Millions of Americans provide unpaid assistance each year to elderly family, friends, and neighbors to help them remain in their own homes and communities for as long as possible. Sometimes these caregivers need time off to relax or take care of other responsibilities. This is where respite care can be helpful. It provides the -family caregivers with the break they need, and also ensures that their elderly loved one is still receiving the attention that he or she needs. Respite care is not all the same. Respite can vary in time from part of a day to several weeks. Respite encompasses a wide variety of services including traditional home-based care, as well as adult day care, skilled nursing, home health, and short term institutional care. More specifically respite care may take any one of the following forms:
- Adult Day Care: These programs are designed to provide care and companionship for frail and disabled persons who need assistance or supervision during the day. The program offers relief to family members or caregivers and allows them the freedom to go to work, handle personal business or just relax while knowing their relative is well cared for and safe.
- Informal and Volunteer Respite Care: This is as simple as it sounds. It is accepting help from other family members, friends, neighbors, or church volunteers who offer to stay with the elderly individual while you go to the store or run other errands. Sometimes your local church group or area agency on aging (AAA) will even run a formal “Friendly Visitor Program” in which volunteers may be able to provide basic respite care, as well. Many communities have formed either Interfaith Caregiver or Faith in Action Programs where volunteers from faith-based communities are matched with caregivers to provide them with some relief.
- In-home respite care: Generally speaking, in-home respite care involves the following four types of services for the more impaired older person:
- Companion services to help the family caregiver supervise, entertain, or just visit with the senior when he or she is lonely and wants company.
- Homemaker services to assist with housekeeping chores, preparing meals, or shopping.
- Personal care services to help the aged individual bathe, get dressed, go to the bathroom, and/or exercise.
- Skilled care services to assist the family caregiver in tending to the senior’s medical needs, such as when administering medications.
HOW DO YOU PAY FOR RESPITE?
The cost of respite care varies with the type of agency and the services needed, but federal and/or state programs may help to pay for it. Long term care insurance policies may cover some of the cost of respite care. Your local AAA will have more information on whether financial assistance is available, depending on your situation and where you live.
To solve the problem, Kathy called her AAA and then contacted a respite care program that the AAA staff recommended. After talking with Kathy, the respite care agency began sending over a trained caregiver to her house three days a week. The respite care provider makes sure that Mr. M eats regularly and is as comfortable as possible during the afternoons when Kathy has to work or attend to her children.
CAN THE NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM OFFERS RESPITE
The enactment of the Older Americans Act Amendments of 2000 (Public Law 106-501) established an important program, the National Family Caregiver Support Program (NFCSP). Funds have been allocated to states to work in partnership with area agencies on aging and local and community service providers to put into place multi-faceted systems of support for family caregivers. A specific component of these systems is respite. That could include, for example, respite care provided in a home, an adult day-care program or over a weekend in a nursing home or an assisted living facility. For more information on the NFCSP visit the Administration on Aging website at http://www.aoa.gov/carenetwork
HOW CAN I ENSURE THAT RESPITE CARE IS QUALITY CARE?
When evaluating a respite care program, family members should check to see if it is licensed by
the state where they live (where required) and if the caregivers have the qualifications
necessary for the job. They can ask respite care program managers the following questions to
assess their credentials:
- Are families limited to a certain number of hours for services needed?
- Can the provider take care of more than one person at a time?
- Can family members meet and interview the people who will be providing the respite care?
- Does the program provide transportation for the caregiver/senior?
- Does the program keep an active file on the senior’s medical condition and other needs?
- Is there a written care plan?
- How are the caregivers screened for their jobs?
- How are the caregivers trained? Do they receive extra training, where appropriate, to meet specific family needs?
- How are the caregivers supervised and evaluated?
Case Study
The following case study illustrates one situation in which a family caregiver could benefit greatly from arranging for basic respite care services to help a loved one recuperate at home after a hospital stay:
Mr. M is 83 years old and lives with his daughter Kathy and her family out in the country. Two weeks ago, Mr. M fell down the stairs in front of the house and suffered a broken hip. He was admitted to the local hospital and had an operation to repair the fracture, and then was sent home to recover from his injuries.
Although Kathy is happy to do what she can to assist her father in getting better, she has a part-time job and two children who need her support as well. There just are not enough hours in the day for her to look after everyone else, do her paid work, and also keep from getting stressed out and sick herself.
- How much does the respite care cost? What is included in the fee?
- How far ahead of time do family members have to call to arrange services?
- How do the caregivers handle emergencies? What instructions do they receive to prepare them for unexpected situations (being snowed in or losing power during a thunderstorm, for example)?
- How is the program evaluated? Are family members contacted for their feedback? If so, review their comments!
- Second, when interviewing an in-home respite care aide, you may want to ask these questions:
- Are you insured?
- Do you have any references? What are they?
- Do you have any special skills that might help you with this job?
- Have you ever worked with someone in the same medical condition as my loved one?
- How would you handle the following situation? (Cite examples of challenges you have encountered as a family caregiver.)
- What is your background and training?
- What are your past experiences in providing respite care?
- When are you available? Do you have a back-up/assistant if you are unable to come when expected?
- Who can I talk to at your agency if I am concerned about something?
- Why are you interested in this job?
- Why did you leave your last job?
WHERE CAN I LEARN MORE ABOUT RESPITE SERVICES?
The following organizations provide useful information to caregivers on a variety of topics including respite:
The Alzheimer’s Association provides education and support for people diagnosed with the condition, their families, and caregivers. To find a local chapter closest to you or to order a copy of the association’s respite care guide visit their website at www.alz.org or call 800-272-3900.
The Family Caregiver Alliance runs a resource center and publishes fact sheets and a newsletter with tips for family caregivers. The organization can be reached by calling 1-415-434-3388 or visiting its website at: http://www.caregiver.org
The National Alliance for Caregiving is a joint venture of several private and governmental agencies. The alliance web site provides useful information and links for caregivers. You can contact this resource by visiting its website at: http://www.caregiving.org
Information concerning adult day services can be obtained from the National Adult Day Services Association at (703) 610-9005 or by visiting their website at: http://www.nadsa.org
To find out more about hospice programs where you live, you can contact your local aging information and assistance provider or area agency on aging (AAA). The Eldercare Locator, a public service of the Administration on Aging (at 1-800-677-1116 or www.eldercare.gov) can
help connect you to these agencies.
