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 home care companies and interviewing the companions or home health aides a company recommends will help ensure that the first day of services goes as smoothly as possible. Involving aging loved ones in the interview process (where appropriate) will give them early exposure to the company’s employees and a greater sense of control over and involvement in their own care.

Read: How to Select an In-Home Care Agency

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 five distinct stages: the introduction, the discussion, the tour, the care plan trial run and the follow-up. Each of these parts are explored in detail below.

5 Stages of the First Day of In-Home Care Services

  1. A Smooth Introduction

    If agency resources permit, chances are that the new caregiver will not show up on your doorstep solo. Ideally, new caregivers will 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, RN, owner of a Right at Home franchise in St. Louis, Missouri. “We don’t want someone showing up on your doorstep as a stranger.”
  2. Building Trust Through Conversation

    Once introductions have been made, everyone will sit down to review the elder 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 new home health aide, the senior and their family member(s) can get to know each other better. This first day is mainly about building a relationship between the companion or home health 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,” Madison explains. “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 become a professional caregiver. A quality home care company will have already taken many of these things into account when matching a family with a home health aide, but it’s important for the senior and new caregiver to form a genuine bond.
  3. 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 home. For example, tell them if there are any areas of the house that are off-limits or if there are sodas or snacks in the kitchen that they may help themselves to during their shifts.
  4. Putting the Care Plan to the Test

    After the tour ends, what happens next generally depends on the specific services detailed in the senior’s care plan. If companionship is the main goal, the new caregiver can socialize with the senior and learn about their daily routine throughout the 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 like assistance with activities of daily living (ADLs) is required, the first priority should be to ensure the physical well-being of the senior. For example, the new caregiver may confirm that the elder is dry and comfortable and that any durable medical equipment they rely on is working properly.
    Regardless of what is involved in the care plan, family caregivers are an asset on the first day. Many stick around for this initial shift (or at least part of it) to ensure things get off to a smooth start. Professional in-home caregivers have received the training they need for this job, but a family caregiver can provide valuable insight into their loved one’s unique needs, routines, habits and preferences. These things are often better demonstrated in person than conveyed in writing or over the phone. This is especially true for dementia caregivers whose loved ones may not be willing or able to participate in their own care or guide a new person through helping them. Once everyone has settled into a routine and gotten comfortable with each other and the care plan after a shift or two, you will be free to enjoy some time away from caregiving.
  5. Follow-Ups Are a Must

    After the first shift has ended, a manager or care coordinator from the home care 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 provide an honest evaluation of the services 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 addressed quickly. Madison encourages clients to take advantage of this opportunity to discuss concerns, even if the family’s only worry is that the home health aide used too much detergent in the washing machine.
    Seniors may worry about getting a new caregiver “in trouble” and hesitate to say anything negative about their aides, but family members should feel comfortable passing along any feedback. On the other hand, it is important to take some comments with a grain of salt, especially if a senior was against hiring in-home care services in the first place. Elders who refuse care have been known to try running off new caregivers or getting them fired by exaggerating or making up stories about their performance. Seniors with dementia may not have a realistic or accurate perception of how the first shift went either. You know your loved one best, so weigh their criticism accordingly.

In-Home Care Services Evolve With the Client’s Needs

It is vital for families to keep in mind that managing professional in-home care services is an ongoing process—much like being a family caregiver. 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 keep communication open and continue monitoring and modifying the arrangement when appropriate. These efforts will ensure your loved one gets the quality care they need and you get the invaluable respite care you need.


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