Most, but not all, states require licensing for home care agencies. Licensure usually means that criminal checks will be done on employees and that staff members must be qualified according to state regulations. For example, if someone is doing nursing care, they must have a nursing license or certificate.

Many do, although the cost for care during non-traditional working hours may be higher.

The activities of daily living, or ADLs, are a way to determine what level of help you need from a caregiver. They include:
<ul>
 <li aria-level="1">Toileting and toilet hygiene</li>
 <li aria-level="1">Bathing and personal grooming of body and hair</li>
 <li aria-level="1">Dressing and undressing</li>
 <li aria-level="1">Cooking and eating regular meals</li>
 <li aria-level="1">Having the mobility to get around your home</li>
 <li aria-level="1">Being able to move yourself from one spot to another, such as from a bed to a chair or wheelchair, if necessary</li>
</ul>

Home caregivers may provide a broad range of services related to medical needs as well as ADLs (activities of daily living). Medical help may be in the form of assisting with physical or occupational therapy, planning and taking medications, and skilled nursing.

If you or your loved one is unable to manage most of the ADLs, or needs round-the-clock nursing care, a nursing home may be a better fit. A doctor can help develop a plan of support that addresses concerns realistically, based on what the individual is able to accomplish and what help is needed.

You should be able to talk to the agency to have another caregiver assigned to you. But be sure you are not acting prematurely. It takes a while for relationships to develop, and you and your new caregiver need to learn to understand one another and determine how to work well together.

Although you will need to look at your policy documents to ensure that this is the case, most long-term care may be used to pay for a home caregiver. Some policies will even pay for a family member who provides care. This is something you can find out by looking at your documents or calling your insurance agent.

If you are working with an agency-provided caregiver, they will have substitutes who can come to your home when your regular caregiver is absent. If you are working with an independent caregiver, you have the responsibility for lining up substitute care when needed.

In terms of whether they will help pay for your care, the answer is probably no, since most home health care agencies are for-profit businesses. But they may have people on staff who are familiar with federal and state programs that can help pay for your care, as well as experts on Medicare, Medicaid, and Veterans Administrations benefits who can assist you in finding financial support.

Almost all agencies will give you a written care plan. This should include details about the tasks that the caregiver will undertake for you, details about any medical equipment or procedures they will handle, and their general responsibilities. You should also receive a document called the patient’s bill of rights, which will list the responsibilities and rights of your caregiver, the agency, and yourself throughout the relationship.

St. Louis, MO

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