Our nation is getting older. There's no question about it. As we age many people are caught in what has been referred to as the "sandwich generation". That means they are, at the same time, responsible for caring for aging parents in addition to their own young children. Literally they are "sandwiched" between these two generations and responsibilities. Those who find themselves in this situation will likely be making some significant health care decisions for their parents.

If you're in this potentially tense and uncomfortable spot, first, you'll want to be certain to consider a qualified home health agency for your loved one rather than a nursing home or care center. It's well known that, with regular professional care, patients will typically do better in their own homes whenever it's possible to treat them in that environment.

Services offered by home health agencies can vary. Some offer a broad range of services from basic assistance with routine tasks such as bathing, cooking or simple housework, to round the clock continuous nursing care or hospice services. It is important to consider what future needs might arise and select a home health agency that will be able to meet those needs.

As time passes, your family member may become more incapacitated and require additional services. It is essential to select an agency which has the capability to continue to provide services so your family member won't have the additional stress of transferring to a care center or learning to accept new care providers.

Family Home Care & Hospice (FHC) headquartered in Spokane, WA is an excellent example of the type of home health agency that can provide the breadth of services needed to accommodate the patient's increasing needs.

"We have structured our services to be able to offer patients continuing care in their homes as long as medically possible," explained FHC President, Michael Nowling. "All signs point to outcomes which are better for the patient and for the family if medical care can be effectively delivered in the home as long as is medically practical."

Medicare keeps records on home health agencies and has recently recognized Nowling and FHC as one of the top one percent of home health agencies in the state of Washington and also among the top three percent of home health agencies in the nation. The recognition, which is based on monitoring of patient outcomes, lends credence to Nowling's commitment to providing the types of services which will keep patients at home as long as possible. The Medicare database is available online at http://www.medicare.gov/HHCompare/home.asp. Visiting the site will allow you to compare patient outcome statistics of any qualified home health agency you may be evaluating.

Most home health agencies have a standard schedule of services, but it is also important for you to ask about any specialized services the agency may provide. You may never need any of these more rare specialties, but in the even you do, you will have the confidence of knowing they are available through your current provider. Types of services in this category may include enteral therapy, wound care specialists or primary care medical services. Be certain to ask your home health agency if these or other specialized services are provided.

A constant battle in any home health agency is recruiting and maintaining qualified personnel. It is critical for you to explore the home health agency's policies for background checks and on-going employee education and training.

"We often remark that it's really hard to get a job here," noted Nowling, "but we think that's the way it should be. FHC is a wonderful organization particularly because of how selective we are in the people we hire. Our hiring practices result in a staff of people who are committed to excellence and high standards of professional conduct. They work hard for our patients and they tend to stay with us for a long time. This is great news for our patients and their families because this results in consistently better outcomes. It's one of the reasons we are rated so highly by Medicare."

Just as important as a home health agency's ability to find and maintain a qualified staff is their commitment to keeping that staff trained and educated in the state of the art techniques and therapies. Ask about their training and continuing education programs.

"There is so much specialized and highly technical medical equipment
which can now be used in a home environment," continued Nowling. "We think it's an important priority of a good home heath agency to make sure that our professional staff are always up to date with the latest advances in care."

It goes without saying that insurance coverage is a critical consideration in your home health agency selection process. Most agencies accept Medicaid, Medicare and private insurance, but it is always best to ask specific questions not only of your potential home health agency, but also of your insurance company. Combing through the legalese of your insurance policy may not always get your question answered. It is often better to simply ask a customer service representative at your insurance carrier.

Just in case you haven't been making notes, here's a checklist:

Put a qualified home health agency on your list of alternatives

Find out what is on their list of standard services

Determine the extent of their specialized services

Visit the Medicare website to check out and compare your selections: http://www.medicare.gov/HHCompare/home.asp

Find out the details of their employee screening and hiring practices

Ask about their staff training programs

Find out if insurance will cover home health, and if your agency will accept your insurance

Whether your part of the "sandwich generation" or not, considering home health as part of your health care choice is just good judgment. Be certain that home health agencies are represented in your evaluation process. Your parent or family member will thank you.

Craig Mecham