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I hired an agency 4 years ago to send caregivers to prepare meals, do laundry, and make sure mom and dad get their medications. Mom and dad both have dementia and other health issues and are unable to do these things for themselves.


Little did I know when I first hired home care, that the agency doesn't guarantee to send someone. Of course, they don't charge for that shift if they don't send someone, but that doesn't help my parents or me. I have missed countless hours of work and other responsibilties and plans due to caregiver "no shows." Yet again this morning, no one showed. These "no shows" are no show and no phone call to tell me no one is coming. If I didn't check up on them, I wouldn't even know that no one was taking care of my parents.


I'd fire the agency if it wasn't for 2 of the caregivers who are very dependable and good with my parents. The one works 5 to 7 shifts a week. I called the agency with today's no show and recommended they give some of their "office cut" to the dependable caregivers, because they are the only reason I stay with that agency. (I know that won't happen!)


I feel like I'm in a no-win situation. If I fire them, I'm taking good caregivers away from mom and dad. I'm also taking jobs away from loyal dedicated workers. Plus, I'm left with finding a new agency, who will most likely do the same thing. Or, I'm left with finding assisted living and placing mom and dad. Or, I can keep going as is, with empty threats of firing the agency, and keep missing work, etc.


Have others had similar experiences with home care? How do you handle it?

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Or, you could look for another agency, compare notes on customer satisfaction with other services users locally, and then fire the current agency. You could even - I can't see any immediate problem with this? - give the dependable caregivers a heads-up about which agency you are taking your parents' business to.

I don't suppose it will ever solve the problem 100% but it's better than driving yourself slowly round the bend!

PS Our service missed a morning call yesterday. A computer mouse slip turned a client from purple (no call) to yellow (pending confirmation) instead of from purple to white (live) on our round spreadsheet. The only reason I suspected an error was that I'd been told the day before that this client was out at an appointment and I couldn't see how she'd be pending anything, so I queried it; but my co-worker on the morning round couldn't possibly have known that - she just didn't go, following her instructions correctly.

I've often told clients that although sadly we are often late, being rather too thin on the ground, we NEVER just don't turn up. I will now have to amend that to *almost* never just don't turn up. Fortunately the client was fine this time.
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Do you know for a fact that the 2 good workers aren't aware of the no shows?  Or that the 2 good workers plan to stay with this particular agency?

I'm sure the agency's contract is so tight that you'd have to pay a penalty to hire the good workers directly, and that would also create other issues to deal with such as your being an employer.  

Countrymouse always gives insightful advice from experience.    I would also consider another agency, and/or ask the good workers if they have any suggestions on the problems you're having with the agency, and what appears to be a lack of consideration for you as a client.   You might even find out that the good workers aren't satisfied and are looking for employment elsewhere.  

Just be circumspect in your actions.
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SwampOphelia, with the covid-19 virus, I wouldn't be surprised that a lot of the agencies are now short handed.

You can keep using the current agency for the two caregivers who are excellent with your parents.... and call another agency to see if you can get a caregiver for another shift. It's worth a try.
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EllensOnly Dec 2020
This would be my suggestion also or ask that the two aides that are working well be assigned all shifts with Mom & Dad.
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My coworker had this issues constantly years before Covid. The agency doesn't care when you complain. They know you need them more than they need you. You might have better luck with a person not connected to an agency. I hired a woman for a one a week visit with my father for 3 hours (she'd help him with his laundry or run him on errands) and she was very reliable.
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I never had a ‘no show’ from caregivers to mom.

I had occasional help from Council on Aging. They had a contract with a local agency.

I was very happy with the majority of aides that were sent out.

There was only a couple that weren’t a good fit for my mom.

When I discussed one of them with the agency they said they had already dismissed her because they had too many complaints about her playing on her phone on watching television.

The other one wanted to switch to morning hours when I had asked for afternoon hours, so that didn’t work out for either of us.

I never complained if they showed up a bit later than they were expected because I felt like it would be hard to pinpoint an exact time. The aides were polite and called my cell if they we’re running behind.

My mom would get nervous that they weren’t showing up and I would have to tell her that they were running a bit late. I never ran my errands until they arrived. My mom was a nervous Nellie.

I would switch to a new agency if someone wasn’t showing up on a regular basis.

Try another agency. You may like them a whole lot better.
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We have had similar problem with my parents care agency. It is simply unsafe for my dad to be alone. Although mom is there she is not 100% and she certainly could not get dad off the floor which happens a couple times a month. Agency manager has come in the past to cover call off staff. We have a stable team for the most part. I did cover one day when the housekeeper did not come due to her covid positive spouse. Housekeeper stays away. I called the agency and to my surprise got a hold of caregiver to cover for housekeeper call off-I was shocked really. I did go to cover for a couple hours till caregiver turns up. But my parents ended up being covid positive. I had to quarantine as a result. My parents refuse to go to facility so this will continue to be an issue-but agency is being helpful so far. Mom has fired the housekeeper (for the moment) due to lady gave them covid. Kind of a blessing due to the team will be more consistent without having to work around housekeeper schedule.
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I've had experience for over 5 years with one agency in our area in MD. I found a flier advertising their services in a waiting room in a hospital. I researched the service through the internet, and saw positive reviews. When I needed to set up home care for my relative shortly after that, I contacted them and was able to have caregivers start the next day! They send out a nurse and a staff person to assess the patient's and family's needs, as well as evaluating the home for safety. Then, working with me, a care plan is put in writing and reviewed with me.

I have now worked with this agency and several caregivers for over 5 years. It's been a good situation for all of us. For almost 2 1/2 years, I had 24/7 care for a close family member (I was POA). It was very expensive, but was partially offset by long term insurance that my family member had the foresight to purchase. She also wanted to stay in her family home until death, and passed peacefully with several of us there with her. We also had hospice care at home for her for most of that time. The caregivers, hospice team and I worked together really well.

Now, I have a caregiver from the same service working with my mom at her home. She does not have the same financial benefits as her sibling had, so we have coordinated a routine between the caregiver and family members to meet her needs. She has other health issues including Alzheimers, mobility issues and her age, 93.

As far as not having a caregiver show up or not accurately reporting their hours, it has happened a few times. That is a liability problem for both the care provider service and our family.
I didn't see the liability side of this until recently. It was resolved by having a different caregiver from the same service.
I have recommended this service to anyone looking for care for family members. I think this may be a franchised service ("Help at Home Services"), but very professionally run. They are responsive and often suggest ways to help handle coverage more effectively.

I know that many people have challengers with health care aides, so I do recommended going through a health care service. They handle payroll, taxes, scheduling, screening of health care aides and much more. Most of the caregivers that we have had are from other countries, but this has not been a problem, rather an opportunity for cultural interaction in a positive way.

This is the only way I will get caregivers. I hope you may have similar positive experiences. Blessings to all!
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We had the same situation with caregivers for our father in law. His Assisted Living facility required that we hire 24/7 caregivers in order for him to stay there, since he kept falling (a big problem for AL facilities.) And he left his stove on. And developed severe complications of his heart disease and diabetes that required more skilled nursing care than AL was responsible for giving. He really needed a nursing home, but put up a fit when we tried to move him to a very, very nice facility where he would have a large private suite and round the clock care.

So we had to hire 24/7 caregivers to stay with him in the AL unit. Which doubled the cost, but he had the money to pay for it, so that was not an issue.
Caregivers who left the him alone when we thought they were there. Or didn't show up. Or took money. Or took a credit card and went shopping in Chicago. This was a "recommended" agency by the Assisted Living organization where he lived.

I'd try another agency. That's really all you can do other than put up with the current situation.
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It is a no-win situation when there's agency caregivers. Caregivers call out sick from work or need a day off just like everyone else working a job. It's the agency's responsibility to send a fill-in to cover for a worker if they're going to be out. That's why they collect the big bucks and the caregiver gets minimum wage or just above. It's definitely a no-win situation for you. It's very hard to find a per diem caregiver to be back up to fill in if one of your regulars is out. Aide pay isn't high enough for a person to make themselves available like that for the possibility of having to take over a client at a moment's notice. I'd recommend you advertise for a private per diem caregiver who can cover the shift hours of your regulars if you need them to. I've done per diem work. How it works is that they go into agreement with you that they will leave certain hours free and will be available to you. Those hours can be the time the regular workers come in or the time you'd prefer. It will cost you though. The going rate for this is normally three times what the agency worker gets per hour. So if your regulars are getting $15 an hour, then assume $45 an hour for your per diem aide to come in. If you hire one privately, they can be depended on.
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We had horrible, horrible problems with an agency. Sometimes my mom was even left alone, and she is totally immobile. They didn't even bother to call my brother or I!! We had no choice but to fire them and hire individuals. That was long before COVID19.
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It’s a shame that the pay is so low. It’s a tough job and caregivers make a very low salary.

It’s not an excuse for poor work. Low wages certainly don’t motivate anyone to do their best work.
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LoveLea Dec 2020
Same problem here. However, I pay a few dollars extra to compensate for their low hourly rate. That ensures I keep the good ones.

But I don’t tolerate the lateness or no-shows. They’re fired instantly.
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It is common in the industry. That's why I got out of the business. Couldn't stand not delivering 100% to clients.
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Talk with your favorite caregivers. Maybe they would consider having contracts with you outside of their agencies - and you could pay them more. Then, find another agency to fill in the gaps.
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KHolzmann Dec 2020
Be careful with this. They may have signed paperwork saying they will not solicit caregiving services from the agency's staff. CGs may also have a non-compete clause in their contract and could get in a lot of trouble if their agencies find out they are working behind the scenes for clients.
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Talk with the agency to find out how no shows are supposed to be handled by their agency. I would say, the one on duty cannot leave until the scheduled or replacement arrives. You are paying for 24 hour care and an agency should be providing that care. The employee on duty should never be leaving when replacement has not arrived - should be the one making a phone call to agency to advise replacement is not there yet. If current agency doesn't do this, start calling around and ask how they handle this situation.

It is also possible that you could hire private caretakers and put this requirement in the hiring contract. No one leaves until replacement arrives. It seems to me that it should be illegal for an agency to allow a patient to be left alone when they are being paid to provide that service. I mean, if they neighbors saw that you were leaving mom/dad alone all day, you'd probably end up in jail for neglect or abuse.
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KHolzmann Dec 2020
depending on the state, caregivers and their agencies are mandatory reporters and we do report caregivers for abandonment of a vulnerable adult when needed.
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Please speak to your agency to know their policy on no-call/no-shows. In my state, we are directed to report caregivers for no-call-no shows for abandonment of a vulnerable adult.

I will say that staffing is a major headache for agencies right now. Caregivers are not the most reliable workforce. I do work as a care coordinator and no-call-no-shows are the bane of my existence. Numerous times this year they have resulted in working *a lot* of overtime or even caregiving myself if we cannot get replacements.

Paying better wages could help, but do know this means the cost of your care is going to increase. I've already seen clients balk at the slight rate increases we've done out of necessity this year.
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Imho, yes, I had a similar situation. Before I left my state and moved in with my late elderly mother 7 states away, my mother had hired a cleaning girl through her town's Council on Aging. As it turned out, this "cleaning girl" caused numerous problems, e.g. left clothes in my mother's dryer for a week, almost caused a fire in the dryer because she was leaving dryer sheets that built up on the air vent, clogged up my mother's vacuum cleaner because she was not emptying it and was cheating on hours worked - what she submitted to her boss for payment was 4 hours shy of her actual hours (actually 40 minutes) at my mother's home. Once I arrived at my mother's to be her caregiver, the supervisor of the cleaning girl came to my mother's house. I informed her of all of her staffer's faulty work, including her pay that never should have been given to her. This supervisor was appalled and the cleaning girl was to never return. My mother would have never said anything as long as the cleaning girl socialized.
So yes, it can happen. Good luck to you.
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NeedHelpWithMom Dec 2020
Llama,

My mom was so accustomed to me waiting on her and anyone else that was in my home that she expected me to wait on the caregiver from Council on Aging! She wanted me to serve her lunch, make her coffee, etc.

I wanted her to feel welcome so I always had enough food for the caregiver to eat a meal with mom.

I kept drinks and snacks for her too. She was welcome to make coffee in my Keurig too.

I had to explain what respite care was. I had to tell my mom that the caregiver wasn’t just for her but was also to give ME a break!

From then on, I left the house when the caregiver came. So I could get a break!
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There were so many things the agency wouldn't guarantee, that we opted out.
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Been there. Had people we loved but never had a single person who showed up on time consistently. Missed a lot of doctor appointments.
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That is a company problem. If they do not handle it...get another company. They may not have a "caregiver mentality" and are just doing "chores" that need to be done. Those people are just looking for a job or acting out of their mind what they did not do in the past to satisfy their needs. They need money. Then they decide it is not important cause they have other needs that take them away from the job they were hired for.
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