How to Find High Quality Home Care with Kean Dillon

Join Kelly and her guest, Kean Dillon, Owner of Senior Helpers of Columbus.

In this episode:

🔹 Home care explained

🔹 Questions to ask a home care provider

🔹 How home care is typically billed

🔹 Ways to pay for home care
            

Find out more about Senior Helpers of Columbus:
https://www.seniorhelpers.com/oh/columbus-north/ 

Watch this episode on YouTube:
https://youtu.be/ac3A_xQnFQ0  

For additional information about Kelly, check her out on Linkedin or www.SteadfastAgents.com.

To explore your options for long-term care insurance, click here.

Steadfast Care Planning podcast is made possible by AMADA Senior Care and Steadfast Insurance LLC.

Come back next time for more helpful guidance! 

Transcript

Kelly Augspurger  0:02  
Hey everyone, welcome to Steadfast Care Planning where we plan for care to live well. I'm your guide Kelly Augspurger. Today with me is Kean Dillon, owner of Senior Helpers of Columbus, Ohio. Thanks so much for being here, Kean.

Kean Dillon  0:15  
Hey Kelly, really glad to be here.

Kelly Augspurger  0:16  
I'm really excited to be talking to you today because we're going to talk about home care and Kean is an expert in the home care industry. So, Kean let's jump right in.

Kean Dillon  0:26  
Sounds good to me.

Kelly Augspurger  0:27  
All right, well, first off Kean, what does home care even mean? Break it down for people. What types of services are provided when you hear home careI

Kean Dillon  0:37  
It's basically going to be anything covering non-medical care to keep somebody living in place. So nurses will come by and do things like shots, that's more of the home health. That's not so much us. Home care will range anything from companion care, which I affectionately referred to as "daughter for hire," which is help around the house, light housekeeping, taking people for errands and an awful lot of its meal preparation. An awful lot of it's companionship. It's going for walks with your clients, it's going and getting ice cream with your clients and making sure people are not suffering from social isolation, and then arranges more into the personal care, which is more of the hands-on type of assistance, which would be help with anything from transfers to showers, incontinence issues, etc.

Right, those activities of daily living, transferring, toileting, bathing, dressing, eating, continence. 

Precisely.

Kelly Augspurger  1:30  
Yeah. Okay, great. So you said "daughter for hire." Is that the term you use?

Kean Dillon  1:34  
I use that term frequently because it kind of develops an empathy real quickly. If somebody is taking care of, you know, one of their parents or something that they love, when you say that "daughter for hire,' it's like, 'Oh, you'll do kind of all the activities that I would normally do." And it's yes, and we can also do the personal care as well.

Kelly Augspurger  1:50  
Oh, that's really, really endearing. So different from true home health care, right? This is non-medical in nature, really helping the person in need throughout the day with those activities of daily living, and also those instrumental activities of daily living, which you referred to:vmeal prep, probably some light housekeeping as well, laundry, those types of things.

Kean Dillon  2:11  
Yeah, I definitely will always emphasize that my aides are really there to take care of the person. So they do light housekeeping, but if you need like a deep clean, Molly Maids is definitely a better answer.

Kelly Augspurger  2:22  
Yeah, right. Oh, absolutely, but while they're there, if they need a load thrown in or something like that, that can be done, but obviously, the primary reason for having the home care is to take care of that care recipient.

Kean Dillon  2:34  
Yeah and it can go all over the place. We've escorted people to weddings, we've escorted people to funerals, we've taken them for vacations, it's all a range.

Kelly Augspurger  2:43  
Yeah. Okay, that gives us a good base of what we're talking about here with home care. When people are considering home care for their loved ones, Kean, what's a good checklist or questions that they should ask the home care provider?

Kean Dillon  2:56  
The first big question is figuring out what the client really truly needs. Different agencies are going to specialize in different aspects of what's going on. Some groups will be really focused on Alzheimer's or Parkinson's, and we fall into that game plan, or in helping people do their physical therapy, so they don't go back to the hospital. So kind of find out what those needs are and that's going to form a lot of your questions. However, a good place to start is Google the company, see how long it's actually been in business and kind of what the reviews look like. You can find out an awful lot about a company by what people are willing to say about them on online.

Kelly Augspurger  3:33  
Yeah. 

Kean Dillon  3:33  
An awful lot of it really comes down to what is their process of hiring caregivers because at the end of the day, it's that caregiver in the home that's really going to make or break the relationship. So some critical things to check are how much experience do the caregivers have? Do they have certifications? For example, in Ohio, a state tested nursing assistant, which couple of months of additional training would be required for personal care. Also, I'd like to find out if they give specialized training in things like Alzheimer's or Parkinson's or congestive heart failure. So they kind of have got a good idea what they're working with there. You'd like to know if their employees or their caregivers are employees or if they're private contractors. There are there are companies in Columbus where you're expected to pay the caregivers directly, which can create taxation issues, liability issues. I always tend to want to hire companies that have employees. They've got background checks and drug tests and insurance and all that sort of good stuff. 

Kelly Augspurger  4:36  
Yeah, good point. 

Kean Dillon  4:36  
I would ask about what their policies are if a caregiver doesn't show up. Most agencies will have a quote on quote "on call," so that if nature happens, somebody is sick, the car won't start, we've got backups to be able to provide in those types of situations. Also ask about cell phone policies. This is one in particular for some of the younger caregivers unless people are specifically told to, they're in my first couple of years, I wasn't wise enough to realize that some caregivers want to spend a lot of time on the phone. So you establish a policy of you can only be on the phone in the event of an emergency or if you're doing something actively with your client, like looking something up.

Kelly Augspurger  5:18  
Okay. Oh, yeah, I wouldn't have even thought about that. That's true because it's so distracting and it's such a draw when we have our cell phones with us and if you are responsible for another individual, being a caregiver, and you've got your phone right there, you're not giving that care recipient really the time that they need and deserve, the care.

Kean Dillon  5:39  
That's one of my pet peeves. So we always make sure that we train people that if you're there as a caregiver, you're there to take care of somebody not to play on your phone.

Kelly Augspurger  5:47  
Right. Don't neglect them. Yeah.

Kean Dillon  5:49  
I would also - a big question is what if we don't like our caregiver? At the end of the day, caregivers and clients should look forward to seeing each other, they should have a relationship. If it's not feeling good, then the agency should probably work upon getting getting another caregiver in. I would also check their policies on do they try to match caregivers to clients? Or do they kind of have the revolving door where multiple caregivers will be coming in to take care? It's just not that efficient. Also, for clients in particular, with Alzheimer's, change isn't necessarily a good thing. So seeing new faces can kind of throw things off. So we always strive to get that one to one relationship. I'd ask about minimum hours. Most home care agencies will have minimum shifts because it's hard to get somebody to go to a client's house for less than three or four hours and they'll have some weekly minimums. Of course, you want to ask about the rates. In the Columbus area, you can, you'll find a wide variety of rates, probably from a low of $30 an hour to on some of the shorter, more specialized pieces, you can get into $40 or so per hour and last, but certainly not least, I'd look at the personalities of the management you're going to work with because they'll be speaking to them on a on a fairly frequent basis and you want to have somebody who you can get along with and that you feel comfortable and safe with.

Kelly Augspurger  7:06  
Oh, gosh, that's a really great checklist. pretty comprehensive there, Kean. Yeah, I would advise everybody write those down. Hopefully, I'll even be able to provide some type of a actual list for people to go back through to be able to see this checklist of Kean's, but you definitely want to ask these questions before you sign any paperwork. Do you typically have people sign a contract, Kean, what is that?

Kean Dillon  7:29  
We call it an agreement. It's not terribly binding. In our case, we ask some standard things. We'll specify the rate and the hours that are there. We'll also specify that we're non-medical home care, just trying to make sure we're covered from a legal standpoint. We'll also say that we're always going to try to give care, but in the event that we aren't able to get there, we still are asking for support from the family or whoever's their loved ones are. A big one, we'll also have a clause in there to say please don't try to hire our caregivers away privately because we spend a lot of time and money training and getting getting them up to speed. We're also, we don't have clients sign the agreement until we know we've got a caregiver ready and staffed for them. I have heard about agencies that are signing beforehand and then not being able to provide caregivers which doesn't feel right.

Kelly Augspurger  8:15  
No, that's bonkers. Yeah.

Kean Dillon  8:16  
And I've got a list of this, these questions I can send over to you after the podcast to save you some time.

Kelly Augspurger  8:22  
Perfect. Yeah, that's perfect. Then we can provide those to the listeners and the viewers. Yeah, that's great. Kean, thank you. So when you have a contract in place, you've got the care recipient. You've got the caregiver there assigned to the right people, how are you then billing the family or billing the care recipient after care is actually given? 

Kean Dillon  8:40  
It could work, honestly, in a variety of ways. We bill every two weeks. We can accept payments online, you know, via credit cards, we can take checks in payment. Preferred method is to do the automatic clearing house, basically, we just get a void check, then we will send a bill over either via traditional mail or email. And if there are no concerns about the bill, we just automatically will deduct the money from the checking account every two weeks.

Kelly Augspurger  9:07  
Gotcha. Okay, is that pretty typical in your industry, Kean, is for most home care agencies to fill every two weeks? Or do some do more frequently, like weekly or even monthly?

Kean Dillon  9:18  
There is variety. Typically, I think monthly would be a rarity, unless you're working with something like the Veterans Administration. Typically it's going to be two weeks or weekly, simply from a cash flow perspective. You don't want to wait for an entire month because that can get to be a lot of payroll before you're having a chance to be reimbursed.

Kelly Augspurger  9:36  
Yeah, that makes sense. Okay.

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What are the different ways that people are paying for home care? What do you see in your business? 

Kean Dillon  10:00  
The vast majority for us is going to be private pay, you know, coming out of savings or investments or something along those lines ,but there are a variety of sources, as I'm sure you're familiar with. Long-term care insurance is probably one of the greatest ways to do it. People have been paying in those policies for a long time and the companies are very easy to work with to get everything going there. Also work with the Veterans Administration. People aren't aware of this, but if somebody's served in the military during the time of an act of war, they didn't actually have to serve in war, and they meet certain thresholds, they're not rich, but they don't have to be poor, the government will give free home care that can range anywhere from a few hours a week, up to I've seen it as high as 30 hours per week, depending on disabilities that were going on. And they didn't even know that they were going to be able to have the benefits for it. In addition to that, there are some more creative things people have gone through and done reverse mortgages to be able to support it, or sometimes family and friends pick it up. One really unique case, so government money is available as well. There's grants for things like multiple sclerosis, cerebral palsy. One of the most interesting ones we've ever worked with is the government of Germany is paying reparations for Holocaust survivors and through Jewish Family Services, we had a client that was with us that was having all of their benefits were paid for by the German government.

Kelly Augspurger  11:24  
No kidding. I've never heard that. That's incredible. Wow. Yeah, so a variety of ways to actually pay for care and we know, I mean both being in the industry, in the long- term care industry, we know that most people prefer to stay at home as long as possible, right? If it's safe for them to be home, if it's the best situation for them, people really want to stay home and age in place, and so being able to have a reputable agency or service to turn to is going to be key for not just the care recipient, but the care family, to give them peace of mind and to know that they are getting quality care, right? And so to know that there are different ways to actually fund the care, really, really valuable. As far as those VA benefits, Kean, where do you suggest people even look to that? Go online and look at the VA's website?

Kean Dillon  12:12  
I would specifically, I would go in and Google Aid and Attendance. 

Yeah.

It's just the name of the policy that will pop up for them very quickly, but you can get to the information quickly through your local VA. 

Kelly Augspurger  12:23  
And then as far as the long-term care insurance, I know that you do have some clients that are on claim and that you're able to help in that process, right? Do some of the carriers that you work with actually direct bill them so that the client is not involved? Does it depend on the insurance company?

Kean Dillon  12:42  
Definitely kind of a grab bag. We've had cases where we bill the long-term care insurance directly. Most frequently, what ends up happening though, is the client will pay and then they're reimbursed by the long-term care company, but I've seen different avenues multiple, multiple times. The biggest thing for us with a long-term care insurance is we need to make sure we're doing at least two of those activities of daily living or ADLs during each shift, so we send them a little bit more information than we might send to a normal customer on their invoice. You know, she helped with going to the bathroom, we had a shower or something along those lines just to make sure that we're taking care of those ADLs.

Kelly Augspurger  13:21  
That's right and just to clarify, so people are aware, if you don't know already, in order to really trigger and access benefits in a qualified long-term care insurance contract, the language really is that you need need to meet two out of the six activities of daily living. You need help with those and your expected need of care is more than 90 days or you have a cognitive impairment and you need supervision. So in Kean's case, what his agency has to do is they have to document really well right, Kean?

Kean Dillon  13:48  
Yeah.

Kelly Augspurger  13:48  
You're having to document for the person on claim and then for you guys too. I'm sure that it is really almost even a buffer for you, right, legally? 

Kean Dillon  13:57  
That's true.

Kelly Augspurger  13:58  
Yeah, in order to keep good records, but for the insurance company, they want to see that indeed, that the person on claim does need help with those activities of daily living.

Kean Dillon  14:08  
And we'll even help people by looking at their policies and letting them know how much care they can actually receive and kind of what that looks like and even explaining to them it will draw it down if you have to go to a facility, this goes against that, and we can walk people through all those basics as well.

Kelly Augspurger  14:25  
Right. That's really helpful if the person on claim no longer has let's say the agent is not around anymore, maybe you know they've retired or they're not getting maybe all the information that they would hope for out of the insurance company, working with someone like Kean, an agency like his, where they can help you decipher that is really helpful and being able to determine: is it a daily, is it a monthly benefit? What's my elimination period? How long do benefits last? How can we really get the most out of this policy and in working with someone that understands how these these contracts work is really important. 

Kean Dillon  15:01  
Absolutely. 

Kelly Augspurger  15:02  
Yeah. Well Kean, any other final advice on how people can plan for care to live well?

Kean Dillon  15:07  
I think one I would throw out in my profession is bringing a caregiver into your life can be a great change as far as the quality of life. So choose well because that person will become part of your family. I mean, I get pictures of clients and their caregivers, you know, going out on picnics, all sorts of things, and that's where it really it truly works, where everybody's getting better out of it. 

Kelly Augspurger  15:30  
That's right and just a quick story too. We both, Kean and I, have a mutual friend and one of your caregivers helped provide care to her dad. The last I don't know how many months or years of his life, Kean?

Kean Dillon  15:45  
Oh let's see, would have been about 15 months. 

Kelly Augspurger  15:47  
15 months. Yeah, I thought it was a little over a year, and from what our friend has told us, it was such a special relationship that that caregiver had with her dad. And it meant so much not only to her dad to be able to have that connection with Kean's caregiver, but it meant so much to our friend, the daughter, right? She just was like over the moon excited and had such peace of mind knowing that she could go to work during the day because she works full time, go to work during the day, and her dad was really well cared for at home while she was at work and she could come home he had the socialization, and he was cared for and got all of his needs met really well. And so yeah, super important I think Kean, great, great advice there. You want to pick and be careful in that selection and if it's not the right fit, and I'm sure that happens sometimes, Kean right, like right off the bat?

Kean Dillon  16:39  
Yeah, you could have two great people. They don't get along well together. I had a gentleman that was rather stoic and I put a caregiver in his home who four of her five clients absolutely loved her to death, full of energy, she got with him and like the first day was like, no, oil and water and 

Kelly Augspurger  16:57  
Not a good fit.

Kean Dillon  16:58  
Nothing against either one of them. So we just find somebody who is a better fit.

Kelly Augspurger  17:01  
That's right, go back to the drawing board and let's reassess the situation who's going to be a better fit and so then yeah, you find that good fit. So that's wonderful. Well, Kean, thanks so much for your time, your expertise today. Really appreciate it. Have a great day!

Kean Dillon  Thank you, Kelly. It's always a pleasure speaking with you.