Services at Home

The reason why I chose the title of my blog Writing&More is because it will give me an opportunity to discuss subjects from my earlier professional life as a Health Care Administrator and Business Owner. And healthcare is a topic that affects everyone, including us writers.

If you have ever been told you are from the “sandwich generation” then you are or will be facing many challenges when it comes to having a balanced life. When I started to write part-time, not even in my wildest dreams did I ever imagine the complexity, effort and persistence that it takes to become a professional writer. Well, take that effort and multiply it by ten and you have arrived to the “Sandwich Generation”, those who care for their young children and their elderly parents. All is well and then, you’re parent’s need more help, one you can’t provide on an ongoing basis either because of time, money or the demands of your young children. Your heart is in the right place but the logistics are close to impossible.

In my experience, as a past owner of a home health agency, I received many calls from “Sandwichers” at a very late stage, with very little time to spare, forcing the family into crises mode. As a writer, your parents’ sudden change in health can change your life and perhaps force you to place your dreams on hold for a long time. So, if you and your elder parents are in a good place in your lives, consider the following steps as you prepare for the inevitable journey into aging:


Evaluate getting a Long-Term Care Insurance policy. I was lucky enough to get one for my mother at age 65 and now, at age 82 afflicted with some dementia and other physical ailments, I am able to financially support a certified nursing assistant every day of the week. It was expensive, but looking back, it was worth it, especially when I also got a Ryder (addendum to the policy) not to pay the premium if she became disabled. Nowadays, policies like my mom’s rarely exist or be very expensive. The market has changed considerably. And now, know, at least as of today, Medicare does not cover for personal care. So if your parents need help with any of the activities of daily living (ADLs) such as bathing, eating, dressing, walking, and other, you are on your own unless you pay privately for those services.


Conduct National Background Checks on any Assistants you hire for your Parents. If you decide you can’t afford a Home Health Agency or Registry (later explained) and decide to hire a private person, you should investigate their background. At the time that I owned my agency in Florida, one of the stricter States in policies that protect the elders, they required a State background check. Not too thrilled with the idea, I expanded my search to include the other States. To my surprise, I had a few cases where the State had approved the home health aides yet they had criminal cases in other states. It’s worth the investment even if the person is a referral by a friend or family member. Also, you can do random drug checking. There are inexpensive saliva kits that you can use. If you plan to use a kit, make sure you get the home health aide to sign a documents releasing you from any liability in performing these tests.


If you decide to hire professional help, learn to distinguish a Nurse Registry from a Home Health Agency. IT IS NOT THE SAME. A Registry is more like a temporary employment agency with some perks; they will conduct the criminal background but in many cases they will not cover for worker’s compensation or liability insurance. If a worker gets injured in your home, and they may hold you liable, your home liability insurance will be your best bet to help you cover for medical expenses. However, you need to confirm this because in some cases they may need you to add an umbrella (additional coverage). Also, a Registry verifies that the home health aide carries their own liability insurance with low limits of coverage. Many Registries do not have good systems in place to verify that the home health aide’s liability insurance is valid so there is always a chance that your parents will not be compensated for any damages should the aide be responsible and their liability insurance has expired. The Home Health Agency must cover both, worker’s compensation and liability insurance, with higher limits of coverage.

In many Registries, the home health aides don’t report to a nurse. A nurse will develop a plan for care for your parents and the aide must follow it. In an agency, a Home health aide reports directly to a Nurse and the Nurse makes sure the plan is being adhered to or updated, when necessary.

    An Aide is not an aide, is not an aide. A home Health aide has an estimated 40 to 80 hours of education while a certified nursing aide has as much as 120 hours of education. There are some functions a Home Health Aide cannot perform; i.e. taking blood pressure readings.


Registries are not typically required to be accredited by recognized accreditation companies. However, in many states, Home Health Agencies are required to be accredited by thirty party agencies, forcing the agencies to adhere to stricter guidelines and protocol.


So why then not go with a Home Health Agency versus a Registry? Price. A Home Health Agency can be between $5 to $7 more per hour.


Familiarize yourself with programs that are geared to protect the elders in your state. If you use a Registry or Home Health Agency, they are required by law to give you pamphlets that would include information about governmental help and elder agencies. In Florida, all you have to do is dial 211 for Community Services. Other States most likely have similar programs that can help you with community services from A to Z for the elderly and others in need of help.


Veteran Aid and Attendance Program. This is a program rarely known to the public and not used to its potential. To qualify , if your parent is a veteran and has been in active duty for 90 days and one day beginning or ending during a period of war, Then he or she and their spouse maybe eligible for the Veteran’s Aide and Attendance program.  There are other eligibility requirements like assets needing to be below $80,000 excluding your primary home and vehicles, etc. If your parent’s or elder relatives qualify, they can receive up to $1500 per month to spend on services related to activities of daily living. However, it can take 5 to 9 months to process the paper work, especially when you do it on your own. The Veterans Administration does have select locations that help in completing this paperwork.

The time to prepare is the time before crises. If you are a “Sandwicher” and do not have a plan in place, start one soon. If you would like more information, please feel free contact me


Wishing all of you a very Happy Holiday!