I used a professional private caregiving Agency for my Dad. Since Dad needed 24 hour care at his house, at the beginning there were many different caregivers that came for their shift. To find whom would be a good fit was like being on Match website.

Dad liked all his caregivers so it wasn't easy for him to narrow down the 3 he would like on a regular basis for during the week. Then 3 more for Saturday, and 3 more for Sunday.

Dad narrowed it down and they were really super. Dad was all smiles whenever they came through the door. Even when Dad moved to senior living he decided to bring along 2 of the caregivers... that help give him a good routine.

When Dad went into Hospice, the two caregivers made sure they were scheduled to be with him 12 hours each, even though the Agency didn't want to do that. The caregivers insisted. They didn't want my Dad to be with a stranger just in case it was his final time. The Agency checked with me first as this would have been overtime for the women. It was well worth it.

In fact, three of the five reasonable aides we have had (out of more than 100 ) have been foreign born. As long as they know what they are doing, I am pleased. However there can be serious problems, such as saying "yes, yes" when they do not understand us and then nearly starting a fire near the oxygen tanks, and wearing their native country's clothing and tripping over it in the shower thus narrowly avoiding a fall while showering a very frail client.

If your PACE program is like ours in Massachusetts, you DO get to pick your caregiver, to an extent. In Mass, the PACE program we're in contracts with several home care agencies, and the agencies offer us alternate choices if one choice isn't working out well. I've found the agencies affiliated with the PACE program to be responsive to client concerns -- more so than the one agency I contracted with before my husband joined the PACE program.

Here's a very difficult issue to bring up, if you live in a region with many foreign-born home health care aides: verbal communication. I've met many foreign-born aides who are diligent and caring. I also respect the fact that they know at least two languages (often more), as I know only one. But when an aide's accent is hard for a hearing- or cognitive-impaired care receiver to understand, that can shut out a lot of what could be very good home care relationships. There's got to be a tactful way to handle this, particularly in a way that won't be costly to the home health aides.

I just need to add that V.N.S.N.Y. is not the only agency that we have delt wtih over three years. They are all very equally uncaring and the agencies they work with are only interested in their own agenda. The frail elderly are the providers of the jobs.

Interesting! Since Ms.. Gelman reportedly works for V.N.S.N. Y. and my husband receives his care through that agency, one might assume that she would likely be speaking of the type of care and respect we could expect to receive. Well, few things could be farther from accurate. Actually, our wishes are nearly never a consideration. Believe me we have had home care for nearly three years and out of more than a hundred personal care aides, fewer than five percent are even passable. Most of the women who take this job do it because they expect to actually work only about one third of the time they are here. The rest of the time is spent charging their cell phone, conducting their personal business over their phone or playing games on the phone if they are not sleeping. We DO NOT have overnight aides, but most of them "work" around the clock because they "wotrk" through multiple agencies. I cannot count on both hands the number of aides whom I have photographed sleeping . I can rarely even leave the apartment because when I do, I return to find my wide awake husband watching the aide.
An on the occasion that they are awake enough or speak enough English to converse with us,, we hear about their troublesome lives--tales of sleeping in their cars overnight because she was driving without insurance and when her car broke down she would not call for help for fear of being caught. Of course her many children were home alone at the time. This or a very similar story has recurred at least three times. The strangest conversation involved the aide who was spending her time going from our home to the hospital where her friend had given birth to a baby who had died. Yes, very sad indeed. The aide and her friend spent their time dressing the deceased baby in all the clothing she had received at her shower, then they planned to return the clothing. This"game" ended when an observant nuse noticed after several days that the body was decaying. We had to. Ask her to leave when she started to show us photos.

Furthermore, we have no say in whom the agency sends here to work. No one seems to know or care about the challenges of Alzheimers. And when my husband has a lung infection and thus is very weak, the often make me do most of his care.

Yes, I have complained to everyone possible. I am either totally ignored, promised that things will change and they never change for the better, or of late I am being told that it is my attitude that is wrong. Each day I should forgive what has happened and start a new. Of course along the way there have been occasions when the aides have outright asked for monetary help, one even asked me to drive a half hour to her home to pick her up.

Why do these things happen? Because these aides and agencies can get away with it. That's why!

I have enrolled my older lady who lives with me in the pace program, I don't think we can pick our caregiver, anyone know?

Great post! you enumerated the most important factors in a good home health agency.

Thank you. Professionalism is also vitally important. Drama kills and if your Aide is prone to panic it can make everyone's life impossible. Calm composure is essential. You DO NOT want phone calls every week with the Aide upset and wanting to rush your loved one to the hospital for minor ailments.

Excellent points. Thank you.