When is it time to hire a home caregiver for your parent?

“As aging parents, particularly those who live alone, face medical and mobility issues, questions relating to their physical, social and psychological well-being arise,” explained Molly Miceli, BA, RN who is the founder and CEO of LifeStyle Options, based in Schaumburg.

“Adult children should be aware of any changes in their parents' attitudes or behavior — changes which are often undetectable over the telephone. There are, however, clear warning signs that some type of intervention is needed,” she continued.

For instance, mail and bills may be left to pile up because the simple act of opening and filing mail becomes overwhelming. Managing a checking account can also be too much for them to handle.

Another indicator is a suddenly cluttered or unkempt house and uneaten or spoiled food left in the refrigerator. All of that housekeeping becomes too much, too.

According to Miceli, if the parent wears the same clothing over and over again and has developed other personal hygiene issues, that can be another sign. Doing laundry may have become too physically challenging or if the machines are in the basement, they may be afraid of falling. Similarly, they may be worried about falling in the tub or shower.

Signs of memory loss may also appear like scorched pots and pans (from leaving them on the stove too long), missed doctor appointments, forgetting to take medication and inappropriate clothing, speech or behavior (like not dressing correctly for the weather) can appear

Finally, depression, often caused by isolation, can lead to feelings of hopelessness or despair, a lack of interest in activities they once found enjoyable, listlessness, crying or even repeated phone calls to friends and relatives at odd hours, Miceli said.

Once it is time for the adult child or other family member to step in, a decision needs to be made about the next step. The options generally fall into one of two categories: sell the home and move the loved one in to a senior living community of some kind or retain a licensed caregiver to live in the home with the senior.

If the senior family member is very attached to their home and the memories contained there or if they are suffering early to mid stages of dementia and an unfamiliar environment could be too disruptive, then home care might be the best choice.

Home care offers one-on-one care of the senior by a trusted companion who learns his or her food and other preferences; can tell if the senior has had a good night's sleep; and is able to form a deep bond with them. One-on-one care generally doesn't

happen in assisted living or nursing home environments where caregivers come and go in shifts and care for many patients.

Offering seniors the chance to stay at home to receive care is also less disruptive to their lives. They are not saying goodbye to years of memories like they must do when they move to a senior care community.

“Each home care situation is unique,” Miceli said. “In the beginning, family or friends step in to help with simple tasks and support for individuals who want to stay in their homes. But as long-term care needs progress, more time is often required to manage those needs, especially when physical and mental conditions make usually routine hygiene and daily living activities difficult.”

“Even with the healthiest of seniors, the ability to drive a car, shop for groceries or do general housekeeping eventually needs to be relinquished to another person,” Miceli added.

If, after weighing your options, it is decided that home care is the correct option for your loved one and family, then you need to carefully evaluate the various companies.

“Before starting your search for a home care company, decide what the care needs are and how much time each week will be required. You may want to consult with your loved one's physician and other family members, as well as an experienced social worker. Most home care companies will also do an assessment at no charge,” she explained.

According to the Home Care Association of America, you should make sure that you get certain questions answered. How long has this provider been serving the community? Does this provider supply literature explaining its services, fee, eligibility requirements and funding sources?

You should also ask, how does the provider select and train its employees? Do they run background checks, reference checks, driving record checks and drug screenings? Do they require CPR certification? Are the caregivers insured and bonded?

Furthermore, is the company licensed? Do they provide supervisors to oversee the caregivers and how often do they visit the home? What happens in the event of an emergency? What are the company's financial procedures?

For more information on home health care agencies, visit www.hcaoa.org.