Non-Medical Respite/Sitter/Companion Services (Respite hereafter) can offer engagement & activity, companionship, light housekeeping, meal preparation, bathing, shopping, and more, usually in 4-hour minimum blocks. The exact services and what they mean are decided by each agency/provider.
How is it paid for?
These are traditionally considered “self-pay” services (not covered by insurances), however, some Medicare Advantage plans (optional Medicare Part C) do have this as a benefit. Some “Long-term care” policies may also have this as a covered expense for a period of time. If you use these services as a benefit with insurance, it is likely that the insurance company has a contract with one or more agencies that must be used. Most states have a “Medicaid Waiver” program whereby a client meeting strict financial and medical requirements may receive an allowance for in-home care. Program services and eligibility requirements vary from state to state, may have a long waiting list, and are fraught with many hoops to clear.
Who is available for hire?
When a family is paying out of pocket, they can hire whoever they want. There are licensed and bonded agencies that screen, hire, train, and manage professional caregivers/sitters and then schedule them to go to your home. There are also independent or “private duty” caregivers/sitters who have the training and experience but who can be hired directly by a family through word of mouth. I’ve also heard of nursing students working with families; the students usually have flexible schedules, have had background checks for school admission, have knowledge from school and perhaps other jobs, and are generally very caring. You may ask to interview the caregiver that the agency would have in mind if you are considering that agency. A male client may only be comfortable with a male caregiver; now is the time to discuss.
What model is best?
There are pros and cons to both the agency and private duty models. Agencies offer the benefit of a background check, ongoing training, insurance, and a backup if the scheduled professional caregiver is ill and cannot go into work. The private duty sitter may cost less and may not have a 4-hour minimum. As with all of these service providers and options, do your homework, supervise and hold any worker accountable.
Considerations.
As with anything, there is no perfect solution. You want to hope that you can trust but remain vigilant. Get things in writing; know what duties and behaviors are expected and not expected. For example, what are the expectations of the caregiver when the client (your loved one) is sleeping-is that the time to do laundry, housekeeping, or watching tv/smartphone? Understand the circumstances of filing a complaint/grievance (with an agency) and when it may be time to find a new agency or private caregiver. Know the tax consequences of hiring an agency compared to a private duty (who may ask for cash payments). Consider that the agency may have a shortage of staff or the one you like may leave. These are risks when seeking outside help.
So where does our faith come in?
While non-medical services in the home can be very helpful and could (not always) prevent or delay placement outside of the home, it is not without additional stressors. Additionally, a family (non-paid) caregiver may still have feelings of burden and anxiety. Pray for patience, good judgment, strength, and other blessings as you pursue in-home assistance.
“Pray as though everything depended on God. Work as though everything depended on you.”
St. Augustine
Future topics in this series.
- Lawn/Housekeeping Service; Home Modification/Safety
- Exercise Coach
- Music Therapy
- Pet Therapy
- Medical “Home Health”
- Physical Therapy
- Occupational Therapy
- Palliative Care/Hospice
Question to think, write, and share here as a comment…What would you like to add? What advice do you have? Please comment.
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