay area (Pasco and Pinellas counties).

Home Helpers With offices located nationwide, their experienced caregivers help aging seniors safely manage and enjoy an active lifestyle while maintaining their independence; help clients recovering from illness or injury to resume their normal activities as quickly as possible; and give those facing lifelong challenges help with everyday tasks, making life easier and more enjoyable.

Home Instead Senior Care World's largest and most trusted provider of comprehensive, non-medical companionship and home care services for the elderly. Their services are designed for practically any living arrangement where an elderly person can manage their personal care, but needs companionship, human interaction and help with other day-to-day activities.

Interim HealthCare With over 40 years of elder care experience, Interim understands how important it is for seniors to stay independent and safe in their homes. Our services include skilled home nursing care, companions, homemakers and therapy services.

Liberty Home Healthcare Services (Connecticut & New York) At Liberty Home Healthcare it is our mission is to protect the well-being of our community residents by delivering quality home care support and compassionate healthcare at all times.

Pampering Plus (Philadelphia, PA) Specializing in providing care with compassion in the privacy of your own home.

Senior Approved Certification Health care providers and other businesses that serve seniors prove to potential clients and referral sources that you are a safe, reliable service focused on quality care. Apply for the Senior Approved Certification. Mention "Aging Parents and Elder Care" in your application for an immediate discount.

Senior Concierge Service (Denver, CO) Providing the non-medical care and support you would provide for your loved one if your schedule or location permitted.

Senior Corps' Senior Companions Program Helps adults who need assistance to live independently in their own homes. Senior Companions assist their clients by providing companionship and friendship to isolated frail seniors, assisting with simple chores, providing transportation, and adding richness to their lives.

Smile & Love, Inc (Cook County, IL) A non-medical, in-home care company for seniors. To ensure the safety of our clients and integrity of our company all of our caregivers are trained and thoroughly screened. All of our caregivers are covered under Liability Insurance and Workers' Compensation. Payment: Long Term Care Insurance (LTCI), Private Payments.

Visiting Nurse Associations of America Visiting Nurse agencies provide skilled nursing care and rehabilitation therapy services that are covered by Medicare. They usually don't provide personal care and homemaker services