Merrily Orsini

Caring.com Expert

About

Merrily Orsini was a pioneer in the business of providing geriatric care managed in-home care. She currently serves as the Chief Strategic Officer for Private Duty at the National Association for Home Care and Hospice and is a recent past member of the advisory board of the Private Duty Homecare Association, an arm of the National Association of Home Care and Hospice. She has a master's degree in social work and is a nationally known writer and speaker on aging, elder issues, and in-home care. She served on the board of the National ASsociation for Home Care and Hospice,the National Association of Professional Geriatric Care Managers, chaired two national conferences presented in conjunction with the National Academy of Elder Law Attorneys, was a delegate to the National Institute on Aging, and cofounded and co-owned a company that provided in-home care to frail elders from 1981 to 1998.

While working in in-home care, Orsini recognized a need for special training for those who provided care at home, so she created a state-licensed, certified elder-caregiver program. She also developed a training system to help caregivers better learn how to work with clients with Alzheimer's disease or related dementias. Her agency provided a unique model of care that used geriatric care management in conjunction with in-home care to allow frail elders to remain at home as long as they desired to do so.

Recently Published on Caring.com

  1. Thursday June 23, 2011

    1. What should I do if I suspect my mother's caregiver has stolen from her?

      Answer - So very sorry you have experienced theft. Unfortunately theft and caregiving is something that happens because of the unsupervised situation. We also found that theft sometimes occurred when there were shifts in the home by others than the caregivers, because the “opportunity” for passing blame was was there...

  2. Monday June 13, 2011

    1. How can I get help for my dad while he's still at home?

      Answer - Your story is all too familiar, and the problem is that there needs to be some planning for in-home care, and some professional assistance in so doing.

  3. Thursday May 19, 2011

    1. What is the typical pay-rate for a untrained caregiver?

      Answer - Researching comparable pay rates would have been my answer to finding out how much to pay. Caring for two people is always more expensive than caring for one. Also, providing 24/7 care brings overtime into the equation. There are laws governing wage and hour, state, local and federal tax withholding...

  4. Wednesday May 11, 2011

    1. How to do about wife who takes 88 year old husband out to dinner despite poor behavior?

      Answer - Your question about bad behavior of 88 year old at restaurants, is a hard one to answer. It seems that the husband must have some sort of dementia that results in a behavioral problem, but you really do not say. If he has always misbehaved, then the answer would be different.

  5. Sunday February 06, 2011

    1. What paperwork is needed for a live-in caregiver?

      Answer - There really is no one site source for rules governing an in-home caregiver because, according to Bob King, Esq., a recent presenter at the Private Duty Homecare Association Conference, “it's literally impossible to answer unless you know what state the person is fr...

  6. Friday January 21, 2011

    1. Can I refuse to continue to be my father's caretaker?

      Answer - What a problem you have, and how I wish there was an easy answer. Unfortunately my knowledge of resources for non-seniors is limited, so I sought advice from two professionals in Michigan. Some ideas were to start with the Area Agency on Aging to see if there are any resources available...

  7. Thursday September 09, 2010

    1. Dad is getting upset with Mom, who has memory loss. How can we help him not get upset?

      Answer - First, there is no “age-related memory loss”. Loss of memory has an associated cause, and finding that cause is essential. Please do not use the physician who made the pronouncement of “age-related” rather seek out a geriatrician or a geriatrics center that does comprehensive eva...

  8. Tuesday July 27, 2010

    1. How do I get my Alzheimer's MIL to take her pills and get dressed?

      Answer - Caring for a rapidly deteriorating Alzheimer's patient necessitates understanding of the disease. First she really needs a thorough screening from a specialist in geriatrics so the diagnosis can be clear. If it is depression masking as dementia then medication will help and she can be functional again...

  9. Wednesday July 21, 2010

    1. If an alert client ask the caregiver to leave what should you do?

      Answer - I assume that by “alert” you mean that the client has no dementia, and has the ability to make his/her own decisions. If that is the case, then asking a caregiver to leave is the same as asking anyone to leave your personal space. Also, the reason for asking the caregiver to leave is not given. Was Was the client uncomfortable in some way with that person...

  10. Thursday May 13, 2010

    1. Are there any classes I can take to become a better family caregiver?

      Answer - Because you are in a situation with such specific disease and disability needs, classes for family caregivers means for you tackling these from a variety of sources. I’ll get to those in a minute, but it seems to me that you really ought to get a geriatric assessment as well, so someone in your commmmunity...

  11. Wednesday May 12, 2010

    1. Are there rules for fairly compensating home health workers?

      Answer - There are laws governing fair compensation for home healthcare workers. The agency where you work should have policies in place that detail what a job entails and how much you are paid for your work. The job description should specify the rate for one client or more, and should also always be in compliance...

  12. Tuesday May 04, 2010

    1. How can I get my mother’s caregiver to communicate better with us?

      Answer - Sometimes communicating with a home health worker is as simple as having a 3 ring binder note book in the home, where all are expected to record what has occurred during a shift. What your mother ate, when she slept, when she took medications, who visited and when, what outings she went on, etc...

  13. Monday March 15, 2010

    1. How can we calm an abusive dementia patient?

      Answer - There are really many techniques for calming an abusive dementia patient. To calm an agitated person with dementia, most techniques revolve around the caregivers being trained on a) the disease itself, b)how to approach the person prior to speaking or interacting, and c) how to react when there is some belligerence...

  14. Sunday March 07, 2010

    1. What is my liability as a live-in caregiver?

      Answer - This question is difficult to answer as there are several levels of potential liability. One is taxes, payment for services and liability for that aspect of the care. If you are an independent contractor then you are responsible (liable) for reporting your wages and that aspect of the value of a place to live (room and board) as income...

  15. Friday October 30, 2009

    1. What are the "do's and don'ts" of home care under Medicaid?

      Answer - Unfortunately the question does not have a simple answer. If you are referring to the qualifications and competencies of personal care workers under Medicaid, federal law leaves most of that up to the individual states to determine. And the services provided are confusing, but relative to the scope of...

  16. Wednesday October 14, 2009

    1. Do I need to get a new home health aide license if I've moved?

      Answer - To inquire about a home health license in California I would start by contacting CAHSAH and see if they can direct you to the correct agency that can answer your question.

  17. Friday October 09, 2009

    1. How can we keep my father-in-law from being so lethargic?

      Answer - You mention that your father-in-law is most content when watching movies. The key to caring for someone with Alzheimer’s is to keep them content and avoid confrontation. Two things that bother me about his movie hobby are the sitting in one place for a long time, and the potential safety issue of hihis being alone without any supervision...

  18. Tuesday September 29, 2009

    1. What happens if in-home care workers do not pay taxes?

      Answer - This is a difficult topic, paying taxes for in-home care workers, and one that full employment home care agencies fight in many ways. In Florida the state association for home care even supports this registry model. In California there is a classification for domestic referral agencies that is condoned by the state as well...

  19. Friday September 04, 2009

    1. Is mom's caregiver taking advantage?

      Answer - There are several red flags in your question. First, is that this caregiver may be privately hired, since if the caregiver is from an agency, then it is the agency’s responsibility to deal with the caregiver, and not yours. Since it sounds as if this may be a privately hired caregiver, and if that i...

  20. Tuesday August 25, 2009

    1. Does long term care insurance cover the costs of a certified nurse aide (CNA)?

      Answer - First, check with your LTCi agent to make certain that you pay directly to the aide and be reimbursed, and not through an agency. Each policy is different as to what constitutes the event that triggers coverage, and what is covered and by whom. Your agent is the best one to cover this with you...

  21. Sunday August 23, 2009

    1. Can I get help to pay for a caregiver?

      Answer - Most states have programs that assist income eligible people who need household assistance to keep out of a nursing home. These programs pay for a caregiver, if you are eligible. I suggest you contact your Area Agency on Aging or your county human services office and see if you can get a case manager assigned to come and assess you for assistance in the home...

    2. What is the benefit of getting a home health aid license?

      Answer - State licensures as well as state home health aid license regulations vary by state, as do payments for state funded programs.I suggest you contact your state licensure department and get these questions answered.If you have trouble finding a contact, try the state home health association to see if they can assist...

  22. Wednesday June 17, 2009

    1. How do I find more affordable home care?

      Answer - What a complicated issue! Having trouble finding affordable in-home care seems to be an issue for you as well as the government. The issue is that pay is commensurate with getting a trained, kind and loving person to come to your home to perform a simple task...

  23. Saturday May 30, 2009

    1. How do I change hospice agencies?

      Answer - A red flag appears when I hear about an ill person distrusting those whose job is to provide care and comfort. Medicine interactions, cognitive impairments related to the disease process-both of these things can make a person distrustful when there is no reason to be distrustful...

  24. Monday May 04, 2009

    1. Do home health care aides commonly charge for travel expenses?

      Answer - Home health aides are paid by the hour or by the visit. When a patient or client lives a distance away from the agency, or from a major metropolitan area where there is adequate public transportation, it is common to charge either a set fee for travel within a certain radius or to charge actual mileage, which is based on the IRS reimbursed rate of $...