Jan 17

Respite Care

by Dillon Kato

Taking care of a parent or loved one who is getting older or has become sick can be a daunting task. Trying to make the right decision both for them and yourself is never easy. However, there are options beyond an assisted living facility or in home nurses that are worth pursuing as caring and often cost-effective means of continuing to take care for a loved one. One such option is respite care.

Respite care is a somewhat broad term, but is generally used to mean providing support to someone caring for a loved one or family member, to give them a break from their duties.

“Caring for a spouse, or a parent who is aging or ill is extremely stressful, and you need to be able to take a break. That’s where respite care can help,” said, Sarah Orbe, respite program manager at Missoula Aging Services.

Orbe said in some situations, especially when one elderly person is caring for another, the caregiver will end up passing away before the person who is sick because of the stress and strain of caring for them.

The staff from MAS are able to come to the house of a caregiver or the person they care for and take care of them for two-hour increments to allow the primary caregiver to have time to work, do errands or do something to relax. The staff at Missoula Aging Services respite care division are not nurses, as the state does not require them to be, but operate more like certified nursing assistants. While they are not able to do medical care, they can help to care for an ill person with daily tasks like medication reminders, bathing and even taking them out to do shopping.

Many of the primary caregivers Orbe sees are part of what she calls the sandwich generation: Adults who are still in the workforce that have an elderly parent they are caring for or who is living with them, but also have their own home life or children. MAS’s staff are able to come to relieve a caregiver up to 20 hours per month. In addition, they can provide additional hours each month in housekeeping services.

Missoula Aging Services uses a scale according to federal poverty limits to determine the cost for respite care. Depending on certain financial factors and the size of household, the cost per hour ranges from $8 to $20, Orbe said. While Medicaid can cover some of this cost, many insurance plans do not. Sadly, Orbe said, respite care is often considered to be a convenience, not a necessity.

MAS also hosts regular classes that teach caregivers about skills and effective methods of caring for their loved ones. These include everything from ways to help with transportation and mobility or personal hygiene of someone who is ill, as well as how to have the difficult conversations about end of life planning, Orbe said.

In addition, MAS holds monthly support groups, where people can come to meet and talk with other caregivers.

“It helps to know that you are not alone. To talk with other people about their situation, people who understand,” Orbe said.

Orbe encouraged people not to wait until someone is sick to begin to think and plan the best course of action for how to care for them. “Nobody wants to talk about aging, so they wait until a crisis. That’s not a good way to make decisions,” she said.

Further information about Missoula Aging Services can be found online at www.missoulaagingservices.org

Another choice for respite care is Nightingale Nursing, which has been in business in Montana for 17 years and has offices across the state.

Like MAS, Nightingale Nursing staff can provide assistance in daily tasks, as well as providing important social time for an elderly or ill person. “Really, what we are able to do is to step in and take over so that the primary caregiver is able to have some time to attend to the needs of their own life,” said Patty Rigney, registered nurse and Nightingale Nursing’s statewide operations manager.

While the respite personal care attendants from Nightingale are not nurses, every branch has oversight by a nurse program manager. Nightingale does also have nurse staff in situations that require it. Largely, what they are able to provide depends on what type of insurance coverage a client has. Rigney said in particular, they have seen an increase in respite care for veteran clients. “Medicaid has rules, the VA has rules. Private insurance has other rules,” Rigney said.

More information about Nightingale Nursing, including contact information for its branches in Missoula, Butte, Bozeman, Billings, Great Falls, Helena and Havre can be
found online at www.nightingalenursing.us.

There is another route to making sure a loved one has good care without bringing in outside assistance. Nightingale Nursing has a sister program that can make it possible for a caregiver, for example a family member or a friend, to be paid for taking care of an ill or elderly person.

The company, called Consumer Direct Personal Care, is one of several outfits in the state that coordinates what is called self-directed personal care. Under this model,
a client, which can be an elderly or ill individual, is empowered to make their own decisions about how they are cared for. This means they have control over who is providing care, the schedule the care is done one, and the evaluation of the quality of their care.

Under the self-directed model, a person could decide to hire a family member or friend to be their officially designated caregiver. This means a son or daughter who is taking care of an ill or elderly parent could be compensated for doing so, said Twyla Kannegiesser, program coordinator for Consumer Direct’s office in Billings.

When a client decides to use the self-directed care option, they contact a company like Consumer Direct to begin the process. An outside nursing agency comes in to make a determination about what type of hours of care are needed, and what tasks the person needs help with. The client then is able to select a caregiver of their choice, which can be a family member or friend, who goes through an application process included training and testing.

Once the process is completed, Consumer Direct is able to handle billing, administration and payment through Medicaid or private pay to compensate the caregiver. Some insurance plans also cover varying levels of self-directed personal care.

There are two exceptions to who can be a caregiver in this model: Parents can’t be paid as caregivers for their children, and spouses can’t be compensated for caring for their partner.

“This type of system makes it possible for someone who has to take time off of work to care for a loved one, or chooses to stay at home, to be able to still receive some amount of pay,” Kannegiesser said.

Self-directed personal care and respite care are both viable, helpful avenues for doing something many people are already needing to do across the state, she said: Caring for their family and trying to do what is best for them as they age.

Information about Consumer Direct can be found online at www.consumerdirectmt.com.

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