Home care agencies' minimum hours.

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I've been contacting home care agencies and find that the minimum number of hours an employee must be able to work for a client varies. One service stated that its employees have a minimum of 3 hours for each visit. Another stated their minimum is 20 hours per week.


It seems these mandatory hours vary widely, and understandably, are set by the agency, not the caregiver (based on caregiver's needs).


Something like a minimum of 20 hours a week puts their employees out of reach financially and workwise. We couldn't even have a cleaning service that worked 20 hours a week unless they scrubbed the house from top to bottom every week.


I do understand that some individuals may need a higher level of care, so the 20 hours might work for some.


I'm wondering though what others who have hired agency caregivers have found to be the minimum ranges the agency requires their employees to work for a caregiver.

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FF, so you both had interviews before signing any contracts? I like that!

Was automatic deduction from a bank account mandatory, or did they accept credit card payments? I've had problems with automatic deductions; with one merchant and card issuer, the merchant refused to stop the deductions after I cancelled the service. The card issuer refused to do anything and charged interest for a few months while I battled both the merchant and the card issuer. I said never again.

I haven't heard from any of the agencies I've called so far that they plan to accompany the rep on the first visit. That's not only a nice touch, but an example in my mind of how much the agency wants to provide support to accomplish a smooth entry and introduction for the hired caregiver and the family.

Sounds as if there was kind of a "shakedown" period as you determine which caregivers were a good match. Once you made the decisions on who you wanted, was the agency able to commit to having them available for you when you needed them? Did you then work out a schedule?

I understand the shower issue. I would actually feel the same way; bathing with a stranger present would not be something I could accept easily unless the person was a medical staffer.

Thanks for the explanations. I need to check my notes, but I think I did call the agency you use sometime ago, before the latest hospital visit and following rehab. I have more information and more questions to ask now.
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GardenArtist, more on the Agency that I use.... when I first called them, they set up an at-home appointment, thus I was "interviewing" them while they were "interviewing" me. The rep took extensive notes with a lot of good questions about my parents, such as their likes and dislikes, medical needs, medicine requirement, etc. Then the rep had me take her on the tour of the house.

It wasn't until after the "interview" that the paperwork was presented. Lot of paperwork, like everything was covered. Payment was via automatic bank withdrawal so one has to make sure there is enough in the checking account.

When the first caregiver came to the house, the Rep came with him and introduced him to me. and to my parents. He was there for a couple of hours, then another caregiver came in, again the Rep came to the house to introduced her to me. Everyone wears a name tag with the name of the Agency.

As I mentioned above my late Mom threw out the caregivers after 3 days due to the fact my Mom didn't want other women in the house or in her kitchen cooking a meal for her husband. Oh dear. A week later Mom had a medical emergency and she spent her remaining days in long-term-care. Thus, my Dad needed help as that man cannot make himself a sandwich, I remember him calling me at 8pm saying he was hungry. Oops. So I called the Agency and they sent over a variety of different people.

Dad had some really good caregivers, and some who pretty much just sat around. Eventually we choose several good matches for Dad... each with their own personality and expertise around the house. Couple earlier caregivers were guys which Dad enjoyed conversing with but Dad felt strange having them help him with a shower. He was also shy around the women caregivers... one caregiver put her hands on her hips and said "Mr. Bob, I raised a houseful of boys, there isn't anything I haven't seen", thus she was able to get Dad into the shower :)
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Thanks to each of you for your responses.

Tacy, I believe you're somewhat west of me in an area that's less congested than SE Michigan. Fortunately or unfortunately, there are a lot of agencies in my area, and they seem to be very competitive.

When I go to the AAA Caregiver Expos in October, I can always expect about a dozen caregiving companies to be represented (and providing free candy or free drink bottles as a temptation for people to stop and get information).

So far I've found that the agencies have both methods of calculation, hourly or minimum by week, but not the flexibility of the agency FF has. And they can be very persistent in trying to catch a new client!

FF, your agency seems to be more sophisticated in terms of pricing, which I think is good because each situation can be different. From what you've written, you really lucked out with a very good agency. That kind of flexibility is something I'm seeking as well.

The cancellation requirement is a bit inflexible, as sometimes things change overnight, especially if someone becomes ill and needs an ER visit. But if there were medical home carers, I would expect them to help identify those situations ASAP to avoid emergencies.

Windy, that price range is similar to agencies in this area (thus far - I still have more to contact). You raised a good point - that transit time is included. I'll have to verify that when I begin contacting agencies again. No mention has been mentioned thus far by the agencies' reps with whom I've spoken of transit time being or not being included, or of direct transportation reimbursement.

Madge, your experience is different as well. Sounds like you've quite a bit of experience in this field. We just don't have the need for a 4 hour shift and certainly can't use or afford someone for 20 hours a week, so that's an easy option to eliminate for the agencies with those kinds of requirements.

The needs are just not there to justify that and we'd be scratching our heads to find things to do.

The personality fit is of course a major concern, which is why I find it annoying that the agencies I've contacted thus far will not allow "meet and greets" until after the contract is signed. So I'll ask them to provide contracts first, and compare them to see which have the better, less onerous contracts. I don't intend to commit to anything until I've met the potential caregiver and I don't intend to be manipulated into signing a contract that is only a contingent one, dependent on finding a suitable match.

Jeanne, thanks for the sympathy. Actually, it's not as bad as it seems. Most of the post-rehab issues are close to resolution, so that shifts the mix of the care I'll need. And that shift is leaning more toward just housekeeping rather than a care agency, so that also shifts the choice to a commercial cleaning service.

Things change almost daily, for the good, so I'm thankful for that.

You've addressed the crux of the issue - the time should be in accordance with the needs, and as I wrote, the medical/semi-medical needs have drastically dropped in the last few days. At this point they wouldn't even exceed 1/2 hour daily.

I do understand the pros and cons, especially for the staff. Those are not jobs I would or could handle. I'm more sympathetic to the staff than the agency. I worked with temp agencies for legal placements and know that they'll put a warm body in literally any situation as long as they get paid for it.

Once an agency I eventually dropped sent me to a temp position at a law firm which didn't have a desk for me. The typewriter was on a stand, the chair was an overturned wastebasket. And it was an uncomfortable wastebasket.

I refused to go back to that dump, and of course that was considered being uncooperative by the agency.

At another job, the firm was too cheap to upgrade its computer network and get the capacity needed. When the attorneys came in from court and both attorneys and staff were on the system (DOS based, BTW), it was only a matter of time before the whole system crashed - generally every day about 4 pm as people were rushing to get work done. And of course the staff was blamed because the work didn't get out.

Temp work sucks; and I'm guessing that the care workers who are on the go regularly have to face a lot of challenges as well. But most of them have also said that they want the freedom, don't want to work in a hospital or medical office, so they seem to be comfortable with their arrangements.

Thanks again for the insight from each of you; I'm reworking my checklist and will start calling again after the weekend's over.
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Ah, GA, I'm so sorry you are dealing with all this now.

The number of hours you hire help for should depend on the needs of the loved one. And it can, as long as that is at least the minimum for a given agency. They are businesses. If they can get enough business in chunks that make economic sense, why should they take on the nickle-and-dime business? More record-keeping, more transportation costs,more time spent scheduling, more difficulties getting and retaining employees who need full-time work, etc.

I do understand the business point of view. As you've discovered, the client needs to compare various aspects of each agency and find the best match.

Another option in some situations is Adult Health Day Programs. You can sign your loved one up for one day a week or possibly even an afternoon.

When I had a local program send a volunteer once a week so I could meet friends for lunch or get my hair cut, etc., she came for 2 hours. But she was a volunteer and was not trying to make a living doing this.

When my husband needed in-home help (after he could no longer handle the day program) it was for 32 hours a week, and I never inquired about the minimum.

I hope you can arrange the care your lo needs!
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Most agencies have a 20 hour week min and min 4 hour shift
Remember agency fees cover workers comp and social security and profit so the caregivers often work multiple clients and travel distances to get to jobs and often only make $10-$12 an hour - not much more than fast food workers

Some agencies require a 2-week deposit and have strict cancellation rules

The agency I use is flexible on cancellations and despite my mother throwing several out of the house continued to work with me - admittedly not everyone they sent I was comfortable with and I tell them so without any questions asked

No one will meet all your needs so it is important to find a personality fit otherwise nothing else matters - also if you're looking for someone to cook clean and take care of changing your mom's diaper you will be disappointed - expect to hire a bi-weekly housekeeper for regular cleaning and don't expect home cooking needs you make it and they're merely re-heating
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The folks I contacted have a 3 hour minimum for all their services, home care, transportation, skilled nursing etc. Their rates are 18 to 22 bucks per hour depending on the service.
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I have used only one Agency but there are rate changes within a time range. Such as if I want only 2 hours per day, the hourly rate would go up considerably, thus it is cheaper to schedule 3 hours instead of 2 hours.

Weekends are now more per hour as it is difficult to find people to work weekends. The over-night shift I was surprised there was no extra cost, but the employee needs to stay awake during the whole shift.

If there is an emergency need of care, such as an extra shift is needed because the client came home from the hospital, then there is an extra cost as it is difficult to find caregivers the last minute.

Any change in schedule, one needed to give 7 days notice, but now it is only 3 day notice. One time my late Mom threw out the caregivers after 3 days, so I told Dad that he and Mom would need to pay for 7 days if no caregiver was here. Thank goodness the Agency didn't charge them for that.... guess the Agency figured they would be back eventually... and they were.

Then there are different rates depending on how much work is involved. My Dad has "companion" care, thus the caregiver keeps an eye on Dad, does light housekeeping, gets him breakfast and lunch, gave him a shower... and takes him to doctor appointments. Mileage is tacked on by the agency.
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Most home care agencies I have dealt with do not have a minimum amount of hours per week but a minimum number per shift. It also depends on your location and if there are other clients in the area.
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