A Personal Care Agreement (sometimes called a Personal Services Agreement) can be an effective way to avoid misunderstandings that could otherwise arise.

According to an article, “How to Prepare a Home Care Agreement With a Family Member,” Joseph L. Matthews, http://www.caring.com/articles/care-agreement, a Personal Care Agreement should include the following basic information:

• “When the care will begin.
• What tasks you’ll perform. Be specific and thorough, but also include the term “or similar tasks to be mutually agreed upon by the parties.” This gives you both some flexibility, so that you won’t feel like you need to rewrite the agreement every time you change the tasks you perform.
• How often, and for how many hours, you’ll provide this care.
• How much you’ll be paid, and when the payment will be made.
• How long the agreement will stay in effect. This can be a set time, like six months or a year, after which you can both decide whether you want to make any changes. It may be simpler, though, to make the contract open-ended, described with a phrase such as, “This agreement shall remain in force until terminated in writing by either party.” In that case, either of you can end the arrangement at any time simply by writing a signed, dated note saying that the agreement is over, and giving the note to the other person.
• A statement that the terms of the agreement can be changed only by mutual agreement, in writing, by both parties.”

A Personal Care Agreement, “can also help avoid misunderstandings with other family members about who’s providing care and how much money is changing hands. If the agreement doesn’t solve a particular disagreement with family members, you may be able to add something to the document, or change its terms, to address the problem.

“If the person you’re caring for is receiving state assistance for in-home care, the agreement can prove to the state exactly where some of the money is going, which the state program might require.

“If the person ever needs to enter a nursing home and wants Medicaid to pay for it, the agreement can show that these payments to you were legitimate, not just an attempt to “hide” funds in order to qualify for Medicaid’s services.”

Developing a Personal Care Agreement not only helps to avoid family conflicts by laying out who will provide necessary care and how it will be paid for. By focusing the family on the need to make arrangements for their parent/s, many potential conflicts can be identified and resolved before they become problems.

Finally, long term care insurance may provide for such care if there is a formal, reasonable agreement.

Recent presentations by Ms. Elizabeth Flurry, Director of Clinical Integration at Johns Hopkins Health Services, showcase some of the exciting technology currently, or soon to be available, to assure and protect one’s health: while living alone with impairments, or monitoring certain conditions.

One such device being developed by Georgia Tech is called a smart shirt, www.smartshirt.gatech.edu/,  a medical-grade EEG shirt that monitors temperature, respiration, blood pressure, heart rate, and blood oxygen levels. The user can wear the shirt to sleep and with a sensor under the sheet can also can be continually monitored for weight gains due to the lungs filling with fluids. Out-of-norm readings could then trigger a call to an emergency service. In other words, the device could prevent someone from dying in their sleep.

On a somewhat simpler scale and available now is the MD.2, www.epill.com/md2.html. The e-pill Monitored Automatic Pill Dispenser can dispense all tablets and capsules. It can be set up to dispense up to six times per day with refill frequency of from four to 28 days, depending on the number of different pills taken. If the medication cup is not removed from the dispenser within a certain time period, it will call the caregiver.

A smart toilet,  www.cnn.com/2005/TECH/06/28/spark.toilet/index.html, has been on the market in the U.S. for about a year, although it has been available in Japan for much longer,. (Their population aged earlier than ours.) The smart toilet can monitor vital signs including hydration and blood sugar levels, and automatically send suspicious results to the doctor. And it has a motorized, adjustable seat height.

The increasing existence of devices like these has several implications. Home care for seniors can more easily be provided by family members and others without formal medical training. Moving these functions out of the out-patient clinic and into the home also reduces the nation’s health care cost. Technology is truly moving us toward early intervention, faster response times to medical emergencies and, in some cases, prevention.

You may want a companion, however, if you or your loved one’s needs primarily relate to the activities of daily living:

• Keeping up the whole house (light, basic house cleaning; taking out the garbage; changing light bulbs; doing the laundry and making all the beds because the kids are coming to visit; etc.)
• Paying bills
• Shopping
• Meal preparation
• Transportation and friendship

The objective of the companion is to be your representative, an honorary family member.

Many home health agencies offer companion as well as CNA services. Experience tells us that this approach doesn’t work for companion care. If a company has primarily a medical model, its focus and attitude will remain medical.

Regardless of the approach you or your family take, Care for You® strongly recommends hiring a care coordinator or case manager. Especially when family members live in another town or state, care coordination can reduce stress and ultimately be very cost effective. Unlike you, a care coordinator doesn’t have to take time off work, or arrange and pay for transportation and other travel costs. Care for You® provides the following care coordination and case management services:

· Regularly check in with you and your loved one and the caregiver

· Give you or your loved one immediate access to someone who’s dedicated to the well-being of the person being cared for

· Research for services and activities

· Schedule appointments with physicians, insurers, therapists, pharmacists, banks, and contractors, visit these service providers, and arbitrate when necessary

· Provide a central point of communication among all parties with responsibilities that affect the person receiving care