Q. I’m writing as a husband, caregiver, and someone who’s starting to realize that I can’t keep doing it all on my own.
My wife was diagnosed with early-stage dementia last year. For now, we’re managing okay, but the days are getting more complicated. I’m still able to care for her, but I can feel the weight of it building. I’m 76, and while I’m in decent health, I know that I need to be realistic about what I can do on my own.
Our kids live out of state and are as supportive as they can be from afar, but I’ve come to the point where I’m thinking about bringing in some in-home help. The idea is a little overwhelming. There are so many options, and I don’t even know what I should be asking or looking for. I want someone who can support my wife with grace and dignity, and also give me a little breathing room to take care of myself without guilt or worry.
What kinds of questions should I be asking when I start looking into home care services? Are there red flags I should watch for?
A. Thank you for your honest and heartfelt letter. You’re doing something incredibly brave by recognizing your limits and seeking support before reaching a crisis point. Here are some key things to consider as you begin your search for in-home care:
Start by asking about their experience and training. Do the caregivers that the agency provides have a lot of experience with dementia care? What kind of training do the caregivers receive, and is it ongoing? Are the caregivers familiar with managing confusion, wandering, or sundowning behaviors? Look for a company that understands the emotional and behavioral shifts that come with memory loss and not just the physical needs.
Get to know how the company operates. Will you have the same caregiver regularly, or will different people rotate? What happens when the regular caregiver is sick or unavailable? Consistency is especially important for someone with dementia, who may struggle with change or unfamiliar faces.
Next, ask about the scope of services. What exactly will the caregiver do? Do they help with bathing, dressing, meal prep, light housekeeping, medication reminders, and companionship? Can they assist with transportation and mobility or transfers if needed in the future? You want a company that can accommodate your wife’s needs, as well as any of your own.
It’s also a great idea to ask about supervision and oversight. Is there a care manager or supervisor who checks in regularly? How does the company handle concerns or issues if something isn’t working out?
Finally, ask about logistics, compatibility, and costs. Can you meet or interview the caregiver before services begin? How are caregivers matched to clients? What are the rates and what’s included? Do you accept long-term care insurance or other benefits, like VA assistance or Medicaid waivers? What’s the cancellation policy?
Red flags to watch for include high staff turnover or lack of references, vague answers about training or supervision, poor communication during the inquiry process, and a rushed or impersonal approach to care.
You don’t have to walk this road alone, and you shouldn’t. The care you give your wife is already an incredible act of love. Asking for help is just another way of showing how deeply you care for her, and for your ability to keep going.
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