Nurse Helping Senior Patient with Water in Bed

When a Caregiver Isn’t Enough: Is It Time for Skilled Nursing Care in the Home?

How do you know when it’s time to hire a professional? Here are some considerations to take into account if you’re thinking about private duty nursing for your loved one’s care at home.

Are you considering private duty nursing for your loved one? If you’ve been caring for an aged relative or loved one, perhaps the time has come in which their need for help has exceeded your skills and abilities. It happens, but you may feel uneasy about stepping aside and handing off the reins of care to a stranger.

That’s where private duty nursing shines and becomes a tremendous help to you and your entire family. Private duty nurses understand the delicate situations they’re about to enter, and their sole focus is on the care of your family member. That’s their only job.

Skilled nurses providing private care in the home are typically able to do the same things a nurse does in a hospital setting. A private nurse has in-depth training to monitor and evaluate the condition of your loved one and keep records of their status.

Skilled nurses can also administer emergency measures if necessary in the event your family member’s health status should deteriorate. They also communicate as necessary with the doctor.

Do You Really Need Skilled Nursing?

Depending on the physical condition of your family member, it’s possible you may need skilled nursing, you may need CNA care, which is more on the “caregiving” side of the business, or you may need some combination of the two. You may find it helpful to alternate the use of these professionals so you can keep costs down and your loved one still gets all the attention and care they need.

Skilled Nurses may perform semi-invasive tasks such as wound care, catheter care, and starting or maintaining IV medications.  Most caregivers who are not Registered Nurses or otherwise licensed as a nursing professional are not qualified to perform these types of services.

Areas that Private Duty Nursing May Be Helpful

Some of the factors to consider when determining if private duty nursing is right for your situation include:

  • the level of care your loved one requires
  • whether they need constant supervision
  • if they’re able to be up or must stay in bed
  • what medications they’re taking
  • their emotional and cognitive status

Some of the areas in which private duty nursing may help involve personal care, which can include eating, bathing, dressing, toileting and other areas of personal hygiene. It would not necessarily require a skilled nurse to help with any of those activities. This could fall to the home health aide or CNA.

In the area of health care, private duty nursing can assist with medications your family member is on and other health-related activities, such as physical therapy or driving to doctor appointments.

You could choose to have a skilled nurse during the day to administer medications and any necessary treatments, then have a CNA or HHA come in to stay throughout the night.

It’s important not to overlook emotional care, which is also part of what a private duty nurse provides. They can offer conversation and companionship, and engage in activities within the limit of the family member’s abilities.

Hiring someone from the private duty nursing pool relieves you from being the sole caretaker. It allows you to take some time for yourself and also enjoy some time with your other family members.

What Happens If Your Loved One Refuses a Stranger’s Help?

Sometimes a beloved family member will act like a spoiled child when you try to introduce someone unfamiliar. Many times, this is due to the family member’s fears that you’re going to abandon them. You’ll need to reassure them that you’re not leaving them; you’ve just hired someone else to help you take care of them.

You can help make the transition easier by being present, especially in the beginning, to help the nurse establish a bond with your loved one so they can start to form a trusting relationship. Allow your loved one to feel a little bit of control in the decision-making by suggesting that they give the nurse a try, just for a week or two.

The important thing to keep in mind is to be patient with your loved one. They will usually come around eventually and at least accept the additional help, even if they’d rather you were the only one giving it.

Go Direct or Through an Agency?

There are pros and cons on both sides of hiring private duty nursing through an agency versus contacting a private duty nurse directly. If you go through an agency, chances are you’ll have a broader selection of nurses available. Most reputable agencies do background checks on all their caregivers.

If the nurse is not a good fit, the agency can usually arrange to send a substitute fairly quickly. Should a dispute ever come up, the agency can step in and help settle any disagreement. If you have long-term care insurance, your policy probably covers agency hires.

On the other hand, agencies typically tend to be more expensive than direct hiring, and you may encounter an increased amount of turnover in the staff.

Hiring a private duty nurse directly puts you in the position of being the boss, which for some will see as a “pro” and others may see as a “con.” On the “pro” side, it’s less expensive to hire directly and you may find an increased flexibility in the types of tasks you can ask them to perform.

However, if your nurse cannot come for any reason, it’s up to you to find a replacement. Also, extended care insurance might not cover direct hires. As their employer, you may also be responsible for withholding payroll taxes and providing workers compensation coverage.

It is ultimately up to you to determine if private duty nursing is the route you need to go for the best help in caring for your loved one. Whatever you decide, be sure to do your due diligence in researching the private duty nursing agency or the individual and don’t be afraid to ask questions!