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Deciding how to care for an ill or incapacitated parent can be difficult. For the thousands of people who find themselves in the sandwich generation, caring for their own children and aging parents at the same time, knowing the options available can make a big difference in stress levels. In many cases, a nursing home is not the best, or least expensive, choice.

Home health care - where a trained aide or nurse visits the home and helps a patient with daily activities and medical care if required - has become a preferred option to placing a loved one in a nursing home. Although many nursing homes offer excellent care there is a stigma associated with being in an 'institution.' Also, studies show again and again that the elderly respond better when they are cared for in the comfort and privacy of their own homes.

Questions to Ask a Potential Home Health Care Provider According to Ken Wessel, Director of HomeCare Options, those considering home health care, need to ask the following questions of any agency they are considering: How long have you been in business? Have you personally checked this person's references and is he or she bonded? Is there a registered nurse who supervises on a regular basis? Is there a trained coordinator available by telephone 24-7? (a requirement for licensed facilities) Are your home health care workers certified or licensed by the state? How long have they worked in the agency's employ? Is the agency accredited by a recognized accrediting body? Is the agency licensed by the state?

Many families continue to care for dependent parents at home. According to the Family Caregiver Alliance, approximately 25 percent of all workers in the U.S. provide care to an elderly relative or friend. This, however, may become impractical when the caretaker works, has children of her own, or the parents suddenly require greater medical assistance than can be provided.

Home health services have greatly expanded over the years. Patients can get assistance in running errands such as food shopping and picking up prescriptions, preparing meals, cleaning the house and getting a ride to the physician. Home health care can be full-time or part-time. Whether someone needs round the clock attention or an aide to visit for a few hours a day, help is available.

Everyone's situation is different and most home health agencies assign an experienced case manager, usually an R.N., to visit the home, evaluate and assess the person's needs and work with the client, family and home care staff to draft and implement a plan of care.

All home health aides in New Jersey must complete the NJ State Board of Nursing approved course, which includes 77 hours training and both written and practical competency exams.

More than ten million elderly Americans need help today with such basics as bathing and dressing, preparing meals and other activities of daily living. Many more need nursing attention. And with the percentage of senior citizens expected to increase sharply by the year 2020 - by about 50 percent - from 35.5 million persons in 2000 to 52.6 million persons, the demand for home health services is sure to grow.