Once you have selected a reputable home care company, chosen a professional caregiver and begun services, it is important to evaluate this new addition to your loved one’s care team. The home care company should have procedures in place for making a good caregiver match, facilitating introductions and ensuring the start of services goes smoothly.

As the process continues, you should take an active role in determining if the professional caregiver you hired is meeting your loved one’s needs and your own expectations.

Questions to Evaluate a Caregivers Performance

As part of monitoring ongoing care, use this checklist to conduct a caregiver performance evaluation.  Consider the questions below while on a drop-in visit during one of the caregiver’s shifts, and keep them in mind when conversing with your loved one about their care.

The in-home care company should have its own protocols for conducting caregiver performance reviews and gauging client satisfaction, but running through your own checklist will keep any compliments and concerns organized and at the forefront of your mind. This will make it easier for you to communicate with the company’s case manager, care coordinator or head of staffing during formal care plan reviews.

  1. Is the care plan being followed?

    There should always be an official care plan in place before the professional caregiver walks in the door on the first day. Any deviations from this plan, unless they were previously discussed and approved by you or a supervisor, should not be tolerated. Such deviations should be noted in your loved one’s file.
  2. Does your loved one appear safe and well-adjusted?

    Oftentimes, a senior's safety is the primary concern for introducing in-home care. Look for signs of a safer home environment such as improved compliance with a medication schedule, improved nutrition and a less cluttered home environment. An adjustment period, and some initial trust issues may lead to withdrawal or reluctance to talk about time spent with a caregiver. However, an aides contribution to an improved home environment should be visible even if a senior is only semi-compliant. Unless there are actual signs of mistreatment, abuse or safety issues (bruises, cuts, etc.), it can be tricky to gauge whether a senior is adjusting well to the addition of in-home care.
  3. Has your loved one's quality of life improved?

    The goal of in-home care is to elevate an elder's comfort, happiness and health in their own home. Look for signs that they are thriving and enjoying (or at least benefitting in some way from) the professional caregiver’s assistance and company. Even small positive changes in mood, energy and appearance are good indicators that a caregiver is doing an excellent job enriching a senior’s day-to-day life.
  4. Has your loved one expressed any concerns to you?

    If an elder is of sound mind and they voice a concern, discuss the issue with the company’s office instead of addressing the caregiver directly. This helps avoid conflict and makes the correction process smoother for everyone involved. Bear in mind that if an elder suffers from a condition that impairs their cognitive abilities (e.g., Alzheimer's disease or other types of dementia), they may be prone to making false accusations. In these situations, it is important to remember to take your loved one's complaints seriously but allow for the possibility that their condition may be impacting their ability to accurately assess the situation.
  5. Does the caregiver communicate well with you and your loved one?

    Verbal communication is essential to maintaining an effective relationship with a professional caregiver and the company they work for. It is important for everyone involved in executing the care plan (family members, medical professionals, care managers and the senior themselves) to be open and honest.
  6. Does the caregiver seem invested in your loved one’s well-being?

    Are they attentive to your loved one's needs? Do they maintain a calm, concerned demeanor when dealing with difficult behaviors or requests? Are they compassionate while providing care?
  7. Is the caregiver reliable?

    Do they show up on time and ready to work? Do they frequently have others cover their shifts? You should be able to expect a reasonable amount of consistency from professional caregivers. Excessive caregiver turnover can be stressful for a senior and for you.
  8. Does the home care company conduct their own quality checks?

    Most reputable home care companies will arrange for supervisors to make both announced and unannounced home visits on a regular basis to observe their employees in action. These assessments ensure that caregivers are following established care plans and other company policies. Visits from care coordinators also provide an opportunity for the care plan to be discussed and updated if needed.

How to Address Home Care Issues

While it is important to make sure your loved one is getting the care they need, it's equally important to avoid prematurely requesting a new caregiver or discontinuing services completely. If the hiring process was a hurried reaction to a crisis, the initial caregiver may not be the best fit. That does not mean that the whole idea is a bust. Collaborate with your chosen home care company to address any concerns you have and iron out the kinks.

You, your loved one and your professional caregiver are all adjusting to a new relationship. It can take some time to go through a warming up period before everyone becomes comfortable and gets into a groove. Ultimately, though, it is important to trust your gut when it comes to evaluating in-home care providers. Nobody knows your loved one like you do. If the answer is to request a different professional caregiver or switch to another home care company, make sure to screen the new candidates thoroughly to prevent any repeat problems.

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