Archive for the 'Home Health Information' Category

Live-in Home Health Care in NJ

Friday, June 26th, 2009

Is Live-in care something that could benefit your parents? Live in senior care puts a caregiver in the home of the senior to provide 24 hour in home care services. It is the most cost effective way to provide care if you require more than 9 hours of care each day. The caregiver can work a few hours here and a few hours there, basically when you need it. The great part is that they are always there.

You are required to provide room and board on top of their pay and they do need to have time to sleep as well as time for themselves. Live-in home healthcare can be a great alternative to a nursing home for seniors who need extra supervision.

Are Free Senior Care Referrals a Good Deal?

Tuesday, June 9th, 2009

There are several companies out there who advertise free referrals for senior care services. These include home health care, assisted living, Alzheimer’s care, nursing homes and more. While this can be an excellent service when done by the right person, there are a few things you need to look out for. One is whether the company does any kind of review or follow-up on the services they are referring. Many times they will refer any company who pays to have their service advertised.

You also need to be careful of the motivation of the referral source. Often times, a referral source will make a recommendation to service based on who is paying them the best for each referral. Make sure you are careful that your parents are getting the best service for them, and not what is best for the referral source.

Snow Birds Returning

Tuesday, April 1st, 2008

As many seniors return from their winter migration to a warmer area of the country, they may need to reassess their needs. For some, there may have been a decline in their health since they were last in their home. Things to consider include:
• Any changes or adaptations to their house to help them with new limitations.
• Considering hiring home hare services. While they may not have been necessary in the past, some additional help around the house can make a huge difference in the quality of life for a senior.
• It may be time to consider downsizing to a smaller home or assisted living facility.

Not only should the senior themselves be aware of changes, but their children should also be aware. Ask your parent if there have been any changes since they were last in their home and make plans prior to them coming up.

If they are using home health care services in their winter home, have the agency they are currently getting service from communicate with the agency they will be using. If you do not have an agency already, they may be able to refer you to one.

Is it important for home health care workers to be bonded?

Wednesday, March 12th, 2008

Depending on who you ask, you may get different answers. Most consumers are told to ask if the people who are working for a home health care agency are bonded, however they have no idea what that actually means. Bonding means that if a person steals from you while working in your home, the bond will re-pay you for what ever is stolen.

There are several problems that consumers need to be aware of. First of all, in order for the bond to actually pay for damages, a person must be convicted of theft. That means the home owner must be willing to press charges and have the accused thief arrested. Many seniors are reluctant to do this as they are afraid of the repercussions.

It is often hard to prove that a person has stolen anything unless you actually catch them in the act.

Consumers need to see how much the bond that an agency purchases covers. Some bonds may only be for a few thousand dollars and not large enough to cover a major theft.

The best thing for consumers is to work with a reputable agency that does a very thorough screening. While there is no guarantee that even the most stringent screening process produces 100% honest people, it is certainly better than using a service that has a loose screening system. As the old saying goes “an ounce of prevention is worth a pound of cure”

Obviously hiring a person who is bonded does add an additional layer of security, but choosing a reputable service that has proven experience in screening candidates is the best insurance you can get.

Home Health Care - Staying Well When You Are The Caregiver

Wednesday, February 13th, 2008

I can always tell when an overstressed caregiver calls looking to arrange home health care services for their loved one. They are so stressed out that you can hear it in their voice. As they begin to tell you about their situation, you can hear the tears welling up inside. This is such a difficult situation, but there are things you can do to try and prevent it from getting to that point.

1) Seek help, either from professionals such as geriatric care managers, home health agencies, adult day care or any other service or seek help from family and friends. Don’t be ashamed to ask for it and when it is offered, do not be too proud to accept it. The county Office On Aging often offers free respite programs and advice.
2) Exercise regularly by walking, riding a bike or doing mind body exercises such as tai chi, yoga or Qi gong.
3) Eat well, you will feel better and have more energy.
4) Get enough rest and sleep

Most importantly, think of yourself and NEVER feel guilty for getting getting help or taking the time needed for yourself.

Home Health Care- Which Model is Right For You?

Tuesday, November 20th, 2007

Home Health Care agencies can basically be broken down into two different models, the registry model and the employee based model. Both types can offer the services of nurses (RN’s, LPN’s), home health aides (HHA’s)/certified nurses aides (CNA’s), companions and other services such as physical therapy (PT) and occupational therapy (OT) The question for many consumers, what is the difference and which type is right for them.

Nurses registries have been around since the civil war. In this model, an agency does all of the background work, such as interviews, criminal background checks, reference checks and any other checks they feel necessary. Once a candidate has been approved, the registry will refer them to the person in need. The caregiver is considered an independent contractor by the agency and not supervised directly by the agency. This is also called the consumer directed model as the consumer is the person in charge.

With the employee based model, the agency does a similar type of screening, however, instead of referring the caregiver to the consumer, the agency employs them.

Each model has its’ pros and cons.

Pros of the registry model include

  • Cost of the service is generally lower than agency model.
  • Caregivers usually earn more, which tend to attract a higher quality of caregiver.
  • Consumer is in total control. They decide what gets done, when it gets done and how it gets done. They decide if the caregiver stay on the job or needs to be replaced.

Cons of the registry model include:

  • Person is not supervised by agency nurse.
  • Caregiver is not covered by WC insurance.
  • Family may be the employer and need to take out payroll taxes.

Pros of the agency model include:

  • Caregivers are covered by workers comp and bonded by the agency.
  • Caregivers are supervised by agency nurse.
  • Agency is alway the employer and deducts all appropriate taxes.

Cons of the agency model include:

  • Cost tends to be higher.
  • Caregivers do not earn as much as those on the registry side.
  • Agency has control over when and where caregiver performs their duty. Agency can pull a caregiver if they need that person for a different case.

You will find supporters for both sides. It is up to you to decide which type of business is right for you.

To learn more about nurses registries, go to

To learn more about employee based agencies, go to

What to Look For When Choosing Home Health Care

Friday, November 2nd, 2007


A Care Manager’s View of Home Care did an interview with professional care manager Liz Salston, LSW to find out what a professional care manager looks for in a home care agency.


CG -What do you, as a care manager, look for in a home care agency?

LS - I look for an agency that offers a comprehensive service, not just companionship. I want the client to be able to have medication assistance and hands on care from a home health aide should they need it. I also look for supervision from an RN.


Other things I look for include having consistency in terms of coverage, and a good relationship with the care manager, which includes feed back and quick responses to phone calls. Lastly, I want to see that an agency does a good job of screening the home and the client’s needs in order to help make the right match with a caregiver.


CG - What problems do you most often encounter?

LS - I have had some issues with the professionalism of agencies when communicating information about their clients. On a broader scale, making good matches between the client and caregiver is a big problem. Agencies often fall short when taking all of the facts about a client in to account. They need to look at more than just the physical condition and consider things such as the client’s interests, quirks and personality. They also need to consider the caregiver’s needs. For example, an agency should be careful not to send a person with allergies into a house with pets they are allergic to.


Response time when filling cases, especially for call outs and emergency fill-ins tends to be another problem. An agency should be staffed well enough that it does not have gaps in coverage.


CG - What questions should a family ask when speaking with an agency and trying to make a choice?

LS - People searching for care should ask the agency…

What happens if it is not a good match?

How quickly can you make a change if it is needed?

Do you have enough coverage if a person calls out?


CG - How long does it usually take to get service started?

LS - A good agency should be able to get a new case started within 48 hours. Sometimes they have to start with a temp until they can secure more permanent placement.


CG - What are the most difficult cases to fill?

LS – I find cases that are short term, less than two weeks, can be a challenge to get filled. It takes just as much work and costs the agency just as much to staff one of these cases as it does for a long term case. The agencies are just not as motivated. What they fail to recognize is that is that short term placements often result in long term cases over time. Agencies need to take this possibility into account.


Other cases I find hard to get staffed are when there is a racial bias. Unfortunately it is out there. I attempt to teach my clients and their families’ lessons in tolerance and acceptance when engaging home care services. Clients need to understand that the majority of workers in this field come from minority groups and that their priority should be the quality of care provided. Personal biases need to be put aside and relationship building will occur over time if given a chance.



Liz Salston is a social worker with 22 years of experience in the field of services for older adults. She has served as Director of Recreation and Social Services at the Martin and Edith Stein Assisted Living Residence and as a social worker at the Central New Jersey Jewish Home for the Aged in Somerset. She has run several socialization and respite groups at the Jewish Family Service of Southern Middlesex County and has worked as a social worker in HUD senior housing.

Liz holds dual Bachelor of Arts degrees in Sociology and Judaic Studies, a Master of Social Work, as well as a Master of Arts in Contemporary Jewish History.


She is a licensed social worker in the state of New Jersey, a member of the National Association of Professional Geriatric Care Managers, Inc., and the National Association of Social Workers.


You may reach Liz at (732) 238-1775

Interview With Care Manager Mark Zilberman about Home Health Care

Thursday, October 11th, 2007

A care managers view of home care did an interview with professional care manager Mark Zilberman, LCSW to find out what a professional care manager looks for in a home care agency.


CG What do you, as a care manager, look for in a home care agency?

MZ As a care manager, the main thing I look for is service. The caregivers don’t seem to be very different from one agency to another except that certain registries pay better and can attract a slightly higher caliber of person. What does differ is the service I receive. I look for an agency that will work with me, be responsive to my requests and questions. I also look for how well an agency handles problems when they occur. Can they fill in with replacements quickly and can they solve the problems when they come up?


CG What problems do you most often encounter?

MZ The biggest problem I find is that the aide who is sent to a case is not well matched to the client in need of care. When an agency makes a good match, the cases work out much better. Unfortunately, many agencies are very busy and do not have a huge selection of people to try and make the perfect match. They do their best but have to work with who they have available at that particular time. Often, the need for a home attendant is initiated during a crisis. Therefore, the agencies must act quickly.


CG What differences do you see between agencies?

MZ The main distinction I find is agency or registry. The agency employs workers directly while the registry uses independent contractors who work for the client. I tend to lean towards the agency model. I find that there can be advantages with registries, such as lower costs, but the family needs to understand potential problems. I explain how they work and let the family decide which way they want to go.


CG What questions should a family ask when speaking with an agency and trying to make a choice?

MZ Families should ask about after hours coverage, how quickly does the agency get back to them, do they offer medication management, how often is billing done and what the costs are to name just a few.

CG How long does it usually take to get service started?

MZ I have found that is usually takes just a few days to get service started. Companies that use my assessment as a professional care manager are able to get the case started faster than companies who need to do their own.


CG What are the most difficult cases to fill?

MZ Filling a case for a person who smokes tends to be harder to staff. Many caregivers just do not want to sit in a smoky room all day. Cases involving mental illness and behavioral issues can also be a challenge.


CG What role would a care manager play if a family is looking for an agency?

MZ Family’s will probably get better service working with a care manager that has relationships with an agency or agencies. There’s a familiarity with staff that can really help. Obviously, an agency or registry has a greater need to serve a care manager as that CM can be or is a conduit to many other cases.

Mark Zilberman, LCSW, has been working in geriatric care management for almost six years. He brings diverse experience to the field, having worked and studied in the specializations of substance abuse, mental health, developmental disabilities, and homelessness. As Founder of NorthStar Care and Guidance, he and his organization are called upon to manage a spectrum of issues for families. Zilberman was previously affiliated with SeniorBridge, Inc., Beth Israel Medical Center, and The Floating Hospital.
He received his MSW from SUNY at Stony Brook. A licensed clinical social worker in NY and NJ, Zilberman holds credentials in substance abuse counseling from both states. Mark is a member of the National Association of Geriatric Care Management.

You may reach Zilberman at, 888-288-6152

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