The process of downsizing and selling the family home is often overwhelming, even for those with a background in the moving industry. A real estate broker for 25 years, Carol Fine, and her husband, Richard, wanted to make a quick move from their five-bedroom house three years ago, and with the help of Downsize, Etc., they were able to do just that.

Married for 53 years, the Fines have two children. While Richard enjoys playing golf and swimming, Carol can often be seen sewing or settling down with her latest read.

It was when she was diagnosed with early Alzheimer’s that they decided it was time to make the transition and ended up selling their home within a few weeks. “We couldn’t do it ourselves. It was just so overwhelming to stand there and figure out what to take or sell,” she said.

Fortunately, she was introduced to Nancy Malphrus and Bart Goldstein of Downsize, Etc., a company that specializes in real estate, liquidation and design. “Nancy came over and knew what we needed to do,” said Carol. “I was extremely impressed with her presentation and guidelines for downsizing.”

The couple then visited their future two-bedroom apartment with Bart, who drew up a diagram, factoring in the particular furniture they wanted to take.

“They recommended a moving company that was terrific,” said Carol. “It was also a very controlled environment as they limited the number of people who could go through the house.”

Not only were their valuables properly cared for and secure, but the Fines’ home was left spotless. According to Carol, Bart and Nancy made all of the arrangements for selling or donating the remainder of the couple’s belongings while Bart helped decorate their apartment.

Since their move, the Fines have continually stayed in touch with the organization and do not hesitate to recommend it to anyone they know considering a move.

“Being in real estate for so many years I know how much is involved and you just can’t make a move like that on your own,” said Carol. “The process for us was absolutely seamless — it was a dream.”

Liz explains the problem she faced: “People said that one of us would have to move. I thought moving him to California would be too much of an abrupt change for someone who had lived in Baltimore for so long and was already going through so much. Moving to Maryland was not an option for me because I had my own life and my work out here.” While her father was recovering in the hospital, Liz attempted to find a solution that would work for them both.

When the hospital social worker recommended home care, Liz thought it was a great alternative to a nursing home. One of the companies they recommended was Professional Care, Inc. “I called Yvonne Moran, the owner of Professional Care, and she was able to send someone to help my father right away. It worked out so well that I have never gone with anyone else,” explains Liz.

Dr. Sherman received personal care during his rehabilitation at Keswick Multicare Center and has continued receiving 24 hour, live-in care since returning to his home. The caregivers provide meals, do all the shopping, and help Dr. Sherman with all the activities of daily living. Liz says, “My father’s caregivers are really phenomenal people. This is not an easy job, and they do it so well. They are so conscientious, and they have really bonded with him.”

She continues, “Even if your family lives nearby, they cannot be there all the time because they have their own lives and their own families. It is always important to have someone that you can rely on to provide care. For me, it was even more important because I am so far away.” Dr. Sherman has been receiving care from Professional Care for three and a half years now, and his condition has steadily improved with therapy. He has become comfortable with his caregivers, and they have settled into a healthy routine.

Knowing that her father is comfortable and well cared for gives Liz enormous peace of mind. She also knows that should any problems arise they will be dealt with professionally and efficiently. Of Yvonne, Liz says, “She is very hands on and has an excellent rapport with the families and with her caregivers.” The dedication of Yvonne and the caregivers with Professional Care allows Liz to continue to live in California, while Dr. Sherman remains in his long-time home in Baltimore.

Whether performed in the comfort of their own homes or in a facility, home care helps seniors to maintain their independence. Additionally, home care prevents the full responsibility of caregiving from falling on friends and family. These services are intended to promote, maintain, or restore health and help individuals to manage the responsibilities of daily life. Aides and nursing professionals can be engaged privately or through an agency.

*What types of Home Care are available?*

An incredibly diverse field, home care can serve a variety of senior need levels. Home Care can include home support care, skilled nursing care, or hospice care. For information about hospice care, please see our hospice section.

Home Support Care- is for seniors who are no longer able to perform all of the functions of daily living by themselves but who do not yet require skilled medical services. A home health aide can help with activities of daily living (ADLs), which include bathing, dressing, transferring, eating, and hygiene. Additional services generally include meal preparation, mobility exercises, light housekeeping, laundry services, medication reminders, and accompaniment to appointments. Training and certifications will vary from provider to provider.

Skilled Nursing Care – is care that is prescribed by a physician and is administered by a registered nurse. The services provided by skilled nurses include: administering injections, administering medications, wound care, IV monitoring, blood tests, catheter care, respiratory therapy, speech therapy, physical therapy, feeding tube administration, and more.

*How much will Home Care services cost, and who will pay for them?*

Home Support Care – is traditionally a “private-pay” service, which means that it is an out-of-pocket expense for the customer. Prices range from $10-$20 per hour. However, most long-term care insurance policies will cover home support care. You should carefully review your long term care insurance policy with your insurance agent to be sure that the type and amount of coverage you will need will be covered. If you qualify for Medicaid, a government program for low-income individuals, it may pay for some of your home support care needs. Since laws vary from state to state, you will need to contact your local Area Agency on Aging for more information concerning government benefits.

Skilled Nursing Care – will be paid for by Medicare, a government program that covers some of the medical needs of seniors over the age of 65, as long as it is determined to be “intermittent skilled care,” which includes occupational, respiratory, speech, and physical therapy. Major medical health insurance will also cover a limited number of skilled home visits. The number of visits covered will depend on your medical diagnosis and your health insurance plan. Be sure to fully understand what Medicare and your health insurance policy will cover before making arrangements for skilled nursing care. Costs for these services vary greatly depending upon coverage by Medicare, Medicaid, and private insurance and the degree of services required.

*How do I choose a home care provider? *

The questions below will help you choose the home care provider that is appropriate for your medical needs and family situation. Regardless of whether the care you seek is skilled or home support care, it is important that you know the answers to the following questions.

*What should I consider when hiring privately or through an agency?*

AGENCY:
*Is the agency performing criminal background checks?
*How long and what geographical areas are covered in the background check they perform?
*What are the experience levels and specialties of aides available?
*Will the agency be responsible for finding a replacement caregiver if my regular aide is sick or on vacation?
*What hours can I speak to someone from the agency?
*Is the agency licensed and bonded?

PRIVATELY:
*Should the family perform a background check?
*What is the aid’s previous experience?
*Who will replace my caregiver if they are sick or on vacation?
*Does the caregiver have any type of licenses or certifications?
*Do I have to do reference checking?
*Who will be my advocate if I have a problem with my caregiver?

Points to consider when choosing a home care provider:

- How can I cancel the service I requested?

- How much is the cancellation charge?

- Who do I call if my caregiver is unable to work?

- What is their phone number?

- What are the fees?

- What exactly is covered by those fees?

- Will the agency respond to requests for “short notice” services?

- Is there an extra charge for these services?

- Is there a minimum or a maximum number of hours of home care service per day?

- Is there a minimum or a maximum number of days of home care service per week?

- Is there someone available to assist me 24 hours a day, 7 days a week?

- How long will it take someone to return my call after business hours?

- How do I make changes to the initial caregiver schedule?

- Do the aides provide transportation if needed?

- What type of screening does the agency perform?

- How long will I wait for service after placing my request?

- Will the same caregiver assist me every day or will it be somebody different?

- Will someone from the agency call to see if I am satisfied with the services provided to me?

- How often will they call and check-in with me?

- Will I be responsible for providing meals for the caregiver?

- Will my live-in caregiver require a private bedroom?

- Will my caregiver clean my house and do my laundry?

- Do I need to sign a contract with the agency?

- How long is the contract good for?

- What does it entail?

- Do I need to have a qualified, elder law attorney review this contract before signing it?

Special thanks to Family & Nursing Care, for their materials and guidance while compiling this article.

John and Josephine Syres joined Friends Life Care At Home after living in a local retirement community. “We had known about Friends Life Care At Home since I had worked with the Department of Health & Human Services. It was my job to inspect nursing facilities. I became an expert,” Josephine says.

Always active, the couple participated in the local African-American community when they first moved to the Philadelphia area. As head of the Haddington Leadership Organization, Josephine led the drive to redevelop a section of West Philadelphia in the 1960s. John was a counselor in the Philadelphia School District’s pupil personnel department, and is an accomplished artist with 29 watercolors displayed in the Smithsonian National Gallery.

Having moved to Overbrook Park in 1985, Josephine continues her community activities as much as she can. “As John and I get older, we really value our time together, but I still have time for my community,” she proudly proclaims. Josephine serves on their condominium complex’s budget committee.

When they began thinking about long-term care, the Syres were concerned about spending their later years at home. With her husband seven years her senior, Josephine didn’t know if she was up to the challenge of caring for her husband at home as he grew older. “I thought that we might get better care if we were in a community where help was just a call away. We quickly realized that in-home care gives us exactly that service, yet we remain independent and in our own home.”

Josephine called on the services of her Care Coordinator when she had a couple of minor surgical procedures. “Friends Life Care At Home was my saving grace during my recent cataract surgery. It provided transportation to and from my surgery, and John and I had care at home while I was recovering.” She also was given peace of mind during a hospital stay knowing that the service was available for her husband. “In my absence, my husband was given the daily care that I usually provide him. I wasn’t worried about how he was doing at home because I knew he was in good hands,” she relates.