Choosing At Home Care – Helping Dad Not To Suffer


A couple years ago I saw an exhibit of the photographer Henri Cartier-Bresson at MOMA in New York.  A photo hanging on the wall just inside the entrance stopped me in my tracks.

It was of an Asian man in his 70’s pushing his friend down a crowded urban street in a wheelbarrow.  There were people everywhere.  Farm animals roamed the sidewalks and trash lay all over the ground.

Their bond was important because the man in the wheelbarrow had significant physical disabilities.  They didn’t have money for a wheelchair.  A wheelbarrow was the best they could do.

I stood there in awe.

Wow.  That is love.

That is a caregiver.

That is friendship.

That is strength.

What makes this kind of connection possible?  How can you find someone who is just the right fit for your loved one?  What are the steps and strategies to find someone your family can trust?

That’s what this post is about.  I will show you the most effective tools and methodologies.  I will show you the exact strategies that will efficiently and quickly get you the caregiver you need.

It all comes in four simple steps.

This post will cover the first of those four steps.

But before we get into the details I want to speak with you about three caregiver mindsets.


3 Caregiver Mindsets

Many of us come from different backgrounds and families.  But I see common themes across many of the people I have spoken to.  There are three caregiver mindsets that are important to keep in mind as we start this journey.

1. The Person Is Out There

I often hear, ‘I just don’t know if I can find the right person.’

Or, ‘We’ve been through so many people already.’

The right caregiver for your loved one is out there.  I promise.  Here’s how I know.  As often as I hear the complaints I hear the success stories.  ‘My mother has a wonderful caregiver.’  I hear often, ‘We are so blessed.  We found someone wonderful.”

What do these people do?  They are patient.  They push through the challenging times.  They use effective strategies and tools (which we’ll cover very soon).

The caregiver you are looking for is out there.  They’re walking the streets right now.  They’re buying groceries.  They’re looking for a wonderful family just like yours.

Don’t give up just before the miracle.  You’re closer than you think.  I’ll show you tactics you haven’t used before.  I’ll walk you through strategies that have an immediate impact.

2. Emotions Are Ok, You Are Ok

Frequently I hear: “We can’t find the right person.”

Or, “I feel completely overwhelmed.”

And all too often I hear “I should have known how to do this better.”

There’s that awful word ‘should’.  Well let me tell you right now.  You are doing a fantastic job.  You really are.  Your loved one is incredibly fortunate to have you.

There is a difference between ‘feeling bad’ and ‘being bad’.  Feeling angry, frustrated or exhausted from helping a loved one happens.  In fact, it’s expected!  You would be kidding yourself if you didn’t feel overwhelmed at certain points.

But don’t let those challenging emotions make you feel bad about who you are as a person.  Feel them, get support, take rests and do the next right thing.

3. Let Go

Sometimes I hear, ‘There’s just no way we can find someone.’

Another common phrase is, ‘My mother refuses to have anyone in her home.’

Here’s the honest truth.  We are unable to control everything.  We can have significant impact with our loved ones.  But there is always something beyond our control.  And it’s not our fault.  We’re doing the best we can.

And let’s be clear letting go does not mean giving up.  It means focusing on what makes a difference.  It means taking action where there is an impact.  It means focusing on things we can change and letting go of the rest.

Not only is letting go healthy for your loved one, it’s also healthy for you.  It will decrease your stress.  You will have more time to spend with other people you love and pursue your own passions.  Letting go sets you free.

These mindsets work.  Embrace them.  Turn back to them when you feel lost.  Internalize them and you will feel empowered.


Strategy #1: Asking For Help Is A Sign Of Strength

Asking for help can be hard.  We often feel the need to do everything ourselves. Often times I hear from people:

“No one can help me with this situation”

Underneath those words is the feeling of no one having their back.  It’s a feeling of being overwhelmed by not knowing to whom to look to for help.

When I was in my young twenties I picked up a hot skillet with my bare hand off the stove.  I had forgotten that skillet had just come out of being in the oven for thirty minutes.

I massively burned my left hand.

Right after I dropped the pan I remember first the thing I felt was shock.

“Wait what just happened?  Does it hurt?  I can’t tell.”

Then the pain came in.

It started to burn like crazy.

I ran over to the sink and immediately put my hand under the cold water.  It felt better.  But if I took my hand out from under the water for even half a second it burned like fire.

So I sat there thinking, “What in the world am I supposed to do?”

“Do I go to the ER?”  “How in the world would I get there?” “Am I overreacting, or should I just calm down and take some Advil?”

I had no idea how serious the problem was.  In the shock of the event I had lost my ability to appropriately judge my own situation.  Later on I will tell you how the story unfolded.

Many people learn about their loved one needing at home care abruptly.  A health event, a holiday visit, a fall…something sudden occurs.

The family is often in a time of shock.

My message to you is simple.  You need outside help.

Here’s the reason why.

Like me with the burned hand, you need someone to tell you how serious the situation is.  You need an expert to say, ‘Look I’ve seen many similar situations and my advice is that you should do x.”

An expert is important to help you judge where you are.  Is your situation dire?  Is it moderate?  Do you need full-time help?  Do you need someone part time?

You’re too close to the situation to provide an objective view.

So here’s exactly what you need to know and how you can take action.

There are two types of care:

1. Medicare-certified or skilled care

  • Pain management
  • Rehabilitation therapy
  • Medication management
  • Wound care

Sample Conditions: hip replacement, heart surgery

2. Non-medical, non-skilled care

  • Feeding
  • Dressing
  • Bathing
  • Transportation
  • Errands
  • Companionship

Sample Conditions: Alzheimer’s, stroke

There are three types of outside help you should look into.  Some will come to your home directly and provide an assessment of what your loved one needs.  Others, like social workers, may provide your family with assistance at the hospital if your loved one has a major health event.

1. Social Worker (At The Hospital)

  • You see them before the discharge of your loved one
  • Provides contacts and information for services to help your family
  • Make sure you ask your doctor to speak with one

2. Geriatric Care Managers

  • Specialists in care for the elderly
  • Can come provide counsel, do a full assessment or set you up with long-term care
  • Many have significant education in care management
  • Can do an assessment – search here

The cost can be between $500 – $1,200 for an assessment.  The result is that they will speak to your loved one’s doctors, visit your loved one’s home to speak with them and send you a six page summary report.

Looking for more?  Lesley Alderman at the NYT has a great summary here.

3. Occupational Therapists

  • Specialists in assessment of how to live at home with major limitations (e.g., Alzheimer’s)
  • Focus on adapting the environment, building new skills, and family relations
  • Less skill than a Geriatric Care Manager
  • Can do an assessment – search here

The cost is between $150 – $300 for the evaluation depending upon where you live.


Bonus!  Get A Free Assessment!

You may already be facing significant financial challenges.  I often hear, ‘At home care is so expensive.  I don’t know how we are going to afford it.’

I want to provide you with relief right now.  We’ll go through how to pay for at home care in another piece (in significant detail) but I want to save you money today.

Many people don’t know this but there are a few ways you can get a free assessment for your loved one.  These strategies can save you hundreds if not over a thousand dollars.

I want to share them with you now.

First, if your loved one has Alzheimer’s at any stage you can get a free care consultation with a social worker.

Reach out to the Alzheimer’s Association at 800-272-3900 or  They will connect you with a social worker that can provide you with tips and advice, all for free.

Second, find your local Agency on Aging by going here: Depending upon the state you may be eligible for a free visit from a case manager who will come to your loved one’s home.  They will provide an assessment and give you resources and tools.

Fantastic!  You’re well on your way to saving hundreds of dollars and getting your loved one the care she deserves.


Expert Interview Strategies

When families consider asking an expert for help I often hear consistent concerns:

‘Will this person be any good?’

‘I’m spending a good amount of money on this, I really hope it works.’

‘I feel like a failure.  Why can’t I do this?’

This reminds me of my first job out of school.  I just started working at an insurance company.  The first day I went to see the executive who ran my group.

His office was enormous.  The view of the city below was tremendous.

My fear was only doubled by how he looked.

He wore a thousand dollar grey suit and sported slicked back silver hair.

For the next three years I sat in many meetings with him and rarely said anything.  Why?

Because I had never been taught how to.  I never knew how to speak to power.

Often times I had great ideas to share.  Frequently I knew how to make something better.  But I kept quiet.

Asking an expert to come into your home can be a similar experience.  We feel that they have all of the expertise and our job is to listen.  We simply need to sit there.

I cannot emphasize enough – you need to take a direct and active role in their visit.  This is your time.  You can ask questions.  You can request additional information.  You can demand better service for your loved one.

I want to enable you to take a more active role.  I want to tell you exactly how the meeting will go and which tools to use.


Meeting Overview

A great way to increase your power in any situation is to envision the situation before it happens.  Let’s do that now.

If you hire any outside help (e.g., social worker, geriatric care manager, or occupational therapist) they will follow a similar set of steps.

They will come to your loved one’s home and stay for between 1 and 2 hours.  They will begin by sitting down with you and your loved one and ask you a series of questions.

To your loved one:

  • How are you doing?
  • What are your current challenges and limitations?
  • What do you like to do? What are your goals?
  • Who is providing the primary care?
  • How is your mobility to perform daily activities (e.g., eating, showering)?
  • Do you have any challenges with memory or depression?
  • Are there any major financial concerns?
  • How is your health? What medications are you currently on?
  • What concerns do you have about the way your home is structured and how you are able to get around it?

To you and the family:

  • What role do you play in caring for your loved one?
  • What is going well?
  • What are some of the challenges?
  • How are you splitting current care between different people?
  • How are you getting support for yourself?
  • What financial concerns do you have?

They will also likely walk around your home.  The goal is to review potential risks for your elderly loved one.  They will identify improvements you can make to the home to increase mobility.

Then they will sit down with you and your loved one and review specific suggestions.  They may recommend a certain type of in home care.  They may recommend reaching out to specific social services groups.  Take notes.

If it is a geriatric care manager they will put all of their recommendations in a care plan report.  They may also speak to your loved one’s doctors to gather additional information.


Interview Strategies

Asking specific questions will maximize the results of working with an expert.  Practice these in advance with a loved one.  Take the time now to walk through these questions with your spouse or a sibling.

There are five areas that are essential to dig into:

1. Priority – In what priority would you recommend we take action? What is the highest need item? What do we need to address in the next week?

Among the many suggestions you provide, what is your candid view on what is most pressing?  This may be hard to hear but you want to know.

You can also compare this with what you have heard from other people.  It’s a great thing for you and your loved one to hear while in the same room.  It will add clarity to the situation.

2. Evolution Of Care – How do you feel the care needs will change over the next few years? Even if we take care of today’s challenges, what is coming down the line?

It’s critical for the family to know in what direction the care needs are trending.  Is it getting more challenging?  Will at home care increase?  Is a nursing home in the future?

Often times families are focused on the crisis at hand.  It’s extremely helpful to get the broader view.

3. Services – What two services do you think will add the most value for us? What free services have a lot of value but many of your customers fail to use? What are the best practices in reaching out to these service providers?

The primary role of your expert is to introduce you to service options.  They are there to tell you who to reach out to next.

Often times the elderly have significant services available to them but are unaware.  For example, many Public Libraries will drop off books to the elderly for free.

4. Home Improvement – What are the two most important home improvements that you would recommend? What are affordable ways to make the changes? What are the greatest risks to someone in my loved one’s situation?

These experts have visited dozens of homes.  They can see things that you and your family may never have thought of.

Press them on affordable ways to make changes.  Home modifications can be quite expensive.

5. Caregiver Support – How can the family caregivers get support? Where are there support networks in the immediate area? What do caregivers need support for that they often don’t get?

The whole family needs to hear the challenges of providing family caregiver support.  The expert will be the voice to you getting the support you deserve.

Take their advice seriously and consider going to a support group.  You deserve it.


Fantastic!  Well done.

If you want more information about how to get support for you and your loved one sign up for my email list below!

Published: February 5, 2015
By: JP Adams

Subscribe Here! Enter your email and get updates. It's free!

Leave a Reply

Your email address will not be published. Required fields are marked *