Deciding on Home Care


Finding the Right Care at Home

You are here for a reason. You may feel a person you love needs assistance to live safely at home. It could be Mom or Dad is about to be discharged from Rehab or a Hospital and you are worried they need some short term help to get back on their feet. You’re deciding on home care but not sure where to start.

It may be Mom and/or Dad are in a facility and you would be more comfortable with a little outside help from a home care agency. Follow that instinct. Before you leave our site take some action. Be proactive.

Your action may not only help your loved one live well at home, but may also prevent an unfortunate incident that may inhibit your loved one’s ability to continue to stay at home.

We created this page to help you take action at the speed you are comfortable with. This page is a launching point for you to explore information that will help you understand home care and arrive at a decision about how to take action. The sections below provide launching points for you to dig into any area on which you would like more information.

Again, our advice is to take action. We guarantee this information will empower you by helping you to become more informed about home care.

Table of Contents

Help! I don’t know what I need or what services are available?

The first thing to wrap your head around is…what is Home Care?

Is it medical? Non-medical? Who provides it?

Does insurance pay for it? All good questions.

The North Carolina Division of Health Service Regulation/Acute and Home Care Licensure and Certification Section is responsible for oversight of home care in North Carolina.

On this site is a consumer’s guide to home care. The consumer’s guide provides you with an overview of home care and definitions.

We’ve captured those definitions below. We have also provided an overview of what we provide to help you with your understanding of home care and what our role is.

deciding on home care

I think I need help. How do I know for sure?

We have provided an online assessment tool to score activities of daily living (ADLs) in the home. Activities of daily living (ADLs or ADL) is a term used in healthcare to refer to people’s daily self-care activities. Basic ADLs consist of self-care tasks that include, but are not limited to:

  • Bathing and showering
  • Personal hygiene and grooming (including brushing/combing/styling hair)
  • Dressing
  • Toilet hygiene (getting to the toilet, cleaning oneself, and getting back up)
  • Functional mobility, often referred to as “transferring,” as measured by the ability to walk, get in and out of bed, and get into and out of a chair; the broader definition (moving from one place to another while performing activities) is useful for people with different physical abilities who are still able to get around independently
  • Self-feeding (not including cooking or chewing and swallowing)

Basic ADLs are the things many people do when they get up in the morning and get ready to go out of the house: get out of bed, go to the toilet, bathe, dress, groom, and eat.

The Home Care Self-Assessment

The Aware Senior Care “Live Well at Home Self-Assessment” will not only help identify the ADLs a person may need help with, but will also help them to determine whether or not they need help. This is often the toughest decision to make – accepting help in the home. A score of 7 or higher indicates that some help is a good idea.

At your request, this information will be evaluated by an Aware Senior Care registered nurse as part of a formal in-home assessment for home care.

Assess Yourself Now

We do suggest you use this tool, but ultimately we recommend you call us to talk so we can help you. We’ll listen first, and then ask a series of questions to understand your needs, your goals, and your ability to finance care. We will also explain what we can do and more importantly, what we can’t do to help you assess our ability to meet your needs.

I want Home Care services! Help me choose the best provider.

You have arrived here because you have arrived at the conclusion that home care is the right solution for you or your loved one. And yet, you still have questions:

Who are the best home care agencies in you area? Are there websites where I can read family review? When I search “Home Care Cary,” hundreds of agencies come up. How do I choose?

The good news is there are websites that provide ratings on home care and we will share those with you. Still, it’s a challenging process to review and select a home care agency. Tim went through this process five years ago when securing home care for his mother Emily. Based on this experience, we wrote a blog with recommendations on how to evaluate a home care agency: “15 Questions to Ask When Choosing a Home Care Agency for Your Loved One.

How to Choose a Quality Home Care Agency

We recommend creating your own custom list of factors by which to rate your agencies. Use a simple scoring system of 1 (poor) to 5 (excellent). Rate each category and total the score (visit our website under our Circle of Support/Downloads to use a simple spreadsheet we created for this purpose).

Make a short list of your top three and call each one, starting with your first choice. How the agency talks to you on the phone is going to be the closer. Typically, when people call us they look no further. Why? Because we don’t have salespeople. Our goal is to help. We want to understand the challenges you’re going through to assess not only how we can help, but also how some of our good partners can. If we feel you can be helped by a service such as home health, hospice, or in-home food preparation, we will recommend it. We feel tremendous joy when clients find the services that fit their needs – whether we provide the care or not. We constantly get compliments from people about our approach.

Recommended Categories to Rank Home Care Agencies

  1. What’s their story? Why are they in home care? Is it personal? Or are they just another franchise? You can tell a lot about the people you are going to trust with the care for your loved one by understanding why they are in this industry. Their website should tell their story. If they have no story, you may find that if you go with them you are just another number.
  2. Are they team players? In the world of home care, it takes a village to care for families. Look at their website to learn whether they are working with other great people in the community. We call our village the “Circle of Support.” Give high marks to agencies that recognize and embrace the village concept.

Quality of Caregivers and Services

  1. How do they screen and hire professional caregivers? You may not be able to get this information from a website but if you can, it’s a plus. This a very important factor in quality home care. You will want the best caregiver for your loved one. What is the agency doing to hire the best? Aware Senior Care has an extensive screening process which includes phone and in-person interviews, drug tests, and an extensive state and criminal background check. Give high marks to the agencies that are all over this.
  2. How do you retain and take care of good caregivers? Why should this be on your list? Over the years we’ve had clients switch to us because their agency sends a parade of caregivers and at some point they are frustrated enough to finds another agency. An agency with a high turnover rate is one you should avoid. Frankly, our top priority is taking care of our caregivers because if they feel the love, their love goes right to our clients. As evidence of our high retention, we were awarded Employer of Choice from our industry’s leading home care survey and review site, Home Care Pulse. When you call the agency, ask them about their caregiver retention rate. We track ours monthly. It is currently averaging 80%, which puts us in the top fifth percentile in our industry. We like talking about our caregivers and apparently they like talking about us, too!

Caregiver Morale

  1. What are their caregivers saying? Is this important? What does it say about an organization when their employees say they like working there? It speaks volumes. We mentioned our recent award from Home Care Pulse – 2018 Employer of Choice. We all feel that this is the best award and highest compliment. When you review a home care site, see if they publish any caregiver reviews. If you know about recruiting sites such as, check out caregivers who have left reviews. If you can’t find any caregiver reviews or testimonials, it’s a red flag, as they may have a corresponding high caregiver turnover.

Serving the Community

  1. How involved is the agency in the community? Why should you consider this in your evaluation? We think giving back to the community by donating time and educating people about home care speaks volumes about an agency’s owners and staff. The “Aware Senior Care Gives Back” portion of our website is dedicated to community projects and it gives you a feel for our volunteer work, charitable donations, and the seminars we hold at churches, senior centers, and over 55 communities.
  2. Do they provide Veterans assistance? Gina and Tim have a soft spot in our hearts for our veterans. Gina’s father Andy served in World War II as an Army scientist working on the Manhattan project. Tim’s father served briefly in the Air Force post WWII and his stepdad Jack Doyle was a naval officer during WWII. Tim served in the US Navy as a submarine officer on the USS Groton Nuclear Submarine SSN-694. In 2017, Aware Senior Care was honored to be approved for the Veteran Administration Veterans Choice Program. We can provide care to veterans directly or under contract from the VA.

Service Related Considerations

  1. How much do their services cost? Obviously this is an important question to ask because you need to assess your ability to finance care. Agencies typically do not list their prices. In our opinion, cost merits lower priority. It’s only important because of the financial assessment of the care plan, not in selecting the agency. You will find we are priced slightly higher in the market because our caregivers are in the upper fifth percentile in compensation. They deserve more. Taking care of our caregivers is a priority.
  2. Depth of services: Rate the agency on how comprehensive their services are. Do they cover everything you need? Do they cover even more than you need so that you can stay with them longer? Aware Senior Care scores high here because we are one of the few home care agencies that also has a skilled nursing license to provide in-home nurse care.
  3. Communication with clients: Do they have a newsletter, both email and print? Do they make announcements? When you call them, ask them how they communicate with clients and families. Do they spot check their caregivers? Is there an online family portal so you can remotely access the care plan and send emails to the care team?
  4. How do they answer the phone? You can tell a lot about an organization by how they handle your initial query. Find additional tips in this blog. Put a lot of emphasis on this one in your evaluation.

What is their Local Reputation?

  1. Do they have professional references? This is the icing on the cake. If you find the home care agency has professional testimonials from healthcare professionals, including doctors, that’s a big plus. Our nurses and care staff have a deep understanding of medical wellness which is critical to understanding the overall holistic wellness of your loved one.
  2. Do they have case studies? This is another “icing on the cake” criteria. Often, home care takes on difficult cases, with people suffering from chronic illness, ALS, Aphasia, Dementia, and Alzheimer’s. We publish case studies about what we have learned. some of the case studies detail our partnerships with home health, hospice, the Dementia Alliance of NC, and the Triangle Aphasia Project, Unlimited, to name a few. Case studies validate that the agency can understand your needs if you have a loved one suffering from an illness or disability.
  3. Reviews by families: Based on your review of our recommended industry rating sites, rate the agencies on your short list.
  4. Awards: Has the agency won any awards? Give a high rating to ones that have. This is validation that they are doing things right.
Watch this video on YouTube.

I know what services I need and who is going to provide them. Now what?

Hopefully we are your agency of choice when deciding on home care. That said, we designed this section of our site to explain how we go from a discussion on the phone to starting services. We feel our process, “The Aware Holistic Approach,” is unique because we believe in taking a holistic approach with every client by considering the whole person, whether or not we directly provide the services they need.

We think beyond just home care. Our focus is on what the individual and family need. We form a plan that often includes other agencies and services. Remember, it takes a village!

The Steps to Take When Beginning Home Care

  1. Phone evaluation: We do a lot of listening to understand your current situation. The core question is, how can we help you or how can we help your Mom and/or Dad? After listening to your feedback, we will ask specific questions about all aspects of daily living to get the best overall picture of your situation. If we feel we can provide help, we will recommend an in-home assessment.
  2. Free in-home assessment for home care: A registered nurse conducts an in-depth assessment for each client to determine what services are needed and to identify risks in the home. The client’s daily routines, medical history, health status, memory issues, safety concerns and emotional well-being are all considered during this process. We develop a customized Plan of Care from this information. There is no cost or obligation for the in-home care assessment. Our goal is to make sure we are the right fit for your home care needs. (Please note, for cases not requiring personal care we will send one of our care coordinators to manage the assessment.)
  3. Plan of care: This plan is developed during and after the in-home assessment. With the information from the assessment and input from the client and loved ones, a plan of care is developed. The plan outlines tasks and a schedule for services the client will receive. Our caregiver’s first visit will begin by reviewing this plan with the client, family, agency supervisor, and caregiver.

Completing the Process

  1. Signed service agreement: We will not start service, which includes scheduling caregivers, without a signed service agreement. The service agreement describes our commitment to you as your home care agency, and details the scope of our services and what we do in emergencies. It also describes what we are asking of you, including your care plan and the cost. We also provide a client bill of rights which describes your rights as a client. This service agreement can be cancelled at any time.
  2. First day of home care: On the first day of care, one of our nurses or care coordinators will come to the home to introduce the caregiver. It’s a big step for a family member to accept care from a complete stranger, so we go to great lengths to make this a soft and family-like introduction. We have been told this is unique in the home care agency. We feel it is important to put our client at ease and it demonstrates our respect for our caregiver when we make them feel comfortable during the introduction process.
Read more about our Aware holistic approach by visiting our blog: A Holistic Approach to Providing Home Care Services by Gina Murray, RN/BSN and Founder of Aware Senior Care.

How do I access Home Care services?

Patients and/or family members may directly contact home care agencies in order to access services.

Your physician may also make recommendations about home care and, if needed, will provide the necessary medical orders for home care services. Many agencies are listed in the yellow pages of your telephone directory.

What is Home Care?

Home care includes a category of services which are provided to an individual in a place of temporary or permanent residence used as an individual’s home. It is health care brought to your home to maintain or restore your health and well-being.

Home care services include: Nursing Services and Duties, Physical Therapy, Speech Therapy, Occupational Therapy, Medical Social Work Services, In-Home Aide Services, Infusion Nursing Services, Companion Services, Sitter Services, Respite Services, Clinical Respiratory Services, and Home Medical Equipment and Supplies.

Where does Aware Senior Care fit into this definition?

We provide in-home aid services (personal and companion care), sitter services (mostly in facilities), respite, and nursing care, which allows us to help families at home with medication management, IVs, catheter care, and wellness checks.

You may have heard of Home Health, Palliative Care, and Home Hospice. If you would like to learn more about these other services and their relation to home care, click here to visit “Working with Home Health, Palliative Care, and Home Hospice.” This page will give you an understanding of these services and their relationship to our home care

Do you think we can help?

If so, we recommend you call us to validate your conclusions. Furthermore, you may find that our questions help you to come up with things you haven’t yet considered that can make life easier for your or your loved one.

Who pays for Home Care Services?

Many home care services are reimbursed by Medicare, Medicaid, worker’s compensation, private or group health insurance, HMOs, veteran and military benefits (VA/Champus), or through special funds such as block grants.

Also, private payment may be arranged with many home care agencies on an individual basis. Furthermore, when services are reimbursed by either public sources of funding or through insurance, it’s important to understand the eligibility criteria for reimbursement.

Who provides Home Care?

Home care services are provided by a variety of organizations, including licensed home care agencies, certified home health agencies, councils on aging, county departments of social services, therapy companies, (PT, OT & ST) home medical equipment companies, and infusion (IV) nursing agencies.

Why Home Care?

Care provided in the comfort and security of your home through a licensed agency gives you, your family, and friends a sense of control and peace of mind. Home care provides a wide range of health care and social services to the patient and teaches families to help care for their family member.

A Holistic Approach to Providing Home Care Services

What separates Aware Senior Care from other agencies is our belief in taking a holistic approach with every client by considering the whole person, not just the services we can provide them. If we are not the best fit for your needs, we will tell you. If we feel other services can help, we will recommend them. In the end, it’s about making sure your needs are met.

Gina Murray, Aware Senior Care co-founder and RN, wrote a blog about our holistic approach to home care and how we go about it. Please take the time to read it. If you are not yet convinced you have made a good decision to work with us, you will after reading the blog!

Thank You from the Aware Senior Care Team!

A Holistic Approach to Providing Home Care Services, Gina Murray RN BSN Aware Senior Care Director and Co-founder