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.

This can be an uncomfortable and sometimes tense situation. One thing you'll want to be certain you consider is a qualified home heath agency rather than a nursing home or care center. Almost without exception, patients will do better when treated at home than in any other environment.

Many home health agencies offer a wide spectrum of care from assistance with tasks of daily living such as bathing, meal preparation and light cleaning, to 24-hour nursing and hospice services. But, by contrast some are very narrow in their scope of care. You'll want to be certain that the home health agency you select has the capability to perform additional services, as they are needed.

As your parent or loved one ages, it may become more difficult for them to perform their daily routine. If you have chosen well, you'll be comforted knowing that your home health provider can continue to provide care. You will spare your family member the stress of moving to a care facility or getting used to 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.

"It has been our purpose from the beginning to offer a range of services which would allow us to continue with patients as long as possible," explained Michael Nowling, FHC's President. "Every evidence indicates that outcomes are more positive for the patient and the family if care can be effectively provided in the home."

Indeed, FHC has been recognized by Medicare as among the top 1 percent of home health agencies in Washington State and among the top 3 percent of home health agencies in the nation. This recognition is based on extensive monitoring of patient outcomes and lends credibility to their stated goal of keeping patients in their own homes as long as possible. Medicare maintains a database of information about home health agencies and their patient outcomes. It's a good idea to visit their website and look at the data when considering a home health agency. You can log on at http://www.medicare.gov/HHCompare/home.asp.

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've often heard that it is tough to land a job at FHC," Nowing noted, "but we believe it should be. FHC has grown to become the organization it is primarily as a result of how picky we are in our hiring practices. Because we're so selective we have a unique group of employees who are interested in maintaining the highest standards of professionalism. They are dedicated to their patients and they work hard. They tend to stay at FHC for a long time. This makes a big difference to our patients and their families especially as it relates to positive outcomes. This is how we are able to be ranked so highly by Medicare."

With regard to the skill levels and training of home health staff, it is a good idea to find a home health agency that places an emphasis on keeping their people trained in the latest therapies and techniques.

"Much of the highly technical medical devices can now be used in a home setting," continued Nowling. "It's part of our mission to keep our staff in touch with all the most recent improvements in health care delivery."

No home health decision process would be complete without considering insurance coverage. Medicaid and Medicare are accepted by most home health agencies as is private insurance including long term care. This is a high priority question and should be addressed early on in your search. Insurance coverages will vary not only with home health agencies but with insurance companies. Trying to interpret the legal documents associated with your policy may not be as fruitful for you as a simple call to a customer service representative at your insurance company.

Try this simple checklist for your evaluation:

Find a qualified home health agency or two for your list

Make sure you understand their list of typical services

Ask what specialized services are available

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

Evaluate their screening and hiring of new employees

Ask what kind of staff training and education programs they have

Find out what insurance coverages are applicable

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.