August 7, 2020

5 Common Questions from Families Looking for Senior Care



Hi, I’m Ryan McGuire, Director of Community Relations at Griswold Home Care here in San Antonio. And today we’re going to take a look at the five most commonly asked questions for prospects and families exploring senior care, looking at home care options. I think you’re going to get a lot out of it. So stay tuned.

What are the Schedule Requirements?

The first question we want to look at today is around scheduling. What are the scheduling restrictions? Is there a number of shifts per week? Is there a length of shift minimum? So let’s go ahead and get into it. Our ultimate philosophy is to provide as much flexibility as possible so we can meet your needs or your family’s needs and get the care plan specific for you. So we don’t have any number of shifts required. So I know some people may require three shifts a week with a certain number of hours. We don’t have that requirement at all. So we have some clients that schedule as needed maybe once or twice a month, but we have others that have set schedules and a set number of shifts. So we try to leave that up to you and figure out what’s gonna work for your family.

When it comes to the length of shift we are one of few companies that only have a two hour minimum and we believe this is a great way to introduce care for a family member that may be a little bit resistant. I know a lot of people have a four hour minimum, four hours can be a little long when you’re trying to introduce care. And they’re not really sure if this is something that’s going to work out. So you find it some really good way to get things started. It also is a way to manage costs when evaluating senior care. So we’ll get into costs in a little bit, but a two hour shift is a little bit more per hour, but you’re still only paying for two hours of care versus a four hour minimum or something along those lines, so ends up being cheaper.

And sometimes if budget is really tight, we can manage the activities that the caregiver is helping with while they’re in the home and just finding essential activities; maybe getting ready in the morning, getting breakfast, and then that’s the end of their shift. And sometimes they even come back that evening. And so you have a two hour shift in the morning, a two hour shift in the evening, but you’re getting the essential care needed during those two hour periods at that time. And so it works out overall, you’re managing the budget, but getting the care needed. So that’s how we think about scheduling and the restrictions. So once again, just to kind summarize no frequency minimums so you can schedule as needed. And then we have a minimum of two hours for the length of a shift.

How Much Does Care Cost?

Now let’s talk about cost. We believe in simplicity and transparency. You can always find our full rates on the website at It’s really important for families to understand exactly what they’re paying for so they can make the best decision for them. Now I’ll just briefly go over the rates here since that’s what the question was. So our two hour rate, as you mentioned is $28 an hour. We have a three hour shift that’s $26 an hour and anything four and up is going to be $22 an hour flat rate. So you know, that could be a 12 hour shift. That could be a four hour shift to talk, and it would be that $22 an hour. So it is important to understand these are for San Antonio. So when you get out to some of the surrounding counties like Boerne or Bulverde they may be a little bit more. So just so you know that I think it’s important.

But I think it’s important also to understand why we do the flat rate. We have some people, or some companies out there that will do one rate for companionship, one rate for this, one rate for a certain level of ADLs assistance. It gets really confusing for the family to understand exactly what they’re paying for. You know, our rates include everything within our scope, if it is just taking somebody to a doctor’s appointment or grocery shopping, or if it’s full incontinence care; bathing, dressing, all those kinds of things. So it’s really to understand even if somebody is just needing a base level, when they start care, it’s likely that care’s going to increase, and the rate is not going to increase with that level of care. We don’t want to get into a situation where we have to hold back care or trying to manage the costs by not doing as much under the flat rate families know what they’re paying for. We can design a specific care plan without taking costs into consideration. And I think overall care and quality of care is improved. So that’s generally our philosophy on cost.

Ways to Pay for Senior Care?

Usually the next question after how much does it cost is how is care paid for? I think it’s important to understand that traditional health insurance does not cover home care in most cases. So I would say a large majority of our clients are private pay. There is a long-term care insurance available and more and more of our clients are starting to have long term care insurance. It’s very important and a really good benefit. There’s a lot of different kinds of long-term care insurance. So if you do have it, or your loved one has it just important to understand the policy, how much care will be covered under that insurance policy, so we can make a plan, a care plan based on that.

Outside of long-term care some of the VA programs that are available. Aid in attendance is something that a lot of families can look into. We also have a contract directly with the VA for a couple of programs to provide respite or bathing and dressing for veterans. So that’s something that can be used to help supplement care or get care provided for veterans. As I said, there were some exceptions to the health insurance Medicaid, so if your loved one qualify for Medicaid, Medicaid will cover some in home care or in Medicare, there’s some supplemental programs or policies that are just starting to provide some coverage for in home care. Now these are just starting within the last year or so. So some of the details, are just starting to come out but maybe in the future, this will be a bigger option, but for now I think it’s fair to assume that Medicare is not going to cover in home care.

How do you Screen your Caregivers?

So let’s look at caregivers and specifically how we screen our caregivers. We believe this is an area that sets us apart and has been for the last 16 years since we’ve been in San Antonio, the state has very minimal requirements. So a lot of times we’ll get questions like do you run background checks on your caregivers before you hire them? The answer is yes and it’s a requirement from the state in home care and most senior care related fields. So it will be yes from every agency that you asked that question. So it’s not really about, do you run the background? I think it’s more about what you do with that information after you run the background check. Like we said, the state requirements are very minimal and outside of a few violent felonies and things along that line, that’s basically all that it really prevents.

We, on the other hand have a very restrictive policy when it comes to background checks and without getting into too much details, it’s not because we don’t believe in a second chance, but it’s really about managing the risk for our clients and the trust that our families and clients place in us to find great caregivers that are gonna the job needed. So in our senior care industry caregivers are placed in the home and sometimes there’s not a lot of direct oversight, so we have to manage the risk associated with that. And we do that through our screening process. So outside of the background check, we also do a phone screen. We do situational base interview where we actually ask them, how would you handle this situation? Have you experienced this? What would you do if this happened and really get a feel for a person’s experience and philosophy in care.

We also check references where we’re actually talking to the person. So it’s not just an employment verification, but it’s actually a reference check where we talk to the references, which is a really difficult step, but I know very few companies still do it. So once they get through the interview, we have the orientation, we actually have a written test where caregivers have to pass to confirm that they have the knowledge needed to perform the job. And all those, all those steps, you’re going to see people and caregivers fallout. So you get the initial candidate applying for the job. A certain percentage are not going to pass the phone screen. A certain percentage are not going to pass the interview. A certain percentage are not going to pass the background and the reference checks, and it’s all designed to reduce the risk and find great employees.

So we typically receive about a hundred applicants a month and we’re looking to hire about five. So we want to hire the best 5% of caregivers in the industry right now. So I think while we’re on the topic of caregivers, I think it’s also important to give families an understanding of some of the market dynamics that are happening. So there’s a huge caregiver shortage across the industry, and we’ve seen a lot of agencies lower their hiring standards as a result. So they’ll take basically whoever they can get to provide the care as caregivers because there’s such a shortage. We, on the other hand have never reduced our hiring requirements. We’ve just decided to recruit smarter and increase our compensation package.

So we’re one of the few that provide health insurance, provide dental, vision. We provide Teladoc not only for the caregiver, but for the household. And really we believe in treating our caregivers with respect and dignity and give them the appreciation that the job demands. It is such a challenging job. Nobody’s really doing it for the money it’s because they’ve got a passion for caring for people, and that’s what we’re looking for. And that is our entire goal while we’re in the business of home care is to find the best caregivers in the industry and and match them up with clients that need help.

What Precautions are you Taking Related to COVID-19?

Let’s talk about a topic that’s on everybody’s mind, that’s COVID-19 and our response to COVID-19 specifically. I think in general, it’s pretty challenging time for everybody particularly healthcare workers. But I do believe that when it comes to managing your risk for getting COVID-19 and getting the care that you need home care is the best way to do that. Much better than any of the senior care options right now. So when it comes to the response, I like to think about it in two ways; administrative precautions and operational changes to manage a risk associated with COVID-19.

So when it comes to administration, I think it first starts with education and training. So infectious disease is already part of our mandatory training for all caregivers and employees at Griswold Home Care. And now we’ve layered on top specific COVID-19 training, where we talk about the disease itself, how it spreads, how it can prevent the spread and precautions that need to be taken to keep our clients safe and to keep our caregivers and their families safe, which is also a major concern.

I think everybody is fully motivated in doing what’s necessary to prevent the spread of COVID-19. Another part of it is the contact tracing and screening. So before every shift caregivers are screened for symptoms in contact with anybody or anybody in their household, that’s been exposed somebody that’s COVID-19 positive. And we’ve taken that, we do that through our app. So when they check in for each shift, they’ve got a questionnaire that they are required to fill out. And then we also require a screening questionnaire for our clients each shift, once a day. So this is a great tool in identifying early possible exposure. Somebody that might be having symptoms, and then we can work with the family and figure out, all right, should we get this person tested? Do we feel like it’s allergies? Is it related to a condition they’ve had previously?

So what we’ve learned is, you know, every situation is different and it really takes open conversation with the family, the caregiver, and figure out what is the best way in response. All our policies and procedures are based on CDC guidelines. So if there’s been a contact we know this is how long they should be isolated, or this is where they should get tested. And so far we’ve been very successful in managing exposure to our clients and to caregivers. And I just think it comes with being very cautious in managing anything that comes up and that open discussion that we’ve talked about.

And then when it comes to operations, it’s really about scheduling. We try to, as we said, our general philosophy is really a schedule based on the needs of the family. What we’ve seen now is a little bit of a shift in preference. So you know, maybe a family is a little bit more flexible if they can help reduce the number of caregivers assigned to their case. And that is better for everybody. If you can get an unlimited number of caregivers on a limited number of cases, it really reduces exposure across the board. And I think the best case scenario is one caregiver on one client.

And if that schedule meets everybody’s needs they your exposure is very, very limited. And I think overall, that’s the beauty of home care under this environment, is you get the senior care that you need, but we can also limit exposure. So you’re not at a large facility with many different employees, many different residents. All of those are opportunities for exposure. So with home care, obviously that risk is greatly reduced and then when you layer on the precautions that are taken, I think overall it’s the best situation and the best choice for senior care.

So I think that’s all the questions that we have for today. I hope you found it insightful and found some valuable information related to senior care. If you have any questions, feel free to give us a call or check out the website. We’re always happy to work with families and figure out what’s the best care solution is for them. So thank you so much.