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Hi all -
My 90 year old mother has been living with my brother in her home for the past 5 years and has been her primary caregiver, with me staying at her house 2 nights and 4 days a week to give him a break and allow him to leave the house. She had a stroke 5 years ago and has been slowly declining since then. It has reached a point where she needs almost constant supervision due to mobility issues and fecal incontinence. My brother has become very burned out so the plan is for her to move to my home 1 hour away. I am willing to take on this responsibility but I won't be able to do it without someone to help me.


I am just starting the process of trying to find a reliable and good agency in my area and don't really know how to go about choosing one. I spoke to a person at one agency today and it seemed to be more of a family operation - his wife is the nurse that does the initial assessment and his sister is the supervisor of the caregivers. He was very nice and helpful but I didn't really know what questions to ask. Should I ask if the agency is accredited, or if the caregivers have special training?


Someone also mentioned hiring a geriatric social worker agency to supervise home health care. has anyone had any experience with this?


Thanks in advance for any advice you can offer me. I'm heading into unchartered waters (again) and not sure how to go about this process of finding a good health care agency.

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Thank you SO much for all of your helpful responses. I am going to print them out so that I can refer to each of them. Gardenartist, you have provided exactly the questions I was looking for, thank you. You also made a great point about the geriatric social worker. I feel I have a better handle on this now, thank you all.
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In the process of hiring a company for another issue, I'm refining my basic list of questions.

1. Insurance - how much, and will they provide me with a certificate of coverage? If not, their name gets checked off the list. I want to verify they have coverage, and how much. Simply telling me they have it isn't sufficient.

2. How are the employees found, selected, vetted and hired? What kind of background checks are run? How long have the employees who might be caring for your mother been with the agency?

3. What I'm now doing is developing scenarios and ask how they would be handled. E.g., what would they consider an emergency and would they first contact you or call 911? How do they handle an ill employee who is unable to come to work her/his shift? What would they consider grounds for their termination of the contract, and how would they handle such a problem? Alternately, what would they consider grounds for your termination of the contract and how would it be handled?

You can develop scenarios that might happen based on your mother's specific medical conditions.

You might also want to establish, with a list of possible situations, how you want certain situations handled, such as a fall. It might be that a worker has been trained to try to pick someone up, or perhaps would immediately call 911. Go over and establish ground rules to minimize miscommunication later.

I've never worked with a geriatric social worker, but am of the opinion that it's best to keep contractual relations between the family and the agency. Involving someone else who's not in the chain of command could interfere with communication, handling of emergencies, etc. I like to keep things as simple as possible - caregiving is complicated enough.

Over the years, other posters have complained about how an agency employed handled a particular issue, and it's been clear that some families hired agencies without establishing ground rules or criteria for handling emergencies. I would do that up front so there aren't any surprises.
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The way I found the caregiver Agency that I use for my Dad, the last time Dad was in the hospital the Case Manager at the hospital gave me a list of different agencies to call, but she had highlight 3 that were located in my immediate area.

I called one company, left a message as it was after hours, and hours later didn't hear back.... so I went onto the the next name on the list and viewed their website and filled out a contact card, and within 10 minutes I got a call. To me that was important as to how quickly a company would respond.

Make sure an Agency is licensed, bonded, insured, and has workman's comp for their employees. A sales rep came out to my parents house, took down information, gave me ideas on how to elder proof the house, asked about my Dad likes and dislikes, any special food he liked or food he shouldn't be eating, etc.

The agency sent out employees for the different shifts, and eventually I was able to narrow down the employees that were a good fit for my Dad. Six months later, Dad still has these same employees :)
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Jayne, there is a lot written on this subject. See this website (blue box - find housing and care). AARP website also has info on this topic. Since you have been actively involved in your Mom's care, you should have a good idea of what is needed. But, I would start by making a list of your Mom's needs and your expectations. Are you looking for live-in help or someone to come each day?
Websites that help you locate in home help often have a list of questions you should ask included on their websites. Check them out. Ask around -- neighbors and friends have already gone through this and can give you their personal experiences.
You may find a great agency but the particular helper may not gel with you or your Mom. Be prepared to make changes.
AND, I always recommend --- clear the house of anything valuable. Or lock it up. Jewelry, financial statements, personal data, tax records, etc. By clearing the house of this, you eliminate the need to be suspicious when things get lost. Seniors can put things in the strangest places and they aren't located for a while. If you have things around, the first thought is that the new comers has the item. Not fair to them and a worry for you.
You live in an area that has many services and should have no problem finding help. Good luck
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