I have not seen this issue addressed. Does anyone who works full time and cares for their parent after work have caregivers who are difficult for one reason or another? The first one I had was chosen by my family, but I did not know her at all. She gave my mother great care; everyone things that is all that matters. She added enormously to my stress ; she was controlling, in my business, going behind my back to numerous family members, often about things that had nothing to do with my mother . She told lies. She rolled her eyes and smart mouthed if I asked her to do things differently. I always bent over backwards to please her-giving her time off often, rushing home from work so she could leave. Ultimately, she lied about a few things and managed to turn my family against me; we were a very close family. It has been many months, but hard to get over. Since then, a parade of caregivers from irresponsible to sickly to downright lazy have come through. The caregiving is intense ( Mom is 102), my job is crazy, and the caregivers just add to the stress. I'm grateful to have them, but wish I didn't have to.
Yes, agencies are expensive especially if they are licensed, bonded, insured, and have workman's comps for their employees. And it can take awhile to find the right fit for the patient. Plus if a caregiver calls in sick or has transportation issues, the agency gets another person to fill in, even if it is one of the Staff who comes to help.
Dad complains about the cost, but that is what rainy days funds are for.
I don't think Medicaid pays around the clock in any of the States, except if one is in a long-term-care facility.
There's also a vast difference between ones who are mature and have more experience, those who have more experience with elders, and those who are much younger and primarily want the flexibility of working their own hours but don't have that much elder experience.
How are you getting these caregivers? Are they all through the same agency? If so, perhaps it's time to change agencies. I have the feeling though that they're not agency employed, as it doesn't seem as if someone who reports to an agency structure would be as callous as the ones you described.
The caregivers I have for my Dad are a nice variety of different personalities, different ages, and each brings to the table their special knack of doing things. Example, one day I walked into my parent's house and the Caregiver had rearranged the living room making it more user friendly, wow what a difference and much better for my Dad to use.... another Caregiver can open up the refrig and prepare a 3 course meal from the items she finds :)