Home Care for Elderly: Rock or Hard Place

by Jordan Yerman | February 28, 2007 at 09:59 pm

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The attached article discusses alternatives found to traditional nursing homes. The problem is that different people require different levels of care: some need only be reminded to take pills and are able to perform one-armed push-ups at the Oscars whilst others are incapable of leaving the house without assistance.

Whilst nobody would willingly choose an inadequate caregiver, not everyone can afford full-time live-in care. This situation will get worse as we, and our parents, get older. Me, I'm happy to have lived long enough to have to pay rent; one day I may be facing a decision like the folks in this article, and what if I don't have by-then-grown children to help me out? As we elect our government officials, maybe we should be thinking about things like this instead of working ourselves into a froth about orange-level alerts and whatnot.

Are any readers out there dealing with this conundrum now? Have any of you had any experience with some of these "grey-area" care providers?

With 4.2 million Americans currently over 85 — a number expected to grow to 5.9 million by 2014 and then accelerate with the baby boom generation — the exploding need for long-term care is remaking the home-care industry, driving more of it underground. Gray-market hiring, fraught with risks, is a solution that middle-class families are turning to as they face the crushing burden of indefinite home-care expenses. But it is hardly the only one, as businesses rush to meet the needs of these families, the fastest-growing segment of the marketplace, who are intent on keeping their loved ones out of nursing homes.

Traditional agencies like the Visiting Nurse Service, founded to serve the poor with all manner of home health care, are opening divisions geared toward clients who must pay their own way. At VNS, 15 percent of clients now pay out of pocket, an 11 percent increase over last year, and aides trained in wound care and vital signs are also learning to interact with doormen, use espresso machines or escort a client to the opera.

At the same time, upscale agencies providing trained aides are proliferating solely for the private-pay market, as are national chains with more modest services — and more reasonable prices. These franchises are intended for today’s consumer of home health care who need simple companionship, reminders to take medication, an escort to doctors’ appointments and help preparing meals.