Here is a bright idea that ought to spread: You call your home care agency and say you will need your mother’s aide for the normal two hours on Monday and Wednesday, but for just half an hour (to drive her to a doctor’s office) on Tuesday, then 90 minutes on Thursday. And the agency says, “Sure.”
It sounds logical to hire someone to help — with bathing, dressing, errands, meal preparation, medication reminders – for only as many hours as an older adult needs assistance. But it is actually unusual for companies to offer such flexibility.
The majority of agencies require a four-hour minimum. Having to spend $80 — the national average cost for home care is $21 an hour — if you only need $40 worth of help is a big barrier for families trying to keep their elderly relatives living at home longer. A few agencies allow you to hire for fewer than four hours, but at higher rates.
But Mission Healthcare in San Diego, Calif., a three-year-old agency that began with Medicare-certified skilled home nursing and hospice care, expanded to general home care this summer and decided that clients should be able to specify how much help they want – in 15-minute increments — and will pay for.
“We’ll come for as long as they need us to,” said Mark Kimsey, one of Mission’s four directors. “In one hour, a well-trained caregiver can get the client bathed and dressed, prepare three meals and have them organized for the day.” (I have to think that is a speedy caregiver with a not-too-frail client, but still … )
Can Mission, which charges $19 to $20 an hour, actually make money this way? Though overall the agency serves 1,100 clients, its fledgling home care business is still small: 30 aides caring for just 60 clients. The aides can get benefits if they work enough hours, a bonus for them and for consumers (better employees, lower turnover), but an additional cost for the company.
The directors say they are profitable already, and that the approach will succeed because more people will like the flexibility and potential savings, and sign up. It is also true, let’s acknowledge, that a person who can get by with an hour or two a day for now may well need more help eventually, a boost for Mission’s bottom line.
Competitors are no doubt watching to see if this works. I’m curious, too, to see if the policy catches on. “Consumers can change the marketplace if they want to,” Mr. Kimsey said. It would be nice to think that is true.
Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”
The New Old Age Blog: Home Health Care Help by the Hour
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The New Old Age Blog: Home Health Care Help by the Hour
