Senior Living: In-home help options

Q. My mom recently broke her kneecap and needs assistance in bathing. I can't help her because I have back problems. What sort of care is available?

— Diane, La Crescenta

First, contact her doctor and ask him/her to prescribe home health for bathing assistance. Medicare will pay for this for a limited time, depending on her medical needs. If your mother is very low income (less than $1,000 in monthly income and less than $2,000 in assets) she will qualify for MediCal.

Along with MediCal is a program called In Home Supportive Services, which pays for an aide to help with activities of daily living such as bathing, dressing, meal preparation, house cleaning, shopping, etc. She would hire whomever she wants (can be a family member) and the county would pay them a little above minimum wage. The number to call to apply is (888) 944-4477.

The procedure is that a MediCal application will be sent for her to fill out and return. After MediCal is approved, a social worker will visit to assess her needs and authorize a number of monthly hours for an aide. The hours will be retroactive to the date of the application.

If she is not eligible for MediCal and needs more help than home health will provide, the other option is to hire a home care aide. There are many agencies in the area which provide this service or you can hire an aide privately if you are willing to take on the paperwork and responsibilities.

Whether you hire an aide through an agency or privately, you should consider the following issues:

•An agency will screen its workers regarding employment history, training and background checks. If you hire privately, you will need to do that yourself.

•In either case, can you call previous clients as references?

•An agency will be able to provide a substitute if the regular aide becomes ill, quits or goes on a vacation. If you hire privately, you or a family member will have to step in.

• An agency should have workers' comp and liability insurance. You need to, as well.

• Are you prepared to handle the paperwork, paying Social Security taxes, workers' comp and liability insurance?

• You will need to set up rules about everything from whether the aide can give medicine to whether she can share food from the refrigerator.

• Are you prepared to meet with the aide (and will the agency allow you to do so), perhaps after a trial month, to discuss any problems and changes?

• When hiring an aide privately, you are responsible for paying Social Security taxes, having workmen's compensation insurance and withholding taxes. If you opt to pay "under the table" you are setting yourself up for risk if the aide is injured on the job and files a workmen's comp claim or files for unemployment after the job ends.

Whomever you hire, will family members and friends are able to drop in at unpredictable times to monitor the client's care. Just remember that although hiring an aide will relieve you of providing her physical care, it does not relieve you of the responsibility of monitoring her care.

NANCY TURNEY received a bachelor's degree in social work and a certificate in gerontology. If you have a specific question you would like answered in this column, e-mail it to or call Turney at the Crescenta-Cañada YMCA, (818) 790-0123, ext. 225.

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