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RK:                               That’s great. Now, can you tell me how does payment work you know will insurance or Medicare covers services or anything like that?

David Romero:            Of course that’s always one of the — one of the biggest questions that came. Long term care insurance, we always ask clients if they have a long term care insurance policy which would have been a separate policy that they paid for and they have riders that would pay for homecare and will help them with the whole process of starting a claim for long term care insurance. We have lot of long term care insurance clients.

Other than long term care insurance, there are programs through the VA, they have a homemaker program that we can also help them with and besides that it’s against private pay. I always tell everybody that the way that the healthcare system works is if you’re trying to keep your mom or your dad from you know falling at home or actually if they fall or if they get sick, if there’s a medical  need, if they fall and  hurt themselves then Medicare or your regular insurance will pay for it. If you’re trying to do preventive maintenance and keep them from doing it, unfortunately they don’t pay for that, but we help families learn — teach them different ways to be able to spend a little bit of money to do preventive maintenance, so they’re not having to give the price and pay for emergency all the time.

RK:                               Yeah and that seems like the preventative would actually be more cost effective than having to deal you know a break or an injury from a fall or something like that.

David Romero:            Definitely it’s a lot cheaper to do the preventive maintenance and do you know little bit at a   time same with everything, same with maintaining a car, it’s a lot better when you  maintain everything and do a little bit at a time than when you — if you just wait for something big to break. And it’s the same thing when we’re doing you know managing our long term health for our parents is finding out all the things that we need to know, what questions we need to ask and what things we need to put in place to stay ahead of everything and do preventive maintenance and a lot cheaper and a lot easier on everybody psychologically too than just waiting for a big incident to happen.

Cindy Brown:   More than anything, I think what family members and seniors really want for their seniors is for them to continue to have control of their life and have choices. If you wait for crisis to happen, you have far less choices than if you plan ahead and you work to help making sure things that you can avoid happening, don’t, so it’s a matter of control and choice.

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RK:       So can you tell me what sort of training does a caregiver have?

Cindy Brown:               Our caregivers receive training in everything from safety to how to recognize when someone’s in trouble and when they need to call 911 as well as specific hospice training, how to help their clients through the physiological and psychological changes of the hospice program. We are also doing a very specific 14-hour dementia training class that our caregivers are participating in and then we do an ongoing training throughout the year.

David Romero:            [Crosstalk] because as you can imagine so many situations are unique, we have a lot of clients with — are unique, so we have to be able to do training on site and do have that training for that caregivers so that they — one on one, so that they understand what to do with that particular client. We actually have a training center here in Albuquerque that the caregiver can come in and we have a full bathroom that we have installed for them to be able to train how to give somebody a shower. It has a bedroom there with a bed and they’re able to replicate different situations here so they can do have that training before going out to a client’s home:

RK:                               Yeah. Yeah, that’s great. Now, so they’ve gone through the process, they got the training and you said you personally connect a senior with whatever caregiver they feel most comfortable with or they feel that would best serve them?

Cindy Brown:               Part of that has to do with how we do our matching because we actually match our clients and caregivers and that’s because we do an extensive home visit before service even starts. That gives us the opportunity to talk with the clients and even their family members about what their priorities are what their concerns and their anxieties maybe about who is in their home, who they’re most comfortable with, all the way down to what kind of personality that they’re looking for.

Some people want someone who’s super laid back and other folks want someone who’s well the kind of jolt them awake in the morning and start their day with a bang. So it’s opportune that we uncover all of those personal preferences and idiosyncrasies to make sure that the caregiver is well matched with the client.

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RK:                               Can you tell me how do you actually go about you know screening your caregivers?

Cindy Brown:             Our caregivers are very carefully screened. We do a background check — a thorough criminal background check in every state that that person has lived in since the age of 18. So not only do we check the New Mexico criminal background, we also check it in every state since they become an adult. And we talk to our caregivers and we choose folks who want to be in this business because their goal is to help people maintain their independence and their quality of life.

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David Romero:           And we actually only, I think last year the percentage was only 7% of the applicants [are hired] RK. So it is a pretty tough screening. We also do — we also do adult registry check, pre-employment drug screening and on going drug screening and the DMV record check, so it’s a — we have a very thorough check and actually spent quite a bit  of money just on that screening process.

Cindy Brown:             We actually check the driver’s license every single month after they’re employed with us. And by doing that it helps — we do — it helps maintain the accountability that our caregivers had to our organization and to our clients.

RK:                               Yeah. And I’m sure there’s something there where there go to be — there got to be some sort of you know friendly and helpful as well like I was trying to find someone to work  with my mom or you know my grandmother that they would have to be friendly and hang out with her and be as helpful as possible.

Cindy Brown:             All of our caregivers have to have a minimum of one year experience caring for seniors whether that’s a professional care giving such as a certified nursing assistant in a nursing home or in assisted living aid or if they’re taking care of their own family members. Maybe they cared for a grandparent or parents or even a spouse, so they know what kind of tasks are going to be asked of them, but they also have a true sincere desire to help people stay at home and be independent in their own way.

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RK:                               Hey, guys this is RK and I am here today with the guys from Home Instead Senior Care in Albuquerque and Rio Rancho. And you know I just wanted to ask them today to answer a few questions that I think a lot of you might be asking when you’re looking to find a home health care provider or in home care health provider, so thank you for joining me today and answering these questions.

Cindy Brown:             You’re most welcome.

David Romero:           You’re welcome, RK.

RK:                               So could you guys introduce yourselves real quick and let us know what you do with Home Instead and then we’ll jump right into the question.

David Romero:           My name is David Romero and I’m the Community Relations Director here at Home Instead.

Cindy Brown:             And I’m Cindy Brown. I’m the Community Care Manager and I’m a social worker.

RK:                               Great. Great. Well, you know I had David send me a list of the questions that their customers are asking the most and so let’s just jump right into this. So the first question is, what do you guys do and what kind of services does Home Instead provide?

David Romero:           So RK, what Home Instead does is we’re the largest home care provider in New Mexico and so what we do is actually we have a wide range of what we help a lot of families with is basically most people wanted to stay at home and they want to understand what services are available to them at home, so when people call us, we would send Cindy out, our licensed social worker and she’ll be able to work with them having customized tailored services that go right to their home, so they don’t have to necessarily go to a nursing home or to assisted living.

Cindy Brown:                         What we do is we do all the things…

Cindy Brown:             …that are challenging for seniors to do in their own home whether cognitively of physically in order to make it possible  for them to stay comfortable and maintain the lifestyle that they come to cherish in their own home. I teasingly tell people to think of us as like rent-a-wife [Laughter] that we could have been that wives do. We’d even kiss you on the forehead goodnight, you don’t have to [00:02:17][Inaudible]  this.

RK:                               That’s great. So basically you’re helping — ’cause a lot of seniors they don’t wanna go to a home or like a facility somewhere, they’d rather stay in their own home. They’ve lived there their whole lives  you know their adult life and they don’t wanna move out and so you guys are just basically helping them with the — getting able to stay at home, is that what you guys are doing?

Cindy Brown:             It’s very individualized non-medical home care, so for some clients it may be things such as managing their bills, grocery list, getting their pet to the groomer, for other clients its things like getting a shower, getting their meals and remembering to take their medication. Each individual client is very different and so what’s a challenge for them is what we assist them in doing.

David Romero:           So the nice thing part about Home Instead is that everything is customized. We do give people you know the option to be able to stay you know at their own home. We also work with a lot of people that actually are at assisted living or nursing homes and they’ll have us come in because they want to see a  more personalized — personal aid to be able to work with them in between times because at assisted living or the nursing home you’ll have staff where the ratios are 12 or 16 residents to one aid and so the nice thing about having this type of service is you have your own person that you pick and that you picked based on your own — your own preferences.

Cindy Brown:             So very much what we do is very much like a personal assistant, so that whatever you need assistance with, be it something at the practical task or be it something that helps you maintain your quality of life. For some of our clients, we take them to the symphony. For other clients, we help them stay clean and help them with their hygiene, so that they feel good about their physical self as well.

RK:                               So you’re gonna send in home basically your — or you’re just gonna send the caregiver to help them with whatever custom plan you create for them…

Or they are trying to age in place safely and do as much preventive maintenance as possible to keep an acute situation from occurring. The skills and duties of home care personnel vary, but all have one thing in common—they make it possible for care recipients to remain at home in a safe, environment and in some cases have more independence than they did before.

In the process, they also provide family caregivers with a chance to replenish their depleted physical and emotional reserves.

Homecare personnel include:

Getting Started with Homecare
If you are considering getting homecare help to assist you with your caregiving responsibilities and/or to get some time for yourself, there are a number of things you need to consider, and also things you need to know.

• The first step is to make sure you and your loved one are comfortable with the idea of someone else taking on some of the tasks that you’ve been doing by yourself. There are many care recipients that are totally opposed to the idea and some negotiations will need to occur before any plan can be put in place. It is important for all concerned to understand what is prompting the need for homecare and the personal issues that lie beneath refusal to consider it. Getting beyond objections isn’t necessarily easy and you might need some guidance on how to go about it, Home Instead Senior Care can help with ideas and solutions to this common issue.
• Defining the tasks that need to be done by the homecare caregiver  will help you determine
  exactly what type of homecare is most appropriate in your situation. Do you need a nurse
  to clean and bandage wounds and monitor equipment, a caregiver to help your loved
  one get showered, dressed, med reminders, transportation, stand-by assist, transfer assist, and companionship ?
• Once you know what type of assistance you need, and all parties agree that it is necessary
  or desirable, the inevitable questions about where to find homecare services, how much
  they will cost, and whether any of the cost is covered by insurance or provided by government
  programs must be asked and answered. Some federally funded programs, insurance
  companies and health maintenance organizations (HMOs) do provide for some home
  health care services, but the coverage provided may not fit your needs. To be sure whether
  or not you have any coverage at all, it is imperative that you review your insurance benefits.
• If you’re like the majority of family caregivers you need the most help with personal care
  tasks—the very type of care that is not typically covered by private health insurance programs
  or Medicare. So unless your loved one had the foresight and the funds to purchase
  long-term-care insurance prior to becoming ill, your access to homecare will be limited by
  what you can afford. You may be able to get some help from state programs that take into
  account your ability to pay, and the age or extent of disability of your care recipient, but
  the sad reality is that more often than not the costs of homecare services will have to come
  out of your own pocket.

Choosing the Right In-Home Care
How do you find the right homecare solution for your family, the one that provides the services you need at a price you can afford? There are several ways of tapping into the homecare network. Here is a look at some of the most common ones and what you need to think about when considering them:
Home Care Agencies are companies in the business of meeting homecare needs. Not all home care agencies provide the same variety and level of service however, so make sure the agency you are considering can provide all the services you need. The issue isn’t bigger or smaller but rather which one meets your criteria.
Questions to Ask Any Agency You Are Thinking of Working With

• Is the agency certified for participation in Medicare and Medicaid programs
  (where applicable)?
• How long has the agency been serving the community?
• Does the agency provide an initial assessment to determine if the patient would be
  appropriate for home care and what those services might be?
• Does the agency provide all of the services you need? Can they provide flexibility to
  meet the patient’s changing health care needs?
• How does the agency choose and train their employees? Are background checks made?
  Does it protect its caregivers with written personnel policies, benefit packages  insurance?
• Does the agency provide literature explaining its services and fees?
• Does the agency have arrangements in place for emergencies? Are the agency’s caregivers
  available 24 hours a day, seven days a week? How quickly can they start service?• Are references from former clients and doctors available?
• What types of programs does the company have in place to assure quality care is provided?
  Privately Employed Home Caregivers. Instead of using a home care agency, you may wish to hire
  a home care worker on your own, especially if you are not looking for skilled medical care, but
  rather for someone to act as a companion or personal aide on a regular, long-term basis. In
  those situations, bypassing commercial agencies can often result in significant financial savings.
  You can start your search by putting the word out to friends and neighbors that may
  know of a homecare worker.

Things to Think About If You Plan to Hire Private Homecare Help

• You yourself must do substantial background checks to ensure that the employee has no
  record of criminal activity or abuse,
• You must be prepared to do all the paperwork necessary to comply with tax and insurance
  laws affecting employees,
• You may not get candidates with the same level of training and licensure as those who
  work for home care agencies,
• You do not have the guarantee of substitute help if your home caregiver is ill or on
  vacation.
• If the caregiver is injured on the job you could be responsible for their medical costs and compensation for missed time from work.

On behalf of the Ortega family we feel such gratitude and admiration for all the aide schedulers and management personnel who worked for my Mom Eloisa Mais Ortega during her extended illness until her death on last August 5th.  The quality of care was exemplary among the vast majority of the aides assigned to Mom’s case.  I felt so secure with the aides at my Mom’s home that I could direct my energies towards other tasks related to Mom’s business, family and spiritual matters.

I had hoped that any aides who had cared for my Mom could have attended her funeral but in those days after her death some  important tasks were dropped between the family and the hospice agency.  I apologize for that mistake.

Sincerly,

Carlos J Ortega and Family

Dear Darryl and Staff of Home Instead,

My sister and I want to thank all of you for your support and help this last year and a half.  Paulina and Ardith were so caring and devoted to Mom.  They really became part of our family.  Because of all of you Mom was able to be somewhat independent a lot longer than she would have.  Thank you so much.

Linda Marshall & Jan Thomson

Dear Debbie,

Thank you so much for helping our Father and Family during a difficult time by assembling such a caring and competent team of caregivers.  We look forward to thanking them individually, but in the short term, we wanted to express our dep gratitude.  Again, please consider us as a future source of recommendations if you would like.

All the Best,

Barb & Lawrence Liviton