Hiring In-Home Care: What Happens On the First Day?


When hiring in-home care, it is important to understand that finding a good fit is a bit of a process. Researching and vetting prospective providers and interviewing the individual caregivers a company recommends for your family will help ensure that the first day of services goes as smoothly as possible.

But what actually happens on the first day of home care? How should you prepare to hand over the reins of your loved one's care to someone else? This pivotal day typically has four distinct stages: the introduction, discussion, tour and follow-up. Each of these parts are explored in detail below.

  1. A Smooth Introduction
    If agency resources permit, chances are that the caregiver will not show up on your doorstep solo. Caregivers may be accompanied by a representative that the family, and possibly the senior, has already met. This representative is usually a nurse or care coordinator who is responsible for managing clients’ schedules and services. Seeing a friendly face can ease tensions and pave the way for more honest, productive communication.
    “It's an easier first day if there's someone familiar introducing the caregiver to the senior and their family,” says Barbara Madison, R.N., B.S.N., owner of a Right at Home franchise in St. Louis, Missouri. “We don't want someone showing up on your doorstep as a stranger.”
  1. Building Trust through Discussion
    Once introductions have been made, everyone will sit down to review the care plan that has been created to meet the family’s needs. The nurse or care coordinator will ensure that you and your loved one understand all the ins and outs of the care plan, procedures for making changes to it, and who to contact at the office for assistance. This is the time to ask any questions you may have and voice any lingering concerns.
    After covering all of the formalities, the care coordinator will typically leave so that the aide, the senior and their family member can get to know each other. The first day is mainly about building a relationship between the aide and the elder they will be looking after. Finding common ground and building rapport should be a top priority.
    “Making someone feel comfortable is vital to having them accept care,” says Madison. “What we do is very personal, so there has to be the right connection between the senior and the caregiver.”
    Family, hobbies, likes and dislikes tend to be common topics of conversation on the first day as all parties learn more about one another. The aide will likely share a bit of background about themselves, their training, and why they decided to care for others professionally.
  1. Taking the Tour
    Next, the family member will conduct a tour of the house, showing the caregiver around and familiarizing them with the location of important rooms and items that are part of the care plan. During this process, let the caregiver know about any “rules” and preferences for the house. For example, tell them if there are any areas of the home that are off-limits, or if there are sodas or snacks in the kitchen that they may help themselves to during their shifts.
    After the tour ends, what happens next generally depends on the specific services detailed in the care plan. If companionship is the main goal, the caregiver can socialize with the senior and learn about their daily routine throughout their shift, lending a helping hand as necessary. “If the caregiver is there for a few hours to help out with tasks like laundry and housekeeping, they should put the senior at ease, and then begin seeing to these responsibilities,” Madison says.
    If more intensive personal care is required, the first priority should be to ensure the physical wellbeing of the senior. For example, they may confirm that the elder is dry and comfortable and that any medical equipment they rely on is working properly.
  1. Follow-Ups Are a Must
    After the first shift has ended, the company should call to check in with you. They’ll inquire about what went well, how the caregiver and the senior got along, and what changes might need to be made to improve future shifts.
    This is a crucial step in the process because it gives seniors and their family members a chance to make an honest evaluation and voice any additional concerns now that they have some experience under their belt. It is important to speak up so that any issues can be quickly addressed. Madison encourages clients to take advantage of this opportunity to discuss concerns, even if the family’s only worry is using too much soap when running the dishwasher.
    Seniors may worry about getting a caregiver “in trouble” and hesitate to say anything negative about their aides. However, it is important for family members to feel comfortable passing along any feedback. On the other hand, it is important to take some feedback with a grain of salt, especially if a senior was against hiring in-home services in the first place. You know your loved one best, so weigh their criticism accordingly.

Take It Day by Day

It is vital for family members to keep in mind that managing professional in-home care is an ongoing process. The day a new caregiver starts is about accomplishing two main goals: executing the initial care plan and establishing a good relationship.

Beyond that, it is up to you and the home care company to continue monitoring and modifying the arrangement as needed to ensure your loved one is getting the quality care they need.

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Sorry but it has not been my experience to have the "nurse" or assessment person show up with a new aide. Some of the aides they have sent look like destitute persons. And aide behaviors are less than stellar. Maybe I am too picky but I have not been pleased. Maybe we are too far from a major city to warrant good quality.
It's a good article, worthwhile - but many agencies are filling many care slots, so they use multiple caregivers, and a different caregiver may show up the next time.
The most important thing is make sure the caregiver knows about the sick person's condition and any movements or position changes that will cause pain or discomfort to the sick. My husband's cancer had gone into the spine and created a compression fracture causing him pain in certain positions. Well, the caregiver did not ask, and before I could say a thing was in there propping pillows behind him and disturbing his comfort zone. I immediately removed them and told her the situation, but it was an unfortunate intrusion into his relaxation. I made sure to monitor constantly. I would create a sign of all condition issues, medications, dosages and times due, emergency numbers, and hang it next to the bed/chair where people, anyone, can see. It is a helpful reminder.