Finding the Best Nurse at Home for Your Aging Parent

When you’re caring for an aging relative, you may eventually need more help than a caregiver can provide. If your loved one wants to remain at home, you can turn to a nurse-at-home service.

An in-home nurse is a highly trained and skilled professional who provides skilled services such as infusion therapy and wound care in the comfort and security of a client’s home. This means your loved one won't need to move to an assisted living home if they don’t want to. They also won’t have to visit a hospital or clinic for common services such as infusions or wound care.

To ensure the best and most appropriate care, you need to choose the right nurse and in-home nursing service.

Types of Nurses and Nursing Services

As you begin your search, you need to know the various types of nurses and at-home nursing services.

Know your nurses and caregivers

Two types of licensed nurses can provide nurse-at-home services:

• Registered Nurses (RNs): These professionals typically have more advanced education and training, enabling them to take on greater responsibilities and perform complex medical tasks and supervise other care providers. They have at least an associate’s degree.
• Licensed Practical Nurses (LPNs): Also sometimes called licensed vocational nurses, they perform more routine duties, including checking vitals and administering medications. They have completed a one-year program.

Non-nurses may also provide at-home services:

• Licensed Nursing Assistants (LNA) and Certified Nursing Assistants (CNA): People with these titles and depending on training and state regulations can take care of tasks like taking vital signs, providing catheter care and assisting clients with following an exercise plan created by a licensed therapist. LNA/CNAs also provide assistance with non-medical tasks such as personal care and transferring.
• Home Health Aides and Certified Home Health Aides: These are professional caregivers who mainly handle non-medical tasks or ADLs such as bathing, dressing, meal prep and medication reminders. 

Types of Nurse-at-Home Services

Just as there are different types of nurses, there are different kinds of services:

• Private Duty Nursing:  A private duty nurse (RNs or LPNs) work with clients providing one on one, long term care in the client’s home. They can be self-employed hired by the client or family member) or work for a home healthcare agency.
• Skilled Nursing: LPNs or RNs provide care for clients who need recovery care after surgery or who have chronic conditions requiring medical management. Skilled nursing services include wound care, infusion therapy and medication management.
• Hospice Care/Palliative Care: Hospice care, which can be offered in your home, focuses on providing comfort and quality of life for individuals approaching the end of life. A hospice nurse provides care, comfort and support to clients navigating the end of their lives. They develop plans to ensure needs are met, perform regular assessments and communicate with family members as needed. 

How to Find a Nurse at Home

There are many ways to find a nurse at home, including online directories and databases that can help you find qualified nurses and agencies. Here are a few options to consider:

• Medicare's Home Health Compare lets you research home health agencies in your area. It offers detailed information on what services they provide and how clients rate them, as well as ratings for quality measures/outcomes.
• The National Association of Home Care and Hospice’s online database(Opens in a new window) lists over 33,000 agencies across the country.
• Referrals from trusted health care providers may be the easiest way to find services. Physicians, rehab therapists, social workers and hospital discharge planners can be valuable sources of referrals.
• Local agencies and organizations can be a resource for finding nursing care. To find your local agency, use the federal government's Eldercare Locator(Opens in a new window) or call 800-677-1116.
• Word-of-mouth recommendations can often yield qualified candidates. Ask friends, acquaintances and support groups about their experiences.

Evaluating Nurse Qualifications and Experience

Before moving forward with having a nurse at home, it’s a good idea to verify the nurse’s licensing and certifications. If you use an agency, they can provide you with this information. You’ll also want to make sure their experience is a good match for your particular situation. If you hire a nurse outside of an agency, check your state’s licensures. 

Skills and Specialties

Depending on your loved one’s condition, they may need a nurse with specific skills or specialties. For example, a nurse with a background in wound care could be crucial for someone recovering from surgery or getting infusions. Ask potential nurses about their areas of expertise.

Relevant Experience 

If your loved one is recovering from a stroke, you wouldn’t want to hire a nurse who has never been responsible for providing stroke care. Consider their tactical knowledge as well as how much in-home care experience they’ve had. You can explore these topics during the interview.

Interviewing and Hiring a Nurse at Home

The next step is to interview nurses and agencies. To prepare, create a checklist of questions. Here are a few questions(Opens in a new window) to get you started:

• What types of home care services do you offer?
• Is your agency accredited by a national organization? (If so, which one?)
• Are you (or the nurse) bonded and insured?
• Can you accommodate both short shifts or up to 24/7 coverage?
• Do you recommend a caregiver based on personalities and compatibility?

Move from there to more nuanced questions. Ask about their approach to caregiving. Watch them interact with your loved one. Is it a good fit?

Next, it is important to conduct a background check and ask for references. If you’re using an agency, they will have already taken care of this.

Finally, be clear about what you and your loved one expect the nurse to do. The three of you can then develop a care plan that ensures your loved one gets the compassionate care they need, and the nurse receives the respect they deserve.

Making the Financial Arrangements

Discussing the financial aspects of home care can be uncomfortable. Here are some tips to help:

• Understand the costs involved, including the hourly rate, additional fees for special services and any extra costs for weekends or holidays.
• Don’t hesitate to negotiate rates with a home care agency. Ask about lower rates for long-term contracts or a certain number of hours per week.
• Explore funding sources. How will you pay? Some options include private health insurance, long-term care insurance, military benefits, Medicaid, Medicare, Medicare Advantage and the Program of All-Inclusive Care for the Elderly (for people eligible for Medicaid and Medicare).
• Understand what’s covered (and what’s not). With private health insurance, long-term care insurance or Medicare Advantage, you need to know services are covered and what requires out-of-pocket payment. Talk to the insurance company.
• Consult with a financial advisor or elder law attorney. They can help you understand the financial implications and make informed decisions.

Managing and Communicating With a Nurse at Home

Effective communication and management are key to a successful relationship with your in-home nurse. Here are some key considerations:

• Make Sure Everyone Is on the Same Page: Regularly review the care plan with the nurse and your loved one. Is it still relevant? You’ll need to update it regularly as the situation changes.
• Discuss Boundaries: It may be uncomfortable, but it has to happen. Some topics are obvious, and others may be particular to your situation:
  • For the nurse, this may mean calling your mother “Dr. Cohen” or “Ms. Cohen” instead of “Barbara” or “Sweetie.” It all depends on how she wants to be addressed.
  • For your loved one, it means treating the nurse as a professional. No insults, no shouting and no sexualized behavior.

• Ask and Provide Feedback: Schedule regular times for a few minutes to discuss any concerns and questions you or the nurse have. Use these feedback sessions to express appreciation for the nurse’s work, when appropriate.

Do the Work to Find the Right Nurse

Finding the right nurse at home for your aging parent involves thorough research and careful evaluation. It may take time, but it’s an important investment. Once you find the right professional, stay engaged. Communicate regularly and make sure they feel respected and supported. The Brightstar Home Care Guide has various resources to help you find an in-home nurse. 

By taking the steps outlined in this guide, you can help ensure your loved one receives the best possible care in the comfort of their home.

Partnering with BrightStar Care® to Find a Nurse at Home

BrightStar Care offers a variety of services that help you find a nurse at home for your loved one. Whether you're looking for in-home care services for your loved one or a reliable medical staffing partner for your organization, our experienced local care team members are ready to help. Find a location near you, contact us online or call (866) 618-7827 to learn more about how BrightStar Care offers A Higher Standard®.