Knowing Your Long Term Care Options

We’re an aging population and the statistics are eye-opening, to say the least: 77 million Baby Boomers, 10,000 are reaching retirement age each day, and about 45% of them have zero retirement savings to support them in older age.  This may be the primary reason that nearly 82% of them support increased taxes to shore up social security benefits. 

Americans are living longer and this is
no exception for Baby Boomers.  Epidemiological
evidence suggests that this generation will have a life expectancy of 82 years.  But longevity does not necessarily correlate
with well-being as a significant number of older adults find that age brings
physical, emotional, and cognitive impairments that interrupt their ability to
live independently.

Elderly and Alzheimer’s Care

Planning for future health challenges is
understandably depressing because many of us are in denial that we’re aging at
all.  I frequently hear from clients that
their personalities are timeless.  The
lens through which we perceive our health challenges may be clouded by emotions
– feeling able and ready to meet any test. 
Yet, some challenges aren’t meant to be faced alone and despite our
resistance to considering ourselves as needing help, we may not have an

Planning for your long-term care now or
sometime in the future requires knowledge. 
I could write several columns on the subject of senior care options and
will discuss assisted living options in two weeks but for now the focus is on
remaining in the comfort of your own home. 

Non-medical home care is basically
hiring a personal aide to assist you with performing activities of daily
living.  What does that look like in the
real world?  Anything from medication
reminders, transportation, and meal preparation to toileting, bathing,
dressing, and grooming.  Please note,
this is not in any way a comprehensive list of services provided by hired

Choosing an In-Home Senior Care Organization

Choosing a home care organization can be overwhelming.  You’ll have dozens of companies to choose from (Disclaimer: my family owns Always Best Care South Bay/West LA) and knowing what to look for can be confusing.  So what criteria can you use to help you make your decision?

The single most important criteria when choosing
a home care organization is determining whether or not the company is licensed.  In 2016, California lawmakers passed the Home
Care Consumer Protection Act, which effectively regulated home care in the state.  New regulations require licensed Home Care Organizations
(HCOs) to:

  1. Hire caregivers registered as Home Care Aides with the Department of
    Social Services.
  2. Aides must pass an FBI fingerprint background check, be free from
    tuberculosis, and receive 3 hours of structured training prior to placement in
    the field.
  3. HCOs are required to employ affiliated home care aides and abide by
    all federal and state payroll and employment laws. 
  4. Home care aides are required to be bonded and insured up to $1
    million per occurrence.
  5. HCOs are required to provide their aides with 5 hours of annual
    continuing education.  

When shopping for a home care agency,
first ask for their HCO number.  If they
have one, they’re legally mandated to adhere to aforementioned
regulations.  You may also inquire about
how they train their staff (in person or online); who supervises their staff in
the field (degreed/licensed/certified healthcare professionals or lay folk);
how long has the company been in business and have they received recognition
for their service; and obviously what are the costs associated with care.
Median rates for HCOs in the South Bay is between $23 and $28 per hour. Rates
are generally determined by the level of care required and the city the client
lives (The city of Los Angeles has a higher minimum wage).  For a comprehensive list of questions to help
you make a home care decision, visit

In-Home Senior Care Organizations Vs. Caregiver Registries

If you’re quoted below the $20/hour
range, more than likely, the company is classified as a caregiver
registry.  Caregiver registries are
unlicensed and unregulated organizations that provide consumers access to a
pool of independent caregivers who contract their services.  Caregivers are not required to be registered
with the Department of Social Services and registries are not required to
provide insurance coverage to their pool of contractors.  Liability is the responsibility of the contracting
party – that would be you! 

What’s the benefit of working with a
caregiver registry vs. hiring a caregiver privately? If your contracted
caregiver happens to call out sick or isn’t the best personality fit or skill
match, you can call the registry and they do the leg work of finding a
replacement; though, probably not immediately. 
Alternatively, if you hire a caregiver privately, you wouldn’t
necessarily have easy access to a pool of available and hopefully vetted

In Home Care | Always Best Care

Of course, there’s always word-of-mouth and private hire caregivers can be contracted to provide non-medical in-home care.  I recently asked one of our home health aides, who also rendezvous as a private caregiver, what the going private rate is.  He reported somewhere in the $15/hour range.  Compared to the median rates of HCOs, this sounds like a deal.  But remember, if the contracted caregiver is hurt while providing care in the home, you will likely be liable for that injury. 

If you intend to contract private
caregivers through a registry or on your own, here’s my advice: make sure that
your home owner’s or renter’s insurance policy covers contractors in the home
and determine your coverage amount.  Many
years ago, one of our caregivers was bitten by a Brown Recluse spider during
her shift in Palos Verdes.  She required
three surgeries and was later classified as permanently disabled.  Don’t leave yourself at risk of a
lawsuit.  Make sure you’re covered if you
go the private route. 

Lastly, and maybe most importantly, non-medical home care is generally paid for out-of-pocket. Clients who qualify for Medi-Cal have some options through a program call-in Home Support Services (IHSS) but for the most part, custodial home care is paid by the client.  Individuals who purchased long-term care insurance may also have a benefit for home care.  Bottom line: the long term costs of home care are exorbitant but worth it for some of you! 

For more information on non-medical
in-home care options, feel free to send me an email.  I’m happy to forward you information that may
help in your decision making process.  You
can also visit our website
and take a quiz to determine your readiness for home care.

Wishing you all the best in life and love, today and tomorrow.

Contact Always Best Care today for More Information.