The Right Care,

Right at Home®

Uncertainty

I N F O R M AT I O N | ADVICE | SUPPORT

Adult Caregiving Guide

 Are you an
adult caregiver?
You’re not alone.
• Over 16 percent of the adult
American population provides care
to someone aged 50 years or older.
• Someone caring for a parent has
been doing so for an average of 20
hours a week for four years.
• One in three adult caregivers is also
raising a child under the age of 18.
• About 70 percent of adult
caregivers have to rely on help from
You know your loved one family members, friends
or neighbors.
needs help, and you’d be • Spouses spend more than 30
hours a week directly caring for
happy to give it, but ... their loved one and are less likely
to get help.
Sometimes that help begins to take more and more time and
energy, more than your family can possibly provide. Meal • Long-distance caregivers spend an
preparation, laundry and housekeeping, transportation to and average of nearly $400 per month on
from medical visits, hygiene and grooming, nursing tasks— travel and out-of-pocket expenses as
eventually the stress can take a toll on family dynamics. part of their caregiving duties.
• There’s a 20 to 50 percent greater

1-2-3
If you need help, you’re not alone. Whether your loved one likelihood for depressive symptoms
lives next door or hundreds of miles away, Right at Home for adult caregivers.
provides caregiving services for thousands of families just like
• Nearly 70 percent of adult
yours across the nation. We can help you, too!
caregivers take time off during
the workday, while 17 percent take
a formal leave of absence and 10
percent take early retirement.
• An informal caregiver is
estimated to lose an average of
$25,494 in Social Security benefits
because of time spent caregiving.
Follow the simple steps in this guide to ensure
that your aging parent, spouse or friend is
getting the right care that he or she needs.

Page 2
1 Determine Whether Your
Loved One Needs Assistance

Signs Your Loved One’s Needs Are Changing

It can often be hard to tell when aging is affecting a family member. Don’t ignore the warning
signs, because small things can add up to a larger challenge incredibly fast. If you notice certain
changes in your loved one, it might be time to seek outside help:
• Withdrawal from social interactions, disinterest.
• Unusual behavior, like increased agitation, speaking loudly or little talking at all.
• Poor hygiene or nutrition.
• Signs of forgetfulness, such as piles of unopened mail, dirty or scorched cookware,
unwashed laundry.
• Mismanagement of finances—not paying bills or making unusual purchases.

To help you better understand your loved one’s limitations, use

the provided Needs Assessment Worksheet on the following
page. Filling out the worksheet can serve as a guide as to whether
or not it’s time to hire a professional caregiver. If it is, the worksheet
can also help your caregiver begin to understand your loved one’s
daily needs.

Page 3
 Needs Assessment
Worksheet for Adult
Caregivers
This worksheet will help you and other family
members determine what types of assistance your
loved one needs.

ACTIVITIES OF DAILY LIVING INSTRUMENTAL ACTIVITIES

(ADLS) OF DAILY LIVING (IADLS)
NEEDS NEEDS

No help Some help Much help No help Some help Much help

Bathing Using the

telephone
Dressing
Shopping for
Grooming personal items
Toileting Transportation
Eating a Managing money
nutritious diet
Doing laundry
Getting out
Light housework
of bed
Preparing meals
Getting out
of chair
Walking

How do the following affect

CONDITIONS/FUNCTIONAL STATUS the person’s ability to function?

EFFECT EFFECT

None Some Major None Some Major

Hearing Strength
Vision Energy
Perception Bladder/bowel control
Orientation Arthritis
Thinking Hypertension
Memory Heart disease
Decision making Diabetes
Judgment Physical deformity
Physical dexterity Depression
Balance
Page 4
ENVIRONMENTAL SAFETY Which barriers can be removed or changed?

Limitation No problem Needs changed

Neighborhood Safety
Convenience
Friends or relatives nearby
Living Quarters Age of dwelling
Roof in good repair
Windows in good repair
Siding in good condition
Looks cared for
Security and safety
Deadbolt locks on outside doors
Peephole in front door
Window bars or locks
Visible from road
(no large trees or bushes block view)
Smoke alarms installed, tested
Passageways clear of wires and clutter
Stairs Handrails on both sides
In good repair and nonskid surface
Clearly marked
Floors Nonskid, level surfaces
Nonglare surfaces
No loose rugs
Furnishings Couch and chairs easy to use
Tables the right height
Bed easy to get in and out of
Lighting Light switches easy to reach
Important areas are well-lit
Light diffused from windows
and surfaces (no glare)
Passageways have night lights
Kitchen Lever handles on sink
Clean rubber mat by the sink
Items used often are accessible
Storage is easy to get to
No objects are over the stove
Bathroom Grab bars attached to studs,
by the toilet and tub or shower
Nonskid strips in the tub or shower
Hand-held shower head
Nonslip bath mat or rug

Page 5
 2 Find Out What Care Might Be
Right for You and Your Loved One

What to Do When Your Loved One Needs Care

As you notice changes in a loved one, there are a few things that you can do to help them and
your family as a whole:
• Arrange for a family meeting to discuss your care options. Be sure to include the
wishes of the loved one who needs care
in the discussion. Use the Needs Assessment
Worksheet as a guide.
• If there is a noticeable decline in thinking and reasoning in a loved one, schedule a doctor’s
appointment and ask the physician to test for cognitive function. And don’t assume
cognitive decline is an unavoidable part of aging. Some causes are treatable, such as
interaction of medications.
• Have everyone in your family (including spouses) check with their employers to see if
their companies offer any caregiver benefits.
• Ask the care agency for a care plan specifically based on your loved one’s physical needs,
cognitive needs and goals.
• Have a family member accompany your loved one to as many medical appointments
as possible. This allows them to serve as another set of eyes and ears, and become a
patient advocate if necessary.
• Use the Home Safety Checklist.

Page 6
Home Safety Checklist for Adult Caregivers
Use this checklist to make sure that your loved one’s routine is as beneficial as possible and that
their home doesn’t pose health or safety hazards. By going through the checklist, you can significantly
reduce harm that may come to a family member as you decide on your approach to care.

General Bathroom

 ind someone to check on the

F G
 rab bars near tub, shower and toilet
individual daily. located and mounted properly.
Schedule vision check. Nonslip surfaces in tub or shower.
Discuss medications with physician N
 ight light.
to determine effects on balance. R
 ugs or bathmats with nonslip
Establish light exercise routine. backing on floor.
Shower/tub bench or seat.

All Rooms
Bedrooms
No loose carpeting or rugs without
nonslip backing. B
 edside table with non-tip lamp and room
Traffic areas free of furniture. for eyeglasses.
C
 lear traffic area from bedroom
to
Electrical cords and other wires taped
against walls. bathroom.

Bright lighting with switches and C

 omfortable, sturdy chair to aid
functioning bulbs. in dressing.

Telephones placed at
height that can be

reached from floor.

Kitchen
Stairs and Inclines
Items placed where they can be reached
Keep free of items. without use of stool.
A
 rea to sit during food preparation.
Plenty of room to move at top
and bottom. F
 looring free of cracks, splits or up-turned
No loose carpeting or edges
to edges.
catch on.
Handrails securely attached and
at proper
height for user.
Proper lighting on all steps, switches at
top and bottom of stairs.

Page 7
 3 Get Help if You Need It

Right at Home Our RightCare

Can Help by is The Difference.
Providing the We exceed your expectations by providing the right care
every time with the reliability and quality of an international
Right Care system. We are the Right People doing the Right Things
the Right Way for the Right Reason.
Once you determine that you
need outside help, we’re happy RightPeople
to give you our assessment and The personal care of a friend with dedicated
create a Custom Care Plan to local owners and trained, committed and
fit your loved one’s needs and compassionate caregivers.
your requirements. We offer
caregiving services for almost
RightServices
The care they need when they need it with a
any family and practically any
wide range of services and flexible scheduling.
situation. Our in-home care
lets loved ones enjoy healthy RightApproach
lives in the comfort of a familiar A personalized Care Plan managed by pro-
environment. We’re thorough, fessionals with caregiver matching based on
professional, committed and a thorough assessment.
flexible, and we can give you
the peace of mind you deserve. RightMission
A resolute passion to improve the quality of
life for those we serve means peace of mind
for you.

Page 8
Custom Care Plan
When you call us we’ll ask questions to form a basic
needs assessment, then set up an in-home visit.
After our initial meeting, we develop a Custom
Care Plan tailored to your loved one’s specific
needs, and make detailed recommendations on
services. We then review the Plan with you in detail
and modify it as you and your loved one see fit.

Caregiver Matching
Once you approve the Custom Care Plan, we match
your loved one with the most appropriate caregiver
possible by considering numerous factors: services
needed, interests, and the personalities of both
caregiver and client. Of course, if you ever have
any concerns about a specific caregiver, we can
promptly arrange a replacement.

Quality Care
Every Right at Home caregiver goes through an
extensive interview process, including background
and reference checks. Caregivers are trained and
bonded/insured before ever caring for a client.
Then, local supervisory staff visit your loved one’s
home periodically to ensure things are going well
and that caregivers are following the specifics of
the Custom Care Plan.

Page 9
 Special Care Situations
Caring for a loved one who has special needs due to an illness or injury can be overwhelming, which
makes Right at Home perfect for either full-time care or respite. We have the right people to help—
caring, compassionate and trained caregivers who can accommodate numerous special physical and
mental situations.* We have the right services, so you can rest assured that we can deliver the care
required, when it’s required. And, we have the right approach, which means your loved one will receive
a customized care regimen that takes their special needs and their environment into account. Some of
these special care situations include:

Alzheimer’s and other dementia

Most Alzheimer’s patients—particularly those in the early and middle stages of the illness—can be
cared for at home. In fact, more than half of all diagnosed Alzheimer’s patients continue to live in
home settings. Right at Home’s services offered to those who suffer from Alzheimer’s include:

• Continuity of daily routines • Minimization of stress that can

and schedule. aggravate symptoms.
• Freedom to move about in a • Daily orientation to time,
familiar, unrestricted space. place and people.

Osteoarthritis
The inability to perform simple, daily tasks with ease can lead to frustration and depression.
But in most cases, people with osteoarthritis can lead full, active lives by properly managing the
condition. Right at Home can help alleviate some of the pressures of daily living by offering:

• Light housekeeping and laundry. • Meal preparation.

• Assisting with recreational activities. • Shopping.

Hypertension/stroke recovery
Lifestyle changes are the best strategy for controlling and preventing high blood pressure.
For seniors, this often means a combination of light exercise and medication. Right at Home can
prepare a customized hypertension program to promote a healthier lifestyle, including:

• Development of a light exercise schedule. • Monitoring and everyday health reminders.

• Healthy meal planning and preparation. • Shopping and errands.

Page 10 *N ot all services are available in every location. For a full list of available services in your area, check with your local Right at Home office.
Diabetes
If your loved one is one of the more than 20 million Americans who suffer from diabetes, Right
at Home can help manage the disease through:

• Education about what affects blood • Healthy meal planning and preparation
glucose levels. (diabetic-friendly).
• Development of a light exercise schedule. • Monitoring and everyday health reminders.
• Shopping
and errands.


Heart disease
Right at Home has extensive experience in prevention and care when it comes to managing
heart disease. We can customize a program for your loved one that includes:

• Developing/implementing a heart • Monitoring and everyday health reminders.

healthy diet. • Assistance with physician-prescribed
• Shopping
and errands. exercises.
• Help with daily activities.

Neuromuscular diseases and disorders

Neuromuscular conditions are complex because they can affect both motor skills and cognition.
Regardless of the particular disease/disorder or the extent of its progression, Right at Home
caregivers can help by offering:

• Safety supervision. • Monitoring and everyday health reminders.

• Help with daily activities. • Light housekeeping and laundry.
• Help getting ready for an outing. • Cognitive stimulation.

Cancer recovery
Many cancer patients feel more comfortable receiving care at home so they’re not separated
from family, friends and familiar surroundings. But cancer is a condition that can change
relationships and require families to address new issues.

In-home care is often a great way to alleviate some of the pressures of family caregiving
when it comes to cancer, allowing you to focus on emotional support instead of the details
of daily activities. Right at Home caregivers can help with any of the care services, as well as
supplement any hospice care.

Page 11
 Hospice/palliative support
Whether you and your family are simply trying to relieve someone’s pain during a serious illness
or whether you’re trying to provide end-of-life care, it can produce a lot of stress for family
members involved in caregiving.

Right at Home can give you and your family a respite from the daily tasks that seem to
build. From light housekeeping to meal preparation, Right at Home caregivers can provide
support during trying times. In addition, we work with hospice and palliative care agencies
to further support your needs and those of your loved one.

Mental health
Regardless of age or physical ability, some people who suffer from mental health disorders
become homebound during their recovery. Anxiety, Post-Traumatic Stress Disorder (PTSD)
and depression can all easily affect entire families, not just those who are diagnosed.

Right at Home can provide numerous services that help families do more than just survive a
loved one’s struggle with the effects of a mental health disorder. We can be a large part of
helping a family thrive on their path of recovery. We can also help when mental health is a
concern for seniors who are coping with the reality of becoming homebound.

Traumatic brain injury

Tragically, families sometimes find themselves coping with the unexpected effects of a sudden injury
to the brain. These traumas can be minor and take time to heal, or major and be a lifetime injury.

Whether it’s helping a family establish new routines immediately after the injury or providing
respite to families who have established a system of care, Right at Home has numerous
services that can help. Refer to the back of this guide for services near you.

Paraplegia/quadriplegia
These disabilities (whether from birth or due to an accident or illness) have a lifetime impact
upon those suffering from the disability and the family caregivers as well. The burden of
caregiving in these cases is typically overwhelming and outside assistance is required.

Our caregivers can provide support to the family members in the form of respite care, as well
as helping someone adjust to a new living situation directly after a spinal cord injury. They can
also help with many instrumental activities of daily living.

Page 12 *N ot all services are available in every location. For a full list of available services in your area, check with your local Right at Home office.
More Resources

Resources and Options Available

to Adult Caregivers
Making the choice to provide formal care for a loved one is a brave and difficult decision, but
you don’t have to do it alone. There are resources available in most communities that will help
you undertake the task of finding care for an elderly or disabled loved one.

If I want my loved one to be cared for at home, what are my options?

A trusted family member, friend or neighbor could be a cost-effective option. And you could
always
hire additional paid caregivers to supplement care. However, if you hire an individual
who isn’t associated with a home care agency, keep in mind that you assume employer
responsibilities. Most homeowner’s insurance policies exclude injury to privately hired caregivers,
and many of those caregivers aren’t bonded or insured, so you’d be legally and financially
responsible for many of their actions and responsible for the tax obligations.

You could also hire a private duty home care agency to provide services for your loved one. You
should ask for proof that they perform background checks on their caregivers, as well as any
required licensing. They should inform you of how they train their staff and whether or not they
have 24-hour emergency scheduling services.

If your loved one doesn’t require too much physical and medical care, many areas have adult
day care centers. These are often a lower-cost option than private home care services.

How do I pay for home care services?

Medicare, Medicaid and most employer-sponsored HMO and PPO plans will only reimburse you
for intermittent visits from a home care nurse on a temporary basis
and only when your loved
one has a specific qualifying medical diagnosis. In general, these types of insurance policies are
not designed to pay for ongoing, hourly caregiving services that are classified as “Long-Term
Care.” (Use the Official Medicare Eligibility Tool at www.medicare.gov/LongTermCare/Static/
Medicare.asp to learn more.)

That said, there are many other financial options available to you in order to pay for ongoing
care services:

• Long-term care insurance • Employee-sponsored • State-subsidized home- and

• Reverse mortgages caregiving stipends, community-based services,
such as “Backup Care” often referred to as “Medicaid
• Employer-sponsored programs for employees Waiver” programs (Age and
Health Savings Accounts who are adult caregivers income qualifications apply.)
(HSAs) or Flexible Spending and travel for work
Accounts (FSAs) • Veterans Aid and
• Workers’ compensation Attendance
• Family trust funds insurance • Catastrophic auto insurance

Page 13
 Powers of Attorney
Terms and formats differ from state to state, but there are typically two types of powers of
attorney. One is for managing finances, the other for managing healthcare.

Healthcare Power Financial Power

of Attorney of Attorney
Healthcare power of attorney becomes active Financial power of attorney allows a person
only when an individual is so ill that he or to nominate a person (or persons) to
she can’t make or communicate a healthcare manage legal and/or financial matters. Once
decision to his or her physicians. For example: a power of attorney is executed, both the
if someone goes into a coma, that person’s person and his or her agent have access to
agent has power of attorney to make medical the person’s finances. They share authority
decisions for that person. Likewise, if a to manage the finances – but the person
person develops dementia which impairs retains ownership of the assets.
the person’s understanding and judgment,
To nominate agents for financial powers of
a power of attorney would be consulted for
attorney, you can often use simple state-
medical decisions.
approved “short forms” or a person may
Family members are not given powers of state in lengthy text the exact powers being
attorney by default. Most state laws are quite granted. The best solution depends on the
vague about who is permitted to make medical individual situation.
decisions for another person. A valid power
of attorney clarifies the decision-maker for To learn more about power
of attorney,
physicians. And when issues such as life support contact an elder law attorney in your area
or terminal illness are involved, clarification through the National Academy of Elder Law
becomes incredibly important. More than one Attorneys (www.naela.org). Laws regarding
agent can be named. If this happens, there is power of attorney are different in every state.
typically an order assigned to agents in terms
of who’s contacted and when.

Page 14
Questions to Ask When Hiring a Caregiver
If you decide on home care, there are several questions you should ask the home care agency to ensure
your family and loved one remains safe, healthy and happy:

• If the caregiver becomes ill, goes out of town • If the caregiver is injured at a client’s residence,
or
is otherwise unavailable, what are the who is responsible? (Many homeowner’s
alternative arrangements? insurance policies exclude injuries to “domestic
• Who pays the caregivers’ federal and state employees,” so the caregiver should be
taxes, Social Security (FICA) and unemployment covered by workers’ compensation insurance.)
insurance so our family is not legally • Do you perform criminal background checks
responsible? and state abuse registry checks? Do you check
• Can you verify that the caregivers are legally caregivers’ references from prior work history?
able
to work in the United States? • Are you bonded/insured in case of injury
• How do you document that your services were or theft?
indeed completed?

Adult Caregiving Resource Links

Aging Caregiving Health/Medical
American Society on Aging Right at Home Newsletter Alzheimer’s Association
www.asaging.org www.caringnews.com www.alz.org
National Council on Aging Caregiver Support Services American Association
www.ncoa.org www.seniorcaregiver for Respiratory Care
support.com www.aarc.org
National Resource Center
on Nutrition, Physical Activity Direct Care Alliance American Cancer Society
and Aging www.directcarealliance.org www.cancer.org
nutritionandaging.fiu.edu Family Caregiver Alliance American Diabetes Association
National Association of www.caregiver.org www.diabetes.org
Area Agencies on Aging National Alliance for Caregiving American Heart Association
www.n4a.org www.caregiving.org www.heart.org
National Association
of Caregiver Action Network American Lung Association
Professional Geriatric www.caregiveraction.org www.lung.org
Care Managers
www.caremanager.org National Guardianship American Stroke Association
Association www.strokeassociation.org
Government www.guardianship.org
National Parkinson Foundation
Administration on Aging Home Care Association www.parkinson.org
www.aoa.gov of America
National Alliance

www.homecareaoa.org
Centers for Medicare for Hispanic Health
and Medicaid Services ThirdAge www.hispanichealth.org
www.cms.gov www.thirdage.com
National Organization
U.S. Government/ AARP Caregiving on Disability
Senior Citizens’ Resources Resource Center www.nod.org
www.seniors.gov www.aarp.org/home-family/
American Hospice Foundation
caregiving
United We Ride www.americanhospice.org
www.unitedweride.gov
Page 15
 Care Services
Companionship/Homemaking
• Safety supervision • Cooking and grocery shopping
• Transportation and errands • Light housekeeping
• Socialization • Organization
• Cognitive stimulation • Laundry services
• Home monitoring • Respite care for family caregivers

Physical Assistance
• Ambulatory assistance • Transfer between
• Dressing bed and chair

• Positioning in chair or bed • Wheelchair assistance

Hygiene
• Bathing and • Shaving with electric razor
showering assistance • Oral hygiene
• Bed baths • Toilet and incontinent care
• Grooming

Wellness
• Light exercise program • Everyday health reminders
development • Safety supervision
• Healthy meal planning • Cognitive stimulation
and preparation

Skilled Nursing
• Visiting nurses • Wound care
• Setup and administration of • Dressing changes
daily health needs • Catheter care
• I.V.-related therapies • Ostomy/colostomy care
and administration
• Tube-feeding assistance
• Insulin injections
• Skilled hospice support

6464 CENTER ST., STE. 150 P 877.697.7537 www.rightathome.net

OMAHA, NE 68106-2818 F 402.697.0289 info@rightathome.net

Right at Home provides in-home care services to clients and equal employment opportunities to
employees and applicants, without regard to race, color, religion, sex, national origin, age, disability,
or other protected class, in compliance with all applicable federal, state and local laws. Each Right
at Home office and business is independently owned and operated under a franchise agreement
with Right at Home, Inc. For comments, questions or to learn more about Right at Home, please
visit www.rightathome.net.