Are you part of the "sandwich generation"? You are if you are responsible not only for caring for your own young children, but also caring for your parents. As the population of our nation ages, many people are finding themselves in exactly this predicament. They are quite literally "sandwiched" between generations with responsibilities on both sides. Those are in this "sandwich" will very likely be making some major health care choices for their parents more quickly than they may have anticipated.

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.

Home health agencies such as Family Home Care & Hospice (FHC), based in Spokane, Washington, serve as a prime example of an organization with the resources to "grow" with the patient.

"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.

In addition to the customary slate of services offered by a home health agency, it would be advisable for you to ask about what specialized services are available. Many home health agencies have the same list of standard services that will fit the needs of most patients quite well, but some patient needs are more specialized and require services that are more difficult to find. Often these services include wound care specialists, primary care medical services and enteral therapy. Ask your home health agency if some of these hard-to-find specialties are available.

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."

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.

"Advances in technology have brought highly specialized medical equipment into the home," Nowling continued. "It is the responsibility of a good home health agency to see that employees are continually kept abreast of the latest developments in care."

Insurance coverage is also an important consideration in selecting a home health agency. Most home health agencies will accept Medicare, Medicaid, and most private insurance, including long term care policies. But this is definitely one of the first questions you should get answered in your search. Insurance coverages for home health will depend not only on the status of the home health agency, but also on your particular insurance policy. Rather than taking the time to comb through the legalese of the policy, it is often much more accurate and fast to simply talk to a customer service representative at the insurance company.

Try this simple checklist for your evaluation:

Put two or three qualified home health agencies on your list of candidates

Determine what their standard services will be

Ask what specialized services are available

Check out your selections by visiting: 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 what insurance coverages are applicable

If you're one of the "sandwich" generation, then you owe it to your parents or loved ones to thoroughly investigate all your health care options. Make sure that home health agencies are on your list. Chances are your parent or loved one will be grateful you did.