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Jewish World Review May 1, 2003 / 29 Nissan, 5763

Jan L. Warner & Jan Collins

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Consumer Reports

What Makes Up a Caregiving Team? | After Dad died last year, our mother has declined steadily, both mentally and physically. Looking back, we now realize that each of our parents had frailties for which the other compensated, and for that reason, we thought they were doing okay. But now Mom has no one to help her, and her defenselessness shows through. She walks with an unsteady gait, has difficulty following conversations, and does not eat properly. While my brother and I want to make sure that she remains at home for as long as possible, we are very concerned that she may fall and hurt herself or become dehydrated. Since both of us have to work full-time and live several hours away by car, taking her in with us is not an option. Mom does have sufficient resources to live at home, but we have heard and read about horror stories concerning caregivers and companions. What is the best way to decide if she can stay at home and, if this is an option, how do we ensure that she will be properly cared for there?

Answer: While statistics tell us that the longer an elderly person remains at home and in the community, the better he or she will function, making sure that at-home care is properly managed can be quite a challenge, especially when family members are not in the immediate vicinity. In these situations, there must be a trust relationship between the family, on the one hand, and a care management team, on the other.

Who makes up the care management team? The geriatric care manager ( and the elder law attorney ( are often considered to be integral parts of the team to (1) assure that the care needs of the elderly individual can be handled at home at an affordable cost and (2) put together the rest of the team, whether it be a full-time caregiver or companions who are hired on an "as-needed" basis.

Without taking precautions, monitoring the situation regularly from the outside, and assuring that appropriate care is being provided, it is only natural for a weakened elderly person to rely upon and trust the only person upon whom he or she depends for care. In time, without regular monitoring, a caregiver could be in a position to influence and take advantage of an elderly person whose capacity to think for himself or herself may be diminished. After all, without the assistance of the caregiver, the elderly person would be placed in an assisted living or nursing facility. Thus, the fear of losing a caretaker and being placed in a facility can become more important than family relationships.

If full-time caregivers are needed, the geriatric care managers can generally provide leads to quality, experienced individuals. Some full-time caregivers can be hired through agencies that insure, bond, and provide payroll services - a real help to the family who otherwise would be required to withhold and file tax returns and reports on their employee. If your mother is found to need medical-related services, home health nurses are also available.

We believe that Home Instead Senior Care ( is a terrific source for non-medical caregivers - either full-time or part-time. A network of franchises throughout the United States and Canada, these folks provide a wide array of non-medical companionship and non-medical home care services for elderly individuals. Each caregiver must not only complete comprehensive criminal background and reference checks, but also a training program. Each caregiver is bonded and insured. Home Instead also handles all administrative duties, including payroll taxes, insurance, and the like.

Taking the NextStep: An ounce of prevention is worth a pound of cure. That's why it's important to deal with experienced professionals who know their stuff about elder care. Next week: Avoiding Abuse Before It Becomes a Problem.

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JAN L. WARNER received his A.B. and J.D. degrees from the University of South Carolina and earned a Master of Legal Letters (L.L.M.) in Taxation from the Emory University School of Law in Atlanta, Georgia. He is a frequent lecturer at legal education and public information programs throughout the United States. His articles have been published in national and state legal publications. Jan Collins began co-authoring Flying SoloŽ in 1989. She has more than 27 years of experience as a journalist, writer, and editor. To comment or ask a question, please click here.


04/09/03: Who is the client, parents or children?

© 2003, Jan Warner