Mom on Medicaid now. Spent all her own money to pay for caregivers to come into the home and help me out. Now this new agency gives me a difficult time when I want my extra time off. I'm allowed 4 extra hours per week and they aren't always on the same day or night and that seems to cause a problem for them. I don't know what else to do. I'm at my wits end. any suggestions?

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Can you try another agency? How much notice do you give them? How skilled does the aide have to be b/c I would be concerned with leaving mom home with a total stranger w/o having time to make sure they can do the job and you have time to orient them to your mom's house and needs situation. And if your mom is alert, it might be upsetting to her also to have a bunch of strangers showing up whenever you leave. As mentioned, you can't expect someone to be on call for you, but maybe with advanced notice the agency can have a pool of regulars with some flexibility. I guess it also depends on where you live b/c there are places where aides desparately need jobs and are willing to take on jobs at the last minute. However an agency should also have backups for emergencies for other clients when the regular aide doesn't show up, so it might help to speak to the agency supervisor, explain your problems and then if they can't help then can you get a list of other agencies that provide medicaid services and talk to them in advance about your problem and whether or not they can accomodate you. You could also try to find someone yourself that is flexible (i'm thinking an older aide if you just need companion/sitter services and there are not specific skills or physical demands ) and then have them register with your medicaid agency provider. the agency shouldn't object since they will keep the client this way.

Otherwise, unless this is a job, school or medical flexibility need and a leisure need for time off, can you adjust your schedule or explain to whoever you are joining that you need advance notice to try to set things up so you can attend/join?

This is a tough one. As you can imagine, an agency has a number of workers at various skill levels. They want to keep these folks employed as much as possible, and, of course, the workers want to work as close to the number of hours they signed up for as possible. So agencies typically don't have a lot of people sitting around idle who can be sent out on an irregular schedule. They might be able to schedule someone for four hours every Tuesday evening, but having someone available this Tuesday evening and next Monday morning and the Wednesday afternoon after that can get to be a real challenge. A very large agency might have enough people "between assignments" at any given time to find someone with the right skill level when you need that, but most medium or smaller agencies just have a very tough time with that.

You would face the same thing if you did your own hiring. Unless you could find someone who only wanted to work four hours a week and didn't care when they were, you'd ask your helper, "Can you come next Monday evening?" and she'd say "No, all my evenings are for my own family. I have three kids and they are always doing something." And the next week you'd ask "Can you come the same time next week but on Thursday instead?" and she'd say, "I'm sorry but I work for the Johnson's every Thursday and Friday." In other words, few people have totally open schedules so that they can rearrange your care slot week-by-week.

I think that you might have to take your four hours on a regular schedule. Sorry.

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