Years ago, when in-home health care was fairly new in our area, I had an elderly neighbor who hired an agency to stay at night so the wife of a man suffering from ill health could get some sleep. These people were in their 80s, but were mentally sharp. The woman caregiver was in fair health, but having someone there over night let her sleep better. Or it did until she got up one night to go to the bathroom and saw the worker asleep on the couch. It turned out that not only did this worker consider her night job to be an opportunity to sleep, but she smoked in the house, as well. Needless to say, the agency was terminated.
Shortly after, the man died, but the whole experience left this woman with a bitter attitude toward in-home care. In-home care is, in theory, what most elders want if family caregivers can't do all the work. And good care can be a lifesaver. I've met some wonderful people who work for agencies providing this service. Many need to cope with disgruntled elders who really don't like a stranger in their home. Others are lucky enough to find an elder who welcomes their company and they enjoy each other.
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Either way, there's a lot to consider when you hire a home care agency. With in-home health care, you are letting strangers into your home. So, number one on the list is to go through a well-known agency. This doesn't necessarily mean you need to go through a large franchise, but get references from the agency you hire, and check those references. One reference isn't good enough. Any agency can have someone who was unhappy for some reason, or someone who is thrilled, only to find another person has different feelings. A good agency should give you a number of references.
Don't Assume They Provide Back-up Care
To help you decide on an agency, ask about backup care. One woman I know had to spend her entire Christmas Eve and Christmas Day sleeping on her elderly aunt's couch because the agency they had coming in didn't have backup for the holidays, and the caregiver who was to come got delayed by a late plane. People get sick. They have sick kids. They take vacation. Ask if the agency has sufficient backup staffing for emergencies and other occasions.
Avoid "Revolving Door" Caregivers
Next, see if they are diligent about getting the same caregivers to go to the home. Can you imagine a stranger showing up at your door saying, "Hi, I'm here to give you a bath!" Then think about how, once you've finally adjusted to this idea and get used to this person, someone else comes, and then again, someone else. Strangers, all of them. It's no wonder an elder gets upset. Agencies can't have one caregiver working seven days a week.
Also, since there are vacations and other times when a different person may need to come to the home, it's good to have elders get used to two or three workers. But an effort needs to be made to consistently send the same personnel. My uncle had eight hours daily of in-home care for quite some time. He had a rotation of three caregivers, all of whom he liked. He liked one best, but all three were okay with him. Occasionally, someone else had to come, as none of the three were available, and he found this very upsetting. But that is life. We were fortunate that he had three good people to help him and the agency did its best to be consistent.
What else do you need to understand about in-home care?