It is always a challenge watching parents’ depreciating health as they age, especially if one is not around to check on them continuously. This is often the case with NRIs who live abroad and have elderly parents back home in India.
The distance gets in the way of caregiving, due to which they opt for home care professionals such as nurses and care attendants. However, hiring a caregiver for the first time could be a tricky task, and we at ParentCare wanted to guide you through all the elements of it:
- What homecare includes
- The difference between a care attendant and a nurse
- Nursing qualifications (ANM, GNM, or BSc)
- Things to consider before hiring homecare service
- How agencies in India verify nurses
What does homecare include?
In India, people usually try to choose a caregiver who is known to them or is referred by a friend because of the trust-factor associated with this process. These are mostly not professional caregivers and don’t have any formal qualification.
There are two major categories of home care as mentioned below:
1. Palliative care:
If the elderly patient is bed-ridden or is living with a serious illness that requires support and immense care, then palliative care is chosen. It is ideal for those who do not necessarily need regular medical attention but require support like cleaning. Palliative care is generally catered to by a care attendant.
2. Medical/nursing care:
If the elderly are sick and have to undergo a medical procedure that can be done at home, then it is ideal to choose medical care. In India, such procedures are conducted by home care nurses.
3. Full-hospitalization care:
This includes everything from requiring a proper hospital bed to nursing service. If the elderly require oxygen, medications, and constant supervision, then it is best to choose full-hospitalisation care.
How to choose between a care attendant and a nurse?
As mentioned above, there are two different kinds of caregiver-nurses, and home care attendants, based on the services required.
1. Care Attendant
Home care attendants are trained in non-medical patientcare. While most of them do not have any professional degrees in caregiving, some of them undergo HHA training. The certificates are not mandatory. The vendor checks thoroughly if they have practical knowledge before sending the attendant to the patient.
Some of the services they attend to are as follows:
- Feeding the elderly parents on time
- Administering medicines
- Cleaning the elderly and changing the diapers
- Maintaining a safe environment
- Offering personal care including grooming, sponge-bathing, and brushing the teeth
- Assisting in walking
- Feeding through the tube
Nurses are skilled in every service that a care attendant can provide. The only difference is that nurses have an added set of medical knowledge. Since they are professionally trained, it is costlier to hire a nurse than an attendant.
Some of the prominent services nurses provide are as follows:
- Dressing the wounds
- Administering intravenous medication
- Monitoring the health
- Creating a diet plan
- Inserting Ryles tube and feeding
When it comes to qualifications, nurses may have either done an ANM course, GNM, or B. Sc. Nursing. They also have skills and advanced medical certifications that enable them to save a life in case of a heart arrest and stroke for example.
- Auxiliary Nursing Midwifery (ANM):
ANM is approximately an 18-month course and teaches how to offer timely medication to patients. ANM nurses have the basic knowledge of nursing and know how to maintain health records as well.
- General Nursing Midwifery (GNM):
This degree is more than 2 years long with a compulsory internship of 6 months. GNM comes under the paramedics’ section and teaches students how to perform clinical tasks.
- B.Sc. Nursing:
This is a 4-year course and the most reputed amongst all three. B.Sc. nurses have the skillset to assist doctors and they know how to brief patients. They can confront a plethora of emergencies that require medical attention and are ideal for those parents who are suffering from major health issues. But since they offer professional medical care and cater to severely ill parents, they are the most expensive to hire.
It is very important to understand that an ANM or GNM nurse with ample experience can be more instrumental than a B.Sc. nurse. The certificate does not matter much when it comes to caregiving unless the requirement is specifically medical-related.
Things to consider before hiring home service.
After gauging whether to choose a care attendant or a nurse (as well as the type of nurse), the next step involves knowing how to hire them. Given below are a few questions that NRIs must ask the caregiver.
- What are the services they offer? Do they match with the ones required by parents?
- Are they capable enough to lift the parent?
- Can they operate the medical equipment required by parents?
- How many hours will they work or be available for?
- How will the payments be made?
- What is the notice period?
- Do they adhere to the list of unacceptable behaviour that should be avoided near parents (such as smoking)?
- Do they have a criminal background?
- Do they have expertise in the specific field that the parents need monitoring for (for example Alzheimer)?
- How many years have they been offering home care services?
- Do they have an established track record? Can they provide references?
- Do they have their course completion certificate (in the case of nurses)?
- Can they communicate seamlessly with parents? Do they have the right temperament for the job?
- Are the procured documents authentic?
- Have they taken a COVID-19 test?
If care attendants or nurses are chosen through home care vendors, then here is a set of questions that need to be asked (in addition to the ones mentioned above).
- How often should the payments be made?
- In case of a 24×7 care requirement, will only one caregiver be assigned or two be allotted with a 12-hour shift routine?
- Will a substitute be sent if the assigned caregiver is sick? In case of emergencies, what is the procedure followed by the agency?
Verification process followed by the home care companies in India.
Home care service vendors are supposed to verify the caregivers by cross-checking their KYC documents including Aadhar card, PAN card, and utility bills (for physical address proof). Some vendors will also perform the criminal check and background check either through a police clearance certificate or by authentic references.
At least 2 references are asked for by the vendor before hiring a caregiver. Any courses and training taken by the caregivers are also considered. Upon receiving a request from a family for a care attendant/nurse, the vendor will shortlist the best fit and send their profile to you along with their charges.
However, the payment process gets extremely cumbersome for NRIs since they will need to add the agency as their beneficiary, do intra-bank transfer, POS, or use portals (most of which do not work from outside India). The entire procedure is tedious and has a waiting period of approximately 3 days until the completion of the payment. Therefore, it is wise to choose a vendor or facility provider that accepts credit cards for seamless payment.
How does ParentCare stand out amongst other homecare companies?
ParentCare works with its home care partners to create a specific NRI focused hiring process. We always keep in mind that the parents could be living alone in India. A complete profile of the caregiver is created, highlighting gaps (if any) to present a full picture of the family as opposed to the basic qualification profile provided by most agencies. We assess if the available professionals are suitable, and only one or two shortlisted caregivers are introduced to the family thereby saving the family time and efforts of going through a number of profiles.
The next step includes the family speaking to the caregiver to ensure that the caregiver fits all their bills. Once selected, the caregiver’s details are verified including criminal background, if not already done by the home care company.
ParentCare accepts credit cards and bank transfers for hassle-free payments. This is a huge relief to the NRIs. The payment is then forwarded to the vendor by ParentCare via a preferred mode.
In a nutshell, the process of choosing home care starts with an assessment of your parents’ requirements. This is to help you understand whether they need a nurse or a care attendant. Then you should interview the caregiver thoroughly and ask all the necessary questions to see how apt they are for the parents. The key things to check are: qualifications, a good background or track record, and the right attitude.
About the author
Bharat Vasandani is the Founder & CEO at ParentCare, a platform for Non-Resident Indians who want to support their parents back in the country of origin. As an Indian living in London, Bharat knows how hard it is to find the right solution when your family needs medical services or some help around the house.
ParentCare gives NRI children a chance to book doctors, lab tests, home carers and errands smoothly, no matter the distance. Their team also manages the delivery of services on the ground, checking nursing qualifications, Covid-19 tests, and the family’s feedback on the provided service.
In his career, Bharat has proven to be a successful founder and team lead. His previous experience includes rebuilding the Asian business unit of ‘Omnimedia Publications Group’ as Operations and Strategy Lead.
Bharat was also a core team member of TresVista Financial Services, a global financial services company. Launching this from a hotel room with a team of 6, they reached a team size of 45 in 2.5 years.
To learn more about ParentCare, visit https://parentcare.family/