Seventy percent of persons with Alzheimer's disease are cared for at home. Home care can be essential to provide personal care and give the family assistance and relief to continue to care for the patient. Deciding on and finding the care needed is not always easy. It is a personal decision based on the person's needs and family situation. The New York Chapter of the Alzheimer's Association does not recommend nor endorse any home care agencies or workers, but provides information on resources available to assist families in making arrangements.

Click here to get information on Home Care Agencies in the New York City area.

Please note that although agencies have their main offices in one borough, they may also service other boroughs.

It is very important to know as much about a home care agency and their workers as possible. Below are some questions to ask.

• How is the agency licensed or accredited?
• How long has the agency been in business?
• Are the employees bonded and insured?
• What kind of criminal background checks are performed for prospective employees? Are references checked? How many? Are personnel files updated annually?
• What kind of experience/certification do their aides have before they are hired?
• What type of training does the company provide to employees? Does training cover Alzheimer's and dementia care?
• Who pays the worker's social security or other insurance?
• What are the fees? Are there additional costs for weekends, holidays or at other times?
• What is the billing procedure? Do you pay the agency or the aide directly?
• Does the agency bill Medicare or other insurance directly for covered services.
• Does the agency provide employee job descriptions, or a plan of care in writing for clients?
• Is there a minimum number of hours or days per week required by the agency?
• Does the agency offer a free home health care consultation by a registered nurse prior to start of service?
• What kind of quality control checks are made by supervisory personnel and how frequently are they made? Who is available if problems arise? Is 24-hour call-in to a registered nurse available?
• Will the same person be providing care on a regular basis?
• Is a list of agency references available for you to check the level of client satisfaction? (Be sure to check these out!)
• Can you interview the employee? Is there a fee for this?
• Does the aide have reliable transportation?
• If you need specialized medical care, are employees licensed to perform it?

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Skilled care paid for by Medicare

If a physician orders skilled care (which are usually the services of a registered nurse, physical therapist, or other healthcare professional), Medicare or other health insurance companies may cover these costs. This care is usually short term and intermittent. Home health care organizations that provide skilled care will bill Medicare directly and can discuss with the patient and family what is covered.

Home care paid for by Insurance or Medicaid

Many long-term care insurance policies provide some coverage for home health care or personal care services, but it is necessary to check your specific policy for what is covered and under what circumstances these benefits can be accessed. Medicaid usually covers some home health care services. Families should talk with their social services worker for more information on covered services and agencies they can contact.

Check additional services provided by the agency

Many home health agencies, registries and referral services have nurses, home health aides and companions who can be employed on an hourly basis. Most agencies require a minimum number of hours (usually four) and some provide live-in assistance. It is helpful to understand if the person you are hiring is an employee of the agency or a referral service or if you are actually hiring the individual yourself.

Geriatric Care Managers

Geriatric Care Managers (GCM's) can be helpful in deciding on and locating home health care services. Care managers are usually employed on a fee for service basis, but some public and non-profit agencies may be able to provide assistance at a lower cost.

To locate a geriatric care manager, click here.

Sources: Missouri Council of Senior Citizens Senior Action Alert, and the Alzheimer's Association, National Capital Area Chapter.

Sources: Missouri Council of Senior Citizens Senior Action Alert, and the Alzheimer's Association, National Capital Area Chapter.

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