Family members who provide assistance or support to a disabled, ill, or older relative need help if they are to maintain their own health and well-being. There are many home and community services available that provide a needed "time out" for the primary caregiver. In addition, programs designed to serve older or disabled adults can also help caregivers. Because caregiving can become overwhelming, and some programs may have waiting lists, it’s a good idea to get to know the respite and caregiver assistance programs in your community before you need them. In King County, there are fee-for-service, volunteer, and government-sponsored services. For help finding the most appropriate service for you, call the Community Information Line.

When arranging for services, it is useful to have the following information on hand:
· Age of care recipient
· Social Security number, telephone number and address
· Information about income and financial resources
· Health insurance; name and telephone number of physician
· Nature of illness or disability
· How much, and what kind of, help is needed
· What services are currently being used and who is providing them
· Ability to pay for care vs. need for subsidized services

Caregiver Information, Advocacy and Support
Most voluntary health organizations dedicated to a specific disease or disability (for example multiple sclerosis, brain injury, Alzheimer’s disease, developmental disabilities) provide information and some kind of assistance for caregivers. Most offer educational classes, information and materials, and support groups. Some may also provide special services like counseling and care management, respite care or transportation. In some instances, these organizations may provide services not available any other place. They are "experts" on special needs for the disability or disease populations they serve and can often meet one-on-one with you to explain the resources and services you will need. Some may have additional money available for services related to the specific disease or disability. Contacting the voluntary health organization associated with your relative’s illness or disability is an important first step.

Many hospitals and senior centers also provide assistance to caregivers. They may have social workers or care managers who will provide resource information or coordination of services. They may also offer transportation, education programs, legal and insurance advisors, counseling and support groups. It’s a good idea to contact the hospital and senior center nearest you to check out their services for caregivers.

Community  Management — Assessment, Care Planning & Coordination
Sometimes caregivers need professional assistance to determine what services are needed and how to access them. Care managers or care consultants can meet with you in your home or in their office to assess your needs, explore options and develop a plan for how those needs can be met in the short and long term. They are able to give you information about how to choose a provider and which kind of service might be best for your situation. In some cases, a care manager may help you arrange for services and monitor them over time.

There are fee-for-service care management programs throughout King County. Some hospitals and senior centers also have social work and/or care management services available in the areas they serve. For low-income disabled and older people, services may be available through the Home and Community Services Division, Department of Social & Health Services (DSHS). Contact Community Information Line for programs nearest you.

In-Home Help Options
Home Care Agency. Agencies provide workers who can perform a range of duties – from simple companionship to skilled nursing care - in the home. Fees for service are by the hour and usually there is a minimum number of hours per visit (typically 2-4 hours). Using a home care agency relieves the family of screening and hiring responsibilities, and also payroll and taxes. Before assigning a worker, most agencies send a nurse or social worker to your home to assess the needs of your relative. In the case of worker illness or unavailability, the agency should provide a replacement and is also responsible for supervision of the worker or to step in if problems arise. Most agencies require that workers are licensed or bonded.

Hiring On Your Own. Hiring a caregiver privately may be less expensive than using an agency, but it is more complicated. The individual or family becomes the worker’s employer and assumes responsibility for paying wages and withholding and reporting social security taxes. The family is also responsible for all supervision as well as disciplinary action if conflict should arise. In the event of worker illness, or if the situation does not work out, the family is responsible for finding a replacement. Before hiring a person to care for your relative, it's important to assess their knowledge and skill and to complete a thorough reference and background criminal history check.

Caregiver Registries. Some organizations maintain lists of persons who are seeking home care work. These organizations may screen and check the references of workers, or they may simply list names of persons seeking work. Registries may provide some training of the worker and may also provide assistance to the family with the hiring process. However, once selection is made, the family is responsible for ongoing monitoring of care.

Whether you use an agency or hire on your own, it’s a good idea to develop a job description with specific information about the expected tasks and schedule for their completion. Some families assemble a "carebook" to share with in-home workers that includes information about the person’s needs and preferences, life story, medications and daily routines.

Adult Day Programs
These are special programs for people who are either physically disabled or cognitively impaired. Some programs meet once or twice a week and provide mainly social and recreational activities for participants, as well as respite for caregivers. Other programs are open 8 hours a day, 5 days a week and provide a full range of health, recreation and social work services. Fees vary, but are usually reasonable, and full or partial funding is almost always available for persons on low or fixed incomes.

Day programs have benefits for both the caregiver and the disabled person. Many offer individualized social and activity programs designed to appeal to people at different levels of ability. Some offer transportation and support groups. For working caregivers, day services may be a cost-effective alternative to home care, and one that allows the family to avoid placement out of the home. Before choosing day services, visit the programs nearest you and talk to them about the services they offer. As with home care, it’s a good idea to develop a "care book" that includes vital information about your family member.

Government Sponsored Long-Term Care and Respite Programs
Seattle-King County Aging and Disability Services sponsors a respite program that offers services at no cost or on a sliding fee scale to eligible persons who reside in King County. Services are usually provided for four hours once or twice a week, and people have the option to receive respite in their homes or at a day program.

A senior or disabled person who meets financial and health eligibility requirements may also be eligible to receive home care, day care or residential care services through the COPES program sponsored by the Department of Social and Health Services (DSHS), Home and Community Services. Contact the Community Information Line about how to apply for these programs.

Crisis Clinic Caregiver Information & Assistance Program

Information, Assistance & Referral Service
If you are a caregiver of someone over the age of 18 who is ill or disabled, the Caregiver Information & Assistance Program at Community Information Line can assist you in locating the services you need. Information & Referral Specialists are available Monday through Friday, 7:30 AM to 7:30 PM, and Saturday from 9:30 AM to 2:30 PM  to help you identify and clarify needs, as well as find resources and support related to your individual caregiving situation. After business hours, calls are answered by the 24-Hour Crisis Line, so someone is always available to offer support.

Respite Care Services
If you are a caregiver of someone over 18, and have an immediate or emergency need for respite due to caregiver illness or family emergency, you may be eligible to receive one-time respite assistance. Eligible caregivers have the option to receive services in their home or community-based settings. The goal of the program is to offer short-term assistance while more permanent care is arranged. Care is subsidized by the program on a sliding fee scale basis based on income and/or need criteria. Call the Community Information Line for more information about this service.

In-Depth or Ongoing Support
If you have an urgent or ongoing need for assistance, a Caregiver Specialist may provide consultation services that include problem solving difficult situations, identifying care needs, decision-making and linkage to resources, as well as follow-up support to assure needs have been met. Callers who need extra assistance and/or emotional support may receive regular or intermittent assistance.