Researching and Choosing the Right Caregiver for Your Family

Are you struggling to navigate the complex world of caregiving? Boy you are in for a treat with our guest Nichole Claiborn as she shares her personal journey from studying psychology to working in the field of home care. Her motivation came from witnessing the challenges her family faced when her grandfather was diagnosed with cancer. This experience made her realize the importance of finding the right care at the right time.

Nicole emphasizes the crucial role of caregivers in providing assistance with daily tasks and non-medical needs. From helping with medication management to grocery shopping, caregivers play a vital role in ensuring the well-being of aging adults. However, she also highlights the difficulties families face in understanding the available services and making informed decisions.

Here are 2-3 tips from the episode:

1.      Research and choose a reputable agency: When selecting a caregiver, it's important to research and choose a licensed and bonded agency. Ask about their certifications, background checks, and liability insurance. Ensure that the agency has a nurse on staff and follows proper safety protocols.

2.      Communicate openly with the caregiver: Establish clear lines of communication with the caregiver and the agency. Discuss expectations, preferences, and any specific needs or concerns. Regular communication can help address any issues or changes in care.

3.      Be aware of financial aspects: Personal care services are not typically covered by insurance, so families often have to pay out-of-pocket. Research options such as long-term care insurance, VA benefits, or Medicaid coverage. Understand the financial requirements and minimum hours of service when hiring a caregiver.

Don't navigate the complex world of caregiving alone. Take action today and find a reputable agency that can provide the support and care you deserve. Ask the right questions, ensure proper qualifications, and prioritize safety protocols. Remember, you have the right to choose the best care for your family. Don't settle for anything less. Take control of your caregiving journey and empower yourself with the knowledge and resources to make informed decisions.

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John & Erin

Episode Transcript

John (00:10):
Hi.
I'm John.
Hi.

Erin (00:11):
And I'm Erin, you're listening to connect and power
the podcast that proves age isno bearer to growth and
enlightenment.

John (00:17):
to growth and enlightenment.
Tune in each week as we breakdown complex subjects into bite
sized, enjoyable episodes thatwill leave you feeling informed,
entertained, and ready toconquer the world.
Our guest today will serve asour guide through the world of
caregiving, offering insightsand wisdom on what it is, what

(00:37):
to expect and how to navigatethis process.
She's also a lover of theoutdoors, camping and hiking,
and she loves to cook and comingup with new recipes.
Maybe we can get her to shareone of her favorites.
She's also a huge animal lover.
But for the past 15 years, shehas been involved in the
personal care side of home care.

(00:58):
She originally was going toschool to become a child
psychologist, but fell in lovewith health care.
When her grandfather wasdiagnosed with cancer, she
witnessed firsthand howdifficult the system can be to
navigate for patients and theirfamilies.
her passion is helping them findthe right care at the right
time.
Let's warmly welcome NicoleClaiborne.

Erin (01:20):
welcome Nicole

Nichole (01:22):
guys.
I'm excited to be here.
I appreciate it.

Erin (01:24):
Playborn.
Welcome Nicole.
I'm excited to So we all have astory.
And so we're curious aboutyours, how you did switch from
the psychology world and thencome into healthcare.
What made

Nichole (01:35):
Really, it was just as John had mentioned.
My grandfather was diagnosedwith bone and lung cancer, and I
had just started working Homecare agency, and I quickly
realized how difficult it wasfor families to figure out what
services they needed when theyneeded them, how services are
paid for, and the type ofcaregivers that they needed.
unfortunately, at the time formy grandfather, he needed more

(01:58):
hospice care and personal careservices.
Thankfully, my aunt was a nurse,and so we, we had that within
our family to, to help andsupport our family, but without
that.
We would not have been able tohave figured it out.
I just started in health care.
I was learning what hospice was,learning what personal care
services were, and I wasn't ableto help them through that, and
that really disappointed me.

(02:19):
And so that's why it's alwaysbeen my passion to, to see how I
can help families betternavigate the system.

Erin (02:25):
I found that too, with a injury that, a family member,
that gosh, it is hard tonavigate.
nobody tells you, here's thechecklist of what you need to
follow, and why, and, so Yeah.

John (02:36):
yeah, the questions to ask and, in that moment, that
emotional moment too, ouremotions are all over the place.
and Memories are popping in andwe want the best thing for this
person that we love, but wedon't know what that consists of
and how to put that all

Erin (02:53):
you don't know what you don't know either, right

Nichole (02:55):
And there's so many agencies out there, and so you
get what everyone tells you, andif you don't know what you're
looking for, you don't knowthose right questions to ask,
and so you just get stuck inthat, this is the right one, and
you don't realize that there'sothers, and that you can
interview, and there's aprocess, and that you have a
right to choose, and that'ssomething that not a lot of
people are aware of.

John (03:12):
I'm so happy that you said that.
So what are the key reasonsaging adults might consider
hiring a caregiver and whatservices can caregivers provide?

Nichole (03:23):
Yeah, that's a great question.
So personal care services, theway that I like to explain it
best, and what you'll probablycommonly hear is it's called
assisting them with theiractivities of daily living.
And so what we help ourselveswith every day, getting our
breakfast, lunch, and dinnertogether, bathing, toileting,
taking our vitamins or takingany medications that we have.
That's really what caregiversare there to do and to help

(03:45):
their participants with.
And so it's really just whateverthey need when they need it.
So if somebody is realizing thatthey're struggling with their
medications, they're forgettingto take them timely, they're
missing them, they're takingtheir morning, but they're not
taking their afternoon andthey're noticing that.
They're seeing other declinesbecause of that.
That's something a caregiver canhelp with.

(04:06):
They can come in and make surethat your medications are being
taken timely.
they can help you with groceryshopping if that's something you
struggle with.
And so if a participant isrealizing that it's really
taxing to get to the grocerystore and they need someone to
help them, whether it's goingfor them or helping them in the
grocery store, that's what thosecaregivers can do as well.
there's so many more things Icould talk about.

(04:26):
Everything that a caregiver canhelp with.
We don't need to get into all ofit.
but really just the way to thinkabout it is what you do for
yourself on a daily basis isreally what caregivers are
intended to do and think of itas more non medical.
And so some people, when theythink of a caregiver, they think
of a nurse and that's not what atypical caregiver is.
A caregiver is non medical.
They usually do not have anursing license.

(04:47):
And so their realm and reallythe scope of where they should
stay is on that caregivingactivity of daily living side
where they're helping you dothose daily tasks.

Erin (04:55):
How does a family go about researching when they pick out a
caregiver?
what are some of the questionsand qualifications they should
look

Nichole (05:02):
you look for?
I think how they can go aboutresearching is there's lists.
You can go online and find alist of agencies.
The Idaho Department of Healthand Welfare has a list of home
care agencies that are certifiedthrough the Department of Health
and Welfare that you can get.
And really, I would say, make acouple of phone calls.
ask them what sets them apart.
In Idaho, caregivers are notrequired to be licensed.

(05:22):
And I think that's somethingthat a lot of people look for
your agency licensed.
They're not licensed.
So it's really important thatyou make sure that the agency is
bonded, that they have liabilityinsurance, that they're going to
be covered.
If anything does happen whilethat caregiver is at your home
and.
a few questions to ask would be,are your caregivers
fingerprinted?
in Idaho specifically, there's alot of agencies that do not have

(05:46):
contracts with the state ofIdaho or for the Department of
Health and Welfare, which wouldbe Medicaid type of insurance.
And because of that, there's notreally any regulations on them.
So an agency can open a homecare agency, and they could
literally work out of their car.
Their trunk can be their officespace and provide caregiving
services to you.
So it's important that Do theyhave liability insurance?

(06:08):
if they are not through theDepartment of Health and Welfare
or contracted through theDepartment of Health and
Welfare, what kind ofcertifications do they have for
their caregivers?
Say the most important one isgoing to be fingerprints and
background checks.
even if you, Decide that youwanna hire a caregiver through
an ad and you don't wanna gothrough an agency, make sure
they're fingerprinted, make surethat you are seeing what's on

(06:29):
their background.
If they're gonna be driving you,do they have a driver's license?
Do they have auto insurance?
Does their insurance cover you?
If the insurance doesn't coveryou, do you have to drive your
own vehicle or does thecaregiver need to drive your
vehicle?
So those are just a fewquestions that I think are
important to, to ask.

Erin (06:44):
So those are you nailed it because I opened up a caregiving
company here.
And when I found that out thatthere's no rules, I was like,
what are you talking about?
But it gave me an advantage whenI met with families because I
had a book that I met with themand go, here's my licensing that
I'm a registered business.
Here's my insurance.
Here's everything.
This is how we certify ourcaregivers in the training that
they go through.

(07:05):
It's just so important.
Literally, you could picksomebody off the street and go,
Hey, I got a job for you.
Here you go.
Good luck.

Nichole (07:11):
Oh, absolutely.
Yeah.
Yep.
I definitely have called a fewagencies before and kids have
answered the phone and, it's alittle weird trying to, can I
talk to your mom?
and so that, that's definitelysomething they need to look at.
and really any agency, I wouldsay, if they're a good agency,
anyone should be able to callthem and say, tell me about your
services, what sets you apart,what makes you different.

(07:33):
They should be willing to comeout and meet with you for free.
that should never be somethingthat they're charging you to do.
And I don't know if that's justme, but I also think that an
agency should be willing to setyou up with the care you need.
So even if that's not with them,there's something specifically
you're looking for in acaregiver, and they can't match
that.
Ask them, do you know of anagency that you like really

(07:54):
well?
Who do you work with?
what agencies have good reviewsthat you've heard?

Erin (07:58):
another question I like to ask is, what are the hours your
caregivers work?
because if they can pullmultiple shifts and they can
work 80 hours a week, I want toknow that I'm not going to be
tired that they're getting thatrest and recovery.
that's So, important

Nichole (08:11):
Yeah.
That's a really great questionbecause there are agencies that
there's really no standard time.
they can work 24 hours a day ifthey want to.
there are some agencies wherethey'll have caregivers work
night shifts and then we'll gointo the next morning and be
working with a client.
And so that's not somethingthat's uncommon that you hear
clients call and say caregiverfell asleep on my shift while I

(08:33):
was showering.
And it's really not necessarilythe caregiver, right?
Like they just pulled anovernight shift and they were
awake the entire night and thenthey had to show up and work the
next morning.
So I do think it's important toask.
What kind of schedules do yourcaregivers work?
What are the amount of hoursthat they work?
And then also I think it's okayto ask the agency what hours
your caregiver works.
I don't think it needs to getinto specifics of like personal,

(08:56):
but my shift starts at 7 a.
m.
I want to make sure that they'renot working an overnight shift
and they're going to be wellrested for my shift tomorrow.
And they should be able to giveyou an honest, true answer.

Erin (09:06):
I agree.

John (09:08):
Wow.
I'm just yeah, I'm reallysurprised that there aren't
mandatory rules and regulationswhen it comes to opening up a
business like that, becausethey're working with these very
vulnerable people and peoplethat maybe have some memory
issues or, open wounds orwhatever.
And you have somebody thatyou're just pulling.

(09:28):
Maybe off the street that'sworking out of their car and, a
pretty bad situation.
I would think

Erin (09:35):
of the other questions we always ask, too, is the
caregiver a smoker or nonsmoker?

Nichole (09:40):
absolutely.
That's a great question.

Erin (09:42):
That's a great question.
Are they okay with pets?
some house have certainreligions where certain
religions, if you have a malecaregiver, can't be alone with a
female and how do you go aboutdealing with a cultural
difference or religious

Nichole (09:53):
preferences?
yeah, yeah, no, that's a greatpoint, is that's definitely
something that's come up, and Iwant to touch really quickly on,
you had mentioned wound carereal quick, so I'll go back to
that, but, On wound care,something that I forgot to
mention that I also think isreally important is whether it's
an agency that's private pay orthrough the Department of Health
and Welfare, that they have anurse on staff.
it's a requirement if they'rethrough a Department of Health

(10:14):
and Welfare, if they have aMedicaid agreement or contract.
It's not required if it'sprivate pay, and so when you're
talking about those more complexcares, no, a caregiver can't
necessarily change a wounddressing, but a caregiver can
keep eyes on that wound and cannotify the nurse from the office
and say, Hey.
Something's a little different.
the family member reported thatit's it's just looks nasty.

(10:35):
It's been oozing out.
Can somebody come in and take alook at this and the nurse will
come out and do that.
And so I think it's importantthat an agency has nursing
services for those more skilledreasons.
But going back to your question,I do think that's important to
ask because that is somethingthat's come up.
there may be a caregiver who isnot comfortable providing
bathing assistance or is notcomfortable helping a male in

(10:56):
the restroom, but it's finehelping a female in the
restroom.
And that's really important forclients to ask, is the caregiver
okay providing these services?
Because I think some agenciesget caught up in just hiring.
there definitely is a lack ofstaff right now in the
healthcare industry.
And so if they hire someone,they want to get them to work
and they'll just bring them inquickly.
They don't necessarily realize.

(11:17):
Providing bathing assistance toa male makes them uncomfortable,
and you don't want to put yourclient or the caregiver in that
situation.
So if you're a family or aclient looking for services, I
think that's something to ask.
I'm a female, I want to makesure that they're comfortable
providing these services to me,and not being embarrassed to ask
those questions.

Erin (11:33):
and it just off topic too, it's interesting, especially
with marijuana being legalized.
and especially with COVID.
So those have definitely come upHey, are you okay?
Caregiving in a home wheresomeone smokes whether medical
or recreational and the samewith COVID do you have your
COVID shot?
And so there's a lot of thingsthat have been presented lately,

(11:54):
which can make it hard.

Nichole (11:55):
It's made it more challenging.
'cause there's staff orcaregivers who did not want to
be vaccinated and there were.
clients that required them tobe.
And so it narrowed down whatthey were looking for.
But again, I think that's whyit's so important that if
someone's looking for services,don't be ashamed or embarrassed
of the questions you're askingat someone who's coming into
your home, providing verypersonal care to you.
So despite what your opinionsmay be on those things, you need

(12:18):
to make sure that it's what youwant.
So if that person is vaccinated,then you need to let the agency
know it's important that theperson's vaccinated for me and
my health, or it's importantthat they do not smoke.
I don't have any, allergies oranything that would make it to
where I can't be around smoke,but I don't want to be, and so I
think that everyone's entitledto that.

John (12:36):
So going to the beginning of the process, how can aging
adults and their families worktogether with a caregiver to
develop personal?
plan of care.
How does that whole thing start?

Nichole (12:48):
So a good agency in the very beginning of services,
they're going to come out,preferably with a nurse.
They're going to talk about whatyour care plan looks like.
Doesn't have to be a nurse, buta lot of agencies will offer
that.
So again, another question toask.
But It's important to talk aboutthe things that they need on
their worst day.
And so when you're developing acare plan, asking the client or
their family, what does a badday look like for you?

(13:10):
You know, a caregiver can skipsomething on a good day and they
can mark that it was notapplicable or not needed that
day.
But typically if it's not in acare plan, a caregiver is not
going to know to provide it.
And so to make sure that theclient and the family stays
happy, think of what you wouldneed on your worst day and write
very specific details into thecare plan.

(13:30):
Make sure that, if there'sspecific laundry detergent
that's used that's mentioned inthe care plan.
If there are specific stores youwant to go to for financial
reasons, mention that in thecare plan.
And then also, most agenciesshould adjust that care plan
every year.
so again, if you're with anagency that's contracted through
the Department of Health andWelfare or Medicaid, it's

(13:52):
required that care plan isreviewed every year.
If it's just a private payagency.
That care plan may stay thereuntil somebody says it needs to
be adjusted.
And so I think that's importantfor families to know, is if at
any time you feel like your careplan does not reflect the needs
that your family member has,request them to come out and

(14:13):
rewrite the care plan.
Because again, that is somethingthat's done in the very
beginning of service, prior tothe first day your care river
comes out.

John (14:19):
and they can modify that too, right?
if say, you know.
the person, the client has anissue or something changes and,
maybe they slip and they falland they need a little bit more
help.
Say they didn't need bathingbefore, but now they do need
bathing.
So they can go in and reevaluatethat, that care plan and say,
okay, now we need to do this.

(14:39):
And they may have to pay alittle bit more money and the
prices may change because nowthey're doing, more cares or a
different type.
Is that

Nichole (14:48):
Yeah, 100%.
It can be modified at any time.
Okay.
Yeah.

Erin (14:52):
as far as communication, what does the family expect from
the caregiver?
Like how often should they beupdated by the caregiver when
there's changes, oh my gosh,today they fell, or they're not
drinking as much as they usedto, and what's the best way for
them to communicate

Nichole (15:06):
So, that can be a little complicated because
that's really going to depend onthe agency.
So there are some agencies thatto protect their clients,
communication with the caregiveris very limited.
They prefer that it go throughthe agency.
So the agency will make surethat they are reviewing the
timesheets or the progress notesof the cares that are completed
every day with that client.

(15:27):
And then it's the agency'sresponsibility to report any
concerns that they have back tothe family.
Now there are also otheragencies that will allow the
caregivers to communicatedirectly with the family and so
I think that's maybe somethingthat brings up another good
point.
Maybe a good question to ask theagency if it's important to them
to communicate with thatcaregiver.
What are their rules andregulations around that?

(15:47):
there also are.
new things now, which is reallycool with technology and new
systems is that they have theability for what's called a
family portal and a lot of,systems that agencies use.
It's called an EMR, but it'sjust basically where all that
stuff goes in a system thatagencies can look at to manage
your family members care.
And so there's what's called afamily portal on some of these.

(16:09):
Systems now where a family canbe given access to that portal
to review some of those notes,and they can log in daily.
They can log in weekly, and thenthey can see anything that's
changed.
So that's.
I guess another important thingto ask things are going to keep
coming up as we talk justbecause I keep forgetting about
these things, but, It issomething that, it's just gonna

(16:30):
vary depending on agency, howoften that communication is and
how it's relayed, whether it'sthrough the agency, through the
system, or through the caregiverdirectly.

John (16:39):
I think that's an amazing.
thing that they've createdbecause I know for people like,
for instance, me living out in adifferent state than my parents,
if they do start utilizingcaregivers, I'd love to be able
to monitor it and see how thingsare going and see what's updated
in the chart notes and so forth.
It, I think it's just abrilliant thing

Erin (17:01):
But you should if you're noticing that, oh, they're not
drinking as much or, oh, theirfood intake is less than what it
used to be.
That might.
I want to go visit mom and dadand go, Hey, what's going on?
How are you feeling?
Have you been to the doctors?
It opens up another questions.
I really feel caregiving is themost important and healthcare.

Nichole (17:19):
I totally

Erin (17:20):
There are so many things, one person or a few people take
care of a client that can gowrong.
If it's not done the right way,things can be missed.
So I'm glad we're talking aboutthis today.

John (17:31):
I think it's amazing too, because unlike some of the other
disciplines like home health oreven hospice and some of those
other things, caregivers withhome care companies or personal
care companies, they have moretime, right?
They have more time to slow theprocess down, to evaluate the
needs.
Of the client, they're moreinvolved.

(17:52):
They're deeper.
they're having deeperconversations.
They're, they're developing arelationship with a person where
when it comes to home health andsometimes even hospice and some
of these other services, it's soquick.
It's, they're coming in for anhour here, 45 minutes there, and
Caregiving.
it's a different depth ofinformation.

(18:12):
That's why I always love thecollaborative approach, So for
instance, if somebody is onhospice, then, it pairs up so
well with a home care companybecause you have another set of
eyes in there to help supportthat hospice team or even that
home health team to continuewith those exercises and stuff.

Erin (18:29):
now that we have the caregiver in their house and
we've picked out the company andthe caregiver that's going to be
the house, sometimes thingsdon't always go the way you feel
it did when you interviewed.
So what are some red flags thatmaybe a family member can look
for going, Hey, this caregiveris just not working out.
It's not that they're not good.
It's just not working out for myfamily member.
What are things we can look outfor?

Nichole (18:50):
Oh my goodness.
I'll try not to get too crazy onthis answer.

Erin (18:54):
No, get crazy! Yeah.

Nichole (18:55):
definitely.
I feel like this goes withoutsaying, but if.
if you have a caregiver that'snot consistent, they're
constantly calling out, theydon't show up, they're late
consistently, those are thingsthat you need to talk to the
agency or that, that caregiverabout and make sure that you
find another caregiver that'smore reliable.
Like I said, I know that goeswithout saying, but a lot of
people I've noticed, they try togive them the benefit of the
doubt.

(19:16):
they said they had to do this.
They needed to drop their childoff at daycare.
This is what happened.
Okay, then if that scheduledoesn't work, then we need to
find a caregiver that scheduleworks for because your mom has
medications at 815 and thecaregiver shows up at nine every
day.
So that's not going to work.
that's one example.
I would say another would be ared flag for me is agencies

(19:37):
should be reviewing time sheets.
And again, if families arelooking at time sheets and cares
that's provided, and it's thesame thing every day for weeks.
Chances are that's probably notreally what's happening.
We all know that things changeevery day, your schedule
changes.
I may not feel like getting upand getting dressed that day.
I may not feel like doing thisday.
And so if you're seeing a timerecord or time sheet, I'm going

(19:59):
to call it multiple things, butprogress note, something that is
documented that shows the carethat's provided, and it's the
same every single day, that tome is a red flag, that person
may not be 100 percent invested.
In your family members care orin your care, because it really
needs to be tailored to you andit needs to be documented
exactly what's happening, evenif it's just doesn't have to be

(20:20):
negative, but had a bad day.
Didn't feel like getting up andshowering today.
Didn't feel like getting dressedtoday.
So dressing is not somethingthat was provided.
Bathing wasn't provided, but wedid do these things.
And so those two should bemissing off of that time sheet.
So I don't know if that thoseare just a few examples, but

John (20:37):
perfect.
No, yeah, that's great.
So talking about red flags canyou.
talk about the importance ofsafety protocols and, going into
a deeper discussion about whatwe just engaged what about the
fear of retaliation, right?
Some of these older people,maybe a guy is a caregiver and
he seems a little bit highstrung one day and intense, or

(21:00):
maybe the, the female caregiver,Had a family issue and brings it
to work with them and is nowworking with a client, but it's
a little bit rough.

Erin (21:08):
Or the other way around, where a client might have a mild
case of Alzheimer's dementia andthey get a little touchy.

John (21:14):
so how are some of those things handled, both for the
safety of the company, but alsothe safety of the client?
because of course, you don'twant, to put either one of those
parties in a compromisingposition, so.
how do we navigate that

Nichole (21:28):
there's a few different ways that agencies can go about
handling that.
I will say For me, that's why Ithink it's always best to go
through an agency.
I know it's cheaper sometimes togo through a direct caregiver,
but if there is an issue andyou're going through an agency,
the agency is helping resolvethat issue.
And so it's taking out some ofthose safety concerns because
they're giving a barrier ofprotection, that, necessarily

(21:50):
there if you just hire someoneoutright, but for an agency, if
there's a concern, the firstthing that we talk about is
we'll bring the caregiver in orwe will go out to the client's
house and talk about, okay, whathappened, what's going on, do a
mini investigation, talk abouthow both parties are feeling
about the situation.
and some situations we've also,If it's, they don't feel
comfortable going back, theydon't want the client to know or

(22:11):
the client doesn't want thecaregiver to know that they
don't want them back out there.
Again, that's something theagency kind of handles of,
unfortunately we had a schedulechange and that schedule change
didn't meet with yours, so wedecided that this wasn't the
best fit.
We can take that on.
Or again, if we're conducting amini investigation and we
realize there's a true problemthere, then the agency is gonna,
going to handle that how theyneed to, especially John, if you

(22:32):
were talking about thecaregivers being a little rough.
is it just because, what doesrough mean that may be an agency
needs to go a little bit furtherthan a mini investigation?
This may be that personshouldn't be a caregiver anymore
period.
So it just depends on thesituation and then also really
depends on how the client wantsit handled.
If they want to remain anonymousand the agency keeps it
anonymous and we will find a wayto an agency.

(22:54):
to eliminate that caregiver inthat situation.
So again, I think that's whythere's benefit to going with an
agency is there's investigationsthat are completed.
There's other caregivers thatare available to you so they can
remove that caregiver from yourhome and provide somebody else.
If it's happening and you're acaregiver, we can find you
another client.
Or if you love that client andyou just don't know how to
navigate that type of emotion,Then we can provide the training

(23:17):
and skills to help youunderstand.
Okay, this is when it's going tohappen.
And this is how you need tohandle it.
Because sometimes it's just aseasy as caregivers may not be
trained on how to handle thebehavior.
And if they know how to handleit, then everyone's a lot more
comfortable.

Erin (23:30):
you brought up another good point that we didn't talk
about.
There are agency and privatepay, but there's also
individuals you can hire ascaregivers.

Nichole (23:39):
Yes.

Erin (23:40):
vetting them out, it's completely different.
And there's different things youneed to look for, Correct.

Nichole (23:45):
Correct.
Yes.
Can you

Erin (23:47):
share some of those?

Nichole (23:48):
Specifically, if it's your vetting the individual?

Erin (23:51):
Yes.

Nichole (23:52):
Definitely, I would ask, making sure you're asking
for references, still make surethey're background checked.
they can provide a backgroundcheck to you.
You can do your own backgroundcheck, whether you're doing that
through what's called an OIGcheck where you can put in their
information, you can ask themfor their name and their date of
birth and you can pull federal,a federal exclusionary check.
You're able to do that.
you just want to make sure thatyou're.

(24:13):
This person's going to be inyour house, right?
So you want to make sure thatthey're safe.
That's just a few ways that youcan do that

Erin (24:18):
Now, they don't carry their insurance always on their
own.
Is that something, as a client,I can request?
hey, can you get insurance whileyou're here to cover us?

Nichole (24:27):
Are you talking about liability insurance?
Yes.
Yeah, I'm pretty sure you canrequest that.
Now, I don't know any caregiverswith what they're being paid
that would necessarily do thatif it's straight through private
pay, or through private paythrough that individual, I'm
sorry, not through a private payagency, but through that
individual.
You definitely can request it,but I don't think I've ever
heard of someone doing that

Erin (24:46):
I think it's also important to let people know you
don't have to stick with thatagency.
If you get a feeling orsomething comes up or they're
not meeting the needs that youfeel need to be met.
It's okay to say, I'm sorry,this is no longer serving us and
go to another service.
Don't feel bad about it.

Nichole (25:04):
Yep, absolutely.
And you're not, you should neverbe stuck to a contract with a
personal care agency.
If you're unhappy for whateverreason, you should always be
able to leave.
If there's an agency that wantsto hold you to a contract, I
probably would steer clear ofthat.

Erin (25:18):
Yeah, I agree When hiring a caregiver, we know it's not
cheap, so what are some of thefinancial aspects?
What are some things to reallylook into when hiring a
caregiver, 24 hour care?
Is there a minimum that we'regoing to have to pay for?
is there a deposit?
Some might take a deposit.
What are some things familiesshould consider?

Nichole (25:37):
This is probably the most frustrating conversation
when it comes to the financialaspect of personal care
services.
So I'll try not to go off on atangent too much, but
unfortunately, personal careservices are not covered through
insurance.
So that's a question that a lotof people ask is, why is it not
covered under insurance?
Home health is, hospice iscovered.
Why isn't personal careservices?
I don't know.

(25:58):
And it should be.
I think that's something that weall need to really push and
advocate for is personal careservices should be covered.
I think it would make things alot cheaper if people were
taking care of the way theyneeded to be taken care of in
the beginning.
It's going to keep them fromthat fall.
That's going to put them in theemergency room.
That's then going to put them inrehab.
So personal care services arereally important.

(26:18):
It saves the state a lot ofmoney.
It saves insurance a lot ofmoney.
If only they realize that andpaid for it, but they don't.
So yeah, One of the ways to payfor it is private pay.
So out of pocket agencies verylargely on what that looks like.
The last I was quoted probably amonth ago here in Idaho is you
can find anywhere.
as 28 an hour to 45 an hour.

(26:39):
It just depends on the agency.
some agencies that do privatepay services only, they do
charge a little bit more becausethey pay their caregivers a lot
more agencies that arecontracted through health and
welfare or Medicaid.
They pay a little bit lessbecause they're confined to what
Medicaid reimburses.
So their pay for staff is alittle less.

(27:01):
But again, they have normally,not all the time, but they have
higher regulations that theyhave to follow because they're
under contract with the state.
The VA will pay for someservices.
so if the person is a veteran,there are services that can be
covered.
It's not a lot, but there aresome.
And then also there's long termcare insurance policies, some

(27:22):
that will cover personal careservices.
There's some restrictions tolong term care insurance
policies, which get a littletricky when you're choosing an
agency.
And you have a long term careinsurance policy, you want to
make sure that agency has anurse.
That's usually a requirement.
The nurse has to complete thecare plan Some people have
fallen in love with agenciesthat don't.
They get started, they'reproviding care, and then the

(27:42):
agency realizes, I can't getbilled for service, so I'm going
to charge the client and theirfamily.
The client and family doesn'twant to pay for it because they
thought it was under theirinsurance.
So just something to think aboutis make sure that the agency
that you choose, if it's under along term care insurance policy,
meets all of those standards.
And then also there usually isan elimination period.
So they'll say you as thepatient need to pay an out of

(28:04):
pocket before your agencypayments kick in.
So VA Medicaid, so stateMedicaid will pay for services
if you meet certain criteria theVA long term care insurance, and
then private pay.

Erin (28:18):
other resources out there that people can search for that
might help cover some of thecaregiving services that aren't
any of those?

John (28:26):
of Aging.
area of aging.
yeah.

Nichole (28:28):
and they can provide some services as well to more of
the rural community.
But I.
I cannot think of any that I'vebeen able to find.
Now, Erin, you may know morethan I do,

Erin (28:39):
I don't, I know there's some like certain places, it's
like grants, where you can goand apply for grants and
different hospitals might offerit or different charity services
and maybe churches and stuffoffer it, but I didn't know for
sure if there's an actualnationwide.

Nichole (28:54):
Not that I've ever come across.
now I do know there's certain,depending on the diagnosis,
there's certain things like ifyou have MS, there's an MS
navigation team and there'sfunding that they have
available.
that funding will pay for someservices, whether that's
building you a ramp or providingyou with medical equipment, and
it may cover some temporarypersonal care services.
So there's probably things likethat's tied more to diagnosis.

Erin (29:15):
There's something here because we came to off topic.
there is a caregivingconference.
I came here when I actually fromCalifornia here.
I thought it was for actualcaregiving, but it was families
caregiving for their own familymembers.
And that's where they wereproviding the free services.
like you get.

(29:36):
So I didn't know just in generalhere if there was something.

John (29:39):
and I, think Nicole can touch base on that a little bit
too.
I think there is like Medicaidwill pay a family member, right?
they'll pay a family member tohelp provide certain cares for
their loved one, which is greatbecause one who's going to be
best to take care of their momor their dad or sister, brother.

(29:59):
Whoever would be, maybe a familymember, but they can't afford to
just stay home and take care ofmom and dad for free, but if
there's some sort ofcompensation.
So do you know how that worksand if, if somebody was
interested in doing that, howdoes, how do they get that ball
going?
Yeah,

Nichole (30:17):
So, first and foremost, that client needs to be on
Medicaid services through thestate of Idaho.
So the agency can help you withthat and IT, or the Department
of Health and Welfare can helpyou with that.
But they have to conduct anassessment out in your home to
make sure that you meet all thecriteria once financially.
So there's a financialapplication that you have to
meet it, and then also themedical side of it.

(30:37):
Do you meet that to needpersonal care services?
Once that's identified and youare covered and eligible for
those services, then the familymember who's interested in
providing the care.
Together, you just need to pickan agency that fits you both
best.
And that caregiver, your familymember, can then get hired on
with that agency to be your

Erin (30:58):
Can you explain that a little bit more because some
people are like, what agency doI join and what are you talking
about?
What do you, what, is there aprogram?
Is there, what is it?
So

Nichole (31:06):
So when I say agency, I mean specific personal care
service agencies that are outthere.
So the companies themselves, thebusinesses themselves.
that's what I mean when I'mreferencing that.
I did want to highlight thatgoing back to what you were
saying, John, with familymembers.
Right now, it's very temporary.
for example, if you have a childand you're a mother, that's a
temporary service and thestate's working right now on

(31:28):
making that long term and tryingto figure out how they can do
that.
COVID really brought a lot ofawareness around that, that
there's not enough caregivers,there's not enough healthcare
personnel, and there were a lotof moms and dads who are having
to quit their jobs and stay hometo take care of their sick kids
because there were no caregiversto help them.
And so that was a temporary.
Kind of approval that camethrough that the state had

(31:50):
given, and that's gonna go awaysoon.
And so there's a lot of familiesand personal care service
businesses who are fighting tomake sure that, that stays
permanent.
so right now when we say family,it's basically if you have an
adult parent that you're wantingto care for or you have an adult
child or a sister, abrother-in-Law, those types of

(32:10):
things are already covered andthey will remain to be covered.
But if it's a.

Erin (32:16):
caregiver burnout.
I know a lot of family memberswant to take care of their mom
or take care of their dad orwhoever their family member is.
But I feel don't feel guiltyeven if you hire a company for a
couple hours a day, right?
That's super important.

Nichole (32:33):
important.
Yeah.

John (32:35):
That's all I'm going to give my dad, but he needs
something.
And I need all of his mealscooked in that one hour.
I need you to cook five or six,some unrealistic expectation,
but they're finding financiallythey can't afford a lot.
So is there a minimum when itcomes to providing

Nichole (32:50):
Yeah, so I'm glad you looped back around on that
because Aaron asked earlier, andI skipped right over it, but.
Every agency is different, andusually, yes, there's a minimum.
And most often, agencies areabout two hours per shift.
Some will have a weekly minimum,where you have to be at least
four hours a week.
And that most often needs to bein one shift.

(33:12):
You couldn't do four hours andhave four days a week.
There's not many agencies thatwill do that.
But yes, that is an importantquestion to ask.
Whatever agency you decide to gowith is, do you have a minimum?
Because a lot of them do

John (33:23):
Okay, great.
And then another thing I was,I've heard stories of where a
long term caregiver will betaking care of a person.
They've developed this amazingbond, this amazing relationship.
And then the, The person they'recaring for, maybe it's a woman
that has a little bit of moneyor a man that has a little bit
of money.
And so the caregiver throws outlittle comments like, Oh yeah,

(33:46):
my car can hardly run.
I'm having all these issues withmy car.
Oh gosh, I have no idea how I'mgoing to pay for my child's
college education.
the client feels almostobligated because the caregiver
is providing so many amazingcares to help them with their
daily activities.

(34:06):
And they almost feel Oh, Ishould help with the car or I
should help with this collegeeducation.
So how do people face that?
Because I'm sure, there's alittle bit of preying on the
vulnerable people out therethat, that do have money.
And they have this long termcare.
So how is that dealt with

Nichole (34:23):
Oh my goodness.
So again, I think that goes backto this is why I'm a huge
proponent of pick a caregiverthat is with an agency, because
again, the agency can helpthrough that.
Don't do it.
I know that's very easy to say,but yes, because they do.
They feel like family.
It feels this is, this is myother, the daughter I never had,
or the son I never had.
And I want to be able to helpthem out.

(34:43):
Don't go there.
The agency's paying them to dothat job.
They're paying them for areason.
Some agencies pay them mileage.
There's more shifts that theycan pick up.
There's more work that they cando so that they can get paid the
right way.
It never works out for theclient or for the family when
money is given to thecaregivers.
And most often, I guess what Iwould say is if you really love

(35:06):
that caregiver.
Don't do it because you're goingto get them fired

John (35:10):
Yeah.

Nichole (35:10):
because truly that's what's going to happen.
for someone who works at anagency for a really long time,
if I had, if I have heard that'shappened, which I have, the
first thing we do when we knowthat it's legitimate and that a
caregiver did accept money froma client, they're terminated.
And so it ends up to where theyno longer have a job and.

(35:31):
It's for what's best for theclient, because I do, I think
that's a really slippery slope.
One thing turns into anotherthing turns into another thing.

Erin (35:38):
But with the holidays, and I don't know for you, but with
the holidays, if they want togift them with something, it is
very wise to go through theagency, through who they're
hired and say, Hey, weappreciate the caregiver and the
time we would like to gift them.
So the agency is aware and caneither be like, I'm sorry, we
can't because of

John (35:57):
Or a limit.

Erin (35:57):
or yes.

John (35:59):
Yeah, because I know again, going back to whether
it's somebody wealthy orsomebody that, is on a fixed
income, somebody wealthy couldsay, it's Christmas time.
She's had car problems.
We love her service.
So we're, we're going to buy hera car and that's just not
appropriate.
if I'm the caregiver, I'm like,I hate to say it, but I would be
tempted to say, it was worthlosing my job because, I got a

(36:21):
car out of it, and, there'sother jobs out there,

Erin (36:24):
but we just want to protect everybody.
Really?
Just make sure everyone's

John (36:29):
Yeah.

Nichole (36:30):
I think in going back to what you were saying with the
holidays, absolutely talk to theagency about it.
there's a lot of situations thatI can think of where you've had
a husband and wife couple andthe spouse gave money away or
gave a gift away for Christmas.
That person passed away sixmonths later.
said spouse found out that thesethings were given and they want
to come after the caregiversbecause it's these caregivers

(36:52):
took this money from my spouse.
And as an agency, you're able tostep in and protect your
caregivers and say, I have thison file that stated that your
spouse wanted to give this gift.
They contact the agency.
This was the amount.
Is that the amount that wasgiven?
Okay.
we have that.
And it's.
just protects things and makesit less messy.
And so absolutely go through theagency, make sure they're aware.

(37:14):
They'll talk to you about what'sappropriate, what would be
acceptable.
And usually they're able todocument that and get it in
writing that it's something thatwas agreed upon.

John (37:22):
Yeah, I'm sure it's not a huge percentage, but more and
more, I do agree with somethingyou said earlier about
caregivers as being one of themost important roles in all of
healthcare.
Even though it's maybe notclassified as a clinical role,
it's still an essential part ofall of us as we age and get
older, we're gonna need someextra care.

(37:43):
And so I love that, that youbrought that up

Erin (37:47):
what do you think about it?
You're getting some PT fromsomebody.
Your caregiver can assist inthat, right?
They can train right there whenthe PT comes to the home and
they're helping the family,they're helping the client, like
they're a vital role in thisperson's life, cooking their
meals, making sure they'rebathed, making sure their
laundry's done.
If they have an animal, maybemaking sure that animal is

(38:08):
walked or taken care of or goneto the bed or keeping track of
their bills.
where's your finance?
Making sure your electricitystays on so

John (38:17):
And I know Nicole, you and I have had discussions about
this, even when it comes toother services such as home
health and hospice, maybe thatcaregiver has been with that
client for a bit of time.
They're going to know everythingabout that client, so when that
home health team does come in todevelop their plan of care or
the hospice team comes in,they're going to have a lot more

(38:38):
success if they respect thatcaregiver by sitting down with
them for a little bit and justsaying, Tell me about this
person, what do they love?
Are they a morning person?
Afternoon person?
What are their favorite topicsto discuss?
Because yeah, it, it createsthis collaborative, approach,
and there's a lot more successwhen we all come together and

(39:00):
communicate

Erin (39:01):
and it's okay for the caregiver to go with them to
their doctor appointment becausethere's some things the families
can't answer and they're morecomfortable or have become more
comfortable with their caregiverbecause they are there every day
going, Hey, this is theirroutine.
Oh, I can answer that question.
And we always encourage ourcaregiver if the family is okay,
if the client is okay, thatyou're there in case the doctor

(39:23):
has questions or needs moreinformation and clarity on
something.

John (39:27):
Yeah.
did you have any more questionsto ask?
Okay.
Okay.
and I do too now because there'sa few, going back to our intro
of this whole discussion.
Yeah.
I'm changing things up.
She's not used to this.
yeah, so I, I want to sharebecause it's so important that
people don't just connect peoplewith their education on.

(39:50):
Service, right?
And so I want people to know whoyou are, and I want you to share
a little bit about some of thestuff we said in the beginning.
if that's okay, like, your lovefor animals, you know, because I
know.
That, you're very involved inhelping pets get adopted and
stuff like that.
So if you could touch base alittle bit on, what that brings
to your life and your love forthat and yeah, maybe share a

(40:12):
recipe.
That would be cool.
If something that you love todo, that would be cool if you
have a sec.

Nichole (40:17):
yeah, I've just always been an animal person.
I love them.
My husband probably does notlove that about me right now, So
we had four animals total, twocats, two dogs.
We lost our two Pomeranianswithin a year of each other.
That was really hard for me andmy husband.
And I had thought, okay, I'mgonna.
I need to find another animal.
I've always been involved intrying to find animals homes.

(40:39):
And I remember I was looking atdogs when I was working at
Terrace and Corey came over andshe's are you kidding me?
You're not going to rescue ananimal.
like, gosh, Corey, you're right.
What am I thinking?
So started looking at therescues that I've always helped
find animals for and, fostered adog and fell in love with her.
She was amazing and perfect.
And so I was a foster fail.

(41:01):
We kept her.
And my husband said, that's it.
We've had two small Pomeranians.
Now we have a giant dog.
We're not having another dog.
So we were on our drive backfrom Moab.
And I saw these dogs need to berescued.
They're going to be euthanizedif they don't find a home.
So I told my husband, I'm justgoing to foster it.
It's fine.
I did fell in love with him, butunfortunately he got adopted out

(41:24):
from under us, which was greatfor him.
bad for us, but then it allowedus to foster another one that we
are in the process of adopting.
So my husband doesn't love it.
Long story short, my husbanddoesn't love that.
I'm an animal lover, but

Erin (41:36):
have just asked us.
We have two.

Nichole (41:38):
always been, do you want to give up some of your
animals?
It's hard

John (41:42):
No, but I love that side of you because not only are you
incredibly educated and verytalented at running companies
and helping serve people andfinding everything that they
need to really.
Yeah.
Do well as they age, but youhave such an amazing heart too.
And it just shows through someof this, of the stuff like
rescuing pets and animals.
And I know that's so dear topeople.

(42:04):
So I want to just quickly touchbase on that.
And, so what's your favoritething to cook?

Erin (42:08):
You mean, what is she making us for dinner

Nichole (42:10):
know, right?

Erin (42:11):
love

Nichole (42:12):
Honestly, I love cooking in general.
I cannot bake.
I cannot.
My sister is the baker.
I'm an awful baker, but I can, Ido enjoy cooking.
I would say my favorite thing tocook that my husband loves the
most is probably I make a friedchicken and jalapeno waffle and
then Pour, like a hot sauce,maple syrup over the top of it.

(42:33):
So that's probably my favoriteand most requested meal of
what's asked of me to

Erin (42:39):
You'll have to share that with us if you don't mind us
sharing it with everybody elselater.
Yeah.

John (42:43):
If you share it, we'll have to attach it to your little
blog post, and you'll becomefamous for this amazing, recipe.
so I think we have one morequestion because Aaron asks this
to everybody.
So I apologize for throwing youa little bit off by my two.
questions that were off topic,but, Erin asks this to
everybody, so she loves it.

Erin (43:04):
know, and I need to find a new way to ask this, but there's
just no other way to ask itreally is.
Do you have an adventure list oris there someplace you've been
or you want to go.

Nichole (43:17):
I am probably the most boring person to talk to about
that, especially for you two,because you're such adventure
driven people.
I have a very old soul.
I'm paranoid about everything aswell.
And so I really don't.
It gives me anxiety to thinkabout going somewhere because
one, I'd have to fly there and Ihate flying and there's probably

(43:37):
water and I hate large bodies ofwater.
So you have to take all of thataway.
And I had zero fears in theworld.
I've always wanted to go toAfrica.
I love animals.
I would love to just see some ofthe, some of those animals up
close, probably very dangerousto see a lion up close, but that
would be, that'd be reallyamazing.

(43:59):
I'll just never get therebecause you can't drive there.

Erin (44:03):
We can always annex

John (44:04):
Yeah, there's plenty of, there's plenty of medications
you can take and cocktails youcan have while on the plane that
would knock you out and you'dsleep the whole way.
So

Nichole (44:13):
I know.
I did get married in St.
Lucia and that was amazing andwonderful.
But it just.
Thinking of places like thatjust stresses me out.
The anxiety is just too much

John (44:23):
for each their own though, right?
I think about your heart andyour love for animals and what
you're doing with, and it bringsyou so much happiness, so much
joy.
And I know you have twobeautiful children that, that
you absolutely adore in youramazing mom.
So I know you invest a ton oftime and energy into those two.
I think Erin and I are on theflip side of it, you know, our
kids are off and gone.
And and so now we're ready toexplore and experience different

(44:47):
things.
So yeah.

Erin (44:48):
I'm just not ready to die doing anything yet because I do
want to see my grandbabies.

John (44:52):
Yeah.

Nichole (44:53):
See, and that's what scares me though.
Every time I go somewhere, it'sthis is going to be the time I
die on this plane.
It's that Alanis Morissettesong.
This will be the day.
So, but yes.
Yes.

Erin (45:04):
higher probability

Nichole (45:05):
that all the time.
It's just, no, there's morecontrol.
in my vehicle, I

Erin (45:08):
true.

John (45:09):
thank you so much for being here with us and sharing
your knowledge of, home care,personal care.
you're so articulate and there'sso much great little nuggets of
information.
And I know that our listeners,some of them, they haven't ever
experienced personal careservices.
And so we're really excited to,broadcast this out on our
channels and let people know,gosh, this is what it is.

(45:32):
These are some of the questionsyou should ask.
and this is how you can protectyourself.
So thank you for all that

Nichole (45:37):
Yeah, absolutely.
Yep.
Pleasure.
Thanks for having me.
And I will just add that ifthere's ever any questions that
someone asks and I know you guysare amazing, come to you too and
ask those questions, but I'mhappy to answer them as well

John (45:49):
thank you.
Thank you for tuning in toanother episode of Connect
Empower.
We want to express our gratitudeto you for being part of our
community, and we hope today'sepisode has provided you with
valuable insights andinspiration to enhance your life
and that of a loved one.

Erin (46:06):
We are more than just a podcast.
We are a community dedicated toenhancing the lives of our aging
adults and their support system.
We encourage you to visit ourwebsite now at www.
connect empower.
com.
Explore more information aboutour guests from today's episode
and to access our freeresources.

John (46:27):
resources.
Our mission doesn't end at theconclusion of this episode.
We invite you to take action nowby sharing the knowledge you've
gained today with someone whomay benefit from it.
Whether it's a family member,friend, or colleague, your
influence can spark positivechange.

Erin (46:42):
Remember, Subscribing to our podcast ensures you never
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So hit that subscribe button andstay connected with us.
Your commitment is the drivingforce behind our mission and
together we can create amovement for a brighter future
as we age.

John (47:03):
I'm John.

Erin (47:03):
I'm Erin.
Until next Wednesday.