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“My parent needs help…and I don’t know what to do!”

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You may recall a vintage TV commercial in which an older woman, laying on the floor next to her walker, cries out, “Help! I’ve fallen and I can’t get up!” While the ad for a medical alert pendant became a humorous catchphrase, it also saved lives.

As the number of people in their 80s, 90s, and beyond continues to spiral upward, such smart health devices are becoming increasingly important.

But what if a senior’s children or other family members have no idea where to turn for help when their elder loved one is suddenly in need — well beyond what a medical alert can provide?

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A Plethora of Resources…If You Know How to Find Them

reverse mortgage newsOver the past few weeks, two women posted pleas to a women’s networking group I belong to, asking other group members how best to assist their injured mothers, each of whom is in her nineties.

In the first instance, the daughter wrote, “Help! I’m going crazy…My 95-year old mother fell and broke her hip and it has turned my life upside-down. I’m stressed to the breaking point.

“I really need someone to consult with who will also let me cry on her shoulder about all the issues I’m dealing with. It doesn’t matter too much where they live, as much of it may be by phone anyway.

“I’d like to have a support group for me and others caring for an aging (dying?) parent…but right now I can’t organize it…anyone interested?

“Please send recommendations ASAP. And thanks so much!”

In the second post, titled, “Don’t know what kind of help I need for my mother,” the concerned daughter wrote, “My 93-year old mother just broke her right wrist and is having trouble with basic things like cracking an egg or opening a jar.

“I don’t know what kind of help to get for her. She lives alone and is competent to do so when she has both hands available. She is very independent and may resist having someone to help her bathe, etc. Any ideas?”

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Surrounded by Invisible Assistance

What surprised me was that neither daughter had any idea where to start. I emailed each woman with a brief explanation of how to find a care provider, and the difference between using a home care agency and hiring someone directly.

I wondered how many other people might not have a clue where to turn if they have no prior background in the field of aging. We’ve covered the changing face of caregiving and the role of technology in senior health care, but not the basics: how to source the right kind of assistance when — or, ideally, before — someone needs it.

So here’s a primer. Feel free to use, share, and adapt what follows to suit the families and reverse mortgage clients you serve.

Language Matters: Senior Concierge Services

For seniors, a steadfast desire to maintain independence as long as possible is completely understandable; we all want autonomy over our lives.

While women as a group are generally more amenable to help once they recognize they have a need, it’s important for LOs, other senior service professionals, children of elderly parents, concerned friends, etc., to understand the implicit threat to independence that saying “yes” to help represents. It opens a doorway to acknowledging one’s mortality, and this creates fear.

One way to ameliorate resistance is simply semantic. Instead of telling your client, mother, father, in-law, etc. that you’d like to bring in a caregiver or a geriatric care manager, mention a “senior concierge”. This term conjures images of a polished professional at a fine hotel, there to make their stay more pleasant.

In fact, this is what a senior concierge does, in a senior’s home environment rather than at a hotel. And the field is growing. A senior concierge may provide services similar to what home care agencies once called a “home health aide” or “companion”. A concierge offers non-medical assistance such as grocery shopping, meal preparation, transportation to appointments, etc., that may be just what someone like the elder with a broken wrist needs now.

The best way to find a senior concierge service in your area is to search this phrase along with your state, county or city. Here are several senior concierge services a quick search revealed. Note: We are not endorsing any of these providers:

Senior Concierge Service (Cincinnati, OH)

Elder Concierge Services (Denver, CO)

Independent Living Concierge (Los Angeles, CA)

Senior Concierge Providers (South Florida)

When A Senior Needs Home Health Care

Of course, some people, such as the woman who broke her hip, will probably require more direct personal care than a senior concierge provides. This is when a home health agency is likely to be the best next step.

There is a huge range of agencies available, from national service providers to local services based in your community. A home care agency will screen, hire, bond/insure, pay the salary, and replace the employee if necessary. Alternatively, you can hire someone directly via a digital bulletin board such as Craig’s List, or from word-of-mouth referral, but you’ll be responsible for all aspects of hiring, employing, and potentially replacing the caregiver.

A family can also search via the National Association for Home Care & Hospice (NAHC) Agency Locator, a comprehensive database that will pull up information germane to someone’s specific needs and indicate whether the provider is state licensed, Medicare certified, an NAHC member, etc.

FYI: In most cases, ongoing care that doesn’t involve skilled nursing (i.e., “custodial care”) is not covered by Medicare. This is one of the areas in which a reverse mortgage could prove very helpful.

A Shoulder to Cry On

What if the family is committed to managing their loved one’s care on their own, and could use some support from people who understand what they’re going through?

Family Caregiver Alliance is one excellent, virtual support network: the first community-based nonprofit organization to address the needs of families and friends providing long-term care for loved ones at home. As a public voice for caregivers, FCA “shines light on the challenges caregivers face daily and champions their cause through education, services, and advocacy.”

A family can also visit the Health and Human Services website for their city or county, which will list a category such as Aging and Adult Services and may specifically offer caregiver support. At the very least, they should be able to make a knowledgeable referral to a caregiver support group within your community. Your local senior center is also a good point of contact to find a caregiver support group.

In our connected age, there is no reason for anyone to feel isolated and burdened by not knowing how to get help for their elder loved one. Please add your ideas and suggestions in the Comments section below. Thank you!

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10 Comments

  1. One thing we found with my elderly mother-in-law when she was fortunate in finding a thoughtful and caring lady to help her, is that when you pay direct and do not withhold taxes or Social Security, you cannot later claim this as a medical expense on your taxes.

    It was considerably less expensive for her than going through an agency. The final year of her life, she paid about $17,000 for what amounted to full days with her caregiver. That was so much less than a senior living facility and allowed her to continue living in her own home and having a social life with her friends. Of course, proper vetting of the person you want in your home is a must, and family and referrals are important in the process.

    • This is such valuable information, Dick! I’m glad your mother-in-law was able to enjoy her final years at home, with the care she needed.

    • Dick,

      This is what is commonly referred to as practicing outside your field of expertise. I can nothing that supports what you share.

      Please read the IRS position on the obligation for withholding tax information on home care providers paid directly to the care giver at:

      https://www.irs.gov/taxtopics/tc756

      Certain exceptions apply to actual family members who supply such care but that is not covered in your comment.

      There are few individual caregivers who can qualify as independent contractors. I have yet to find any.

      As to medical tax deductions, you will find a discussion of the subject at:

      https://www.journalofaccountancy.com/issues/2011/oct/medicaldeduction.html

      While there are interpretations of the law, the one in the Journal of Accountancy was actually litigated. I find nothing that gives me any level of comfort that your position would be found to be sustainable under the law. There is no differentiation between paying an agency for the care or a caregiver directly. It sounds like the misleading marketing of a care giving agency.

      • Hi Jim,

        You bring up some valid points. However, the new senior concierge services described above may be a gray area, as many of these senior service providers ARE set up as independent contractors, may work for more than one client, usually set their own rates and hours, etc.

  2. Hi Amara, thanks for this excellent information. will keep your article in my “Caregiver File” and offer the information when I become aware that one of my current clients or new prospects is looking for this type of information.

    Keep up your great work.

    I don’t know if you remember, but I also went to Penn State and graduated in 1960. Born and raised around the Pittsburgh area.

    • Hi Owen,

      Thanks for your kind words! This week’s post, which will be live tomorrow, adds relevant caregiving related links for your list.

      You graduated from PSU a few years before I did 🙂 and yes, it was a great place to go to school.

  3. That old commercial has been a mixed blessing for our industry. While it has built awareness of the dangers of seniors falling and living alone, it has also become a punchline. Worst of all, the seniors who can benefit the most from a medical alert system remember that old TV spot and want nothing to do with it. But we keep trying to help them anyway – these are some examples of what happens when the medical alert button gets pressed and we send help: https://www.medicalcarealert.com/why-get-a-medical-alert-s/2731.htm

    • Hi Charlie,

      I can appreciate the mixed blessing of that commercial! Using elders as the punchline of jokes is an unfortunate reality of our current society, though as the population continues to age, I expect this will shift dramatically.

      I’ve covered the benefits of medical alert systems a few times in this blog. Here’s one link:

      https://www.hecmworld.com/reverse-mortgage-news/safety-home-seniors-falls-medical

  4. […] Resources. Knowing how and where to find help for a senior — and when to get help as a caregiver — is crucial for anyone who works with or lives with an older person. As the population continues to spiral upward worldwide, this is rapidly defining the majority of people. Caregiver coaching can also make a major difference for the better. […]


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