Millions of Americans provide round-the-clock care for their older or disabled family members. Home care agencies can step in to help families cope. Photo by Sabine Van Erp, Pixabay

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Baltimore County resident Joanne (last name withheld for privacy) spent the last few years finding caregivers for her mother-in-law, who was suffering from Alzheimer’s. After she passed away in March, Joanne jumped in to organize care for her father-in-law.

“I’m not going to say it’s a full-time job, but I spend a tremendous amount of time doing, organizing, dealing with insurance issues, medical insurance, long-term care insurance, doctor’s appointments, things like that,” Joanne said in an interview with the Beacon.

If you know someone like Joanne, November is the time to show your appreciation. Celebrated every November, National Family Caregivers Month is a time to recognize and honor family caregivers. In 1994 Caregiver Action Network, a nonprofit that provides free education, peer support, and resources to family caregivers, proposed the idea of a caregiver awareness month. President Clinton proclaimed the first National Family Caregivers Month in 1997, and every subsequent president has followed suit by issuing an annual proclamation recognizing and honoring family caregivers in November.

Many Americans are caregivers

In the United States, families are the primary source of support for older adults and people with disabilities. According to the National Alliance for Caregiving (NAC), more than 65 million people — 29% of Americans — provide care for a chronically ill, disabled, or aged family member or friend during any given year. They spend an average of 20 hours per week providing unpaid care for their loved ones.

The NAC estimates that these “free” services are valued at $375 billion annually. That is almost twice as much as is spent on homecare and nursing home services combined ($158 billion).

Approximately 66% of family caregivers are women, and more than 37% have children or grandchildren under 18 years old living with them. Most caregivers also work part time or full time and juggle other responsibilities, thus experiencing conflicts between competing obligations.

Research has shown that caregiving takes a significant emotional, physical and financial toll: 40% to 70% of family caregivers have clinically significant symptoms of depression, with approximately a quarter to half meeting the diagnostic criteria for major depression. And with nearly half of all caregivers aged 50 and older, many are vulnerable to a decline in their health. In addition, 47% of working caregivers indicate that an increase in caregiving expenses has caused them to use up all or most of their savings. Coordinated support services, like those promoted in November, can reduce caregiver depression, anxiety, and stress.

Common challenges

Joanne is grateful that her father-in-law has long-term care insurance, but paperwork builds up, she said.

“The major thing is trying to find agencies that will be more than the liaison but will handle the billing so that I don’t have to spend the next five years, or however long, dealing with the insurance company,” Joanne said.

“Another problem is finding an agency that has aides that you like. It’s not so much that I have to like them, but my father-in-law has to like them,” she said. “We are actually with two different agencies because we found somebody my father-in-law loves at one agency, but she could only give us two days a week.”

How home care agencies can help

There are two scenarios where people will typically reach out to an agency, said Mitch Markowitz, vice president of business development with Family & Nursing Care. The first is when adult children or family members see their loved ones aging and start to get concerned. These are the people that Markowitz refers to as the planners.

“The other scenario we see frequently is a family in crisis when there’s an unexpected hospitalization. For example, mom is getting ready to be discharged from the hospital. Family members have no idea what to do because they didn’t plan for a crisis like this,” Markowitz said. Family & Nursing Care sees both scenarios daily.

“There’s not a cookie-cutter strategy because every person we work with is in a different situation and has different needs. Our job in that first phase is to help diffuse the crisis. And it does happen more in crisis. We know that 75% of the people who call us need a caregiver in their home within 48 hours,” Markowitz said.

Agencies like Family & Nursing Care will step in for as little or as much time as needed.

“If people are already helping, we figure out how to work around them. If the person needs help 24 hours a day, we’ll figure out the strategy to accomplish that,” Markowitz said.

Certified Nursing Assistants (CNAs) are typically needed most when somebody wakes up in the morning and again at the end of the day. They help the clients get in and out of bed, with bathing, dressing, meals, and settling in for the night.

How to select a home care agency

So whether you’re a planner or a family in crisis, how do you choose a care company?

“One of the best ways is a referral from a friend, but that’s not how I found any of the ones we use,” Joanne said. She did it the old-fashioned way: looking at advertisements, researching the agencies she saw advertised, and then calling them to ask questions.

“I always encourage people to put feelers out there with people they trust and professionals in their healthcare world. Often the local senior living communities will be able to provide recommendations. Calling the case management department in a local hospital is always a great resource. Social media, like local Facebook community groups, are great too,” Markowitz suggested.

Markowitz cautioned against relying solely on anonymous reviews on Google or Yelp.

“You never know what’s legit, but it’s a way to gather information. I don’t know that I would rely on any one of these data points individually, but these are all different places that you can look to get feedback.”