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Hi, all,
I have written before about my issues with Home Instead. The helpers are great, but it is a revolving door of helpers, often because they never want to pay overtime, so the helpers can't work with my mom as often as they would like. Does anyone have personal experience with a home care agency - no medical care needed? I know these places are franchises, so experiences may vary. I am just desperately looking for input as I don't think I can ride the Home Instead merry go round much longer. Thanks!

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TornadoJan, one thing I discovered with both home health care and private duty care is that some agencies will NOT schedule the same workers, or schedule ahead of time. They schedule the night before, depending on who's available.

dev123, one agency would have charged $75/hour for a nurse and another would charge $85/hour. That's about what contract nurses get, and they have to be well qualified.

I suspect the workers are independent contractors. Perhaps this is for financial reasons so the agency doesn't have to pay benefits for its workers.

I've also discovered there's a wide variation in the competence and professionalism. I had two top notch nurses, but the physical therapist was mediocre.
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I'm going to be a real b**ch here. I went through so many agencies and accrued over $100,000 in debt. The agencies where I am are NOT covered by insurance or medicare. There are tons of them. Making a mint off of people. Most of the "nurses" and "aides" are third world and I found I had to teach them many things. Including speaking very slow and wishing I knew their language. The agencies charge beaucoup bucks but the employees get only $9 bucks out of $25. Am not sure how much the nurses get but the agencies charge $50 an hour. I finally went off the grid after nightmare experiences and finding a few people who could take care of my Mom and understand her.

When I have time, they need to be investigated and I intend to pursue this. Even a friend of mine who lives in a small town hired Visiting Angels for his Mom and all she did was talk about herself constantly. I'm in a big city and everyone, and I do mean everyone tells me the same thing. Luckily I had experience as a care giver and can go most things but I needed someone to help me lift. Do I think they care about the patients? Not really. Perhaps a few do. Most of them are from other cultures and it's easy money. Personally I still get up at 5 a.m. even tho my Mom has passed to make sure an aide is awake and not on her/his phone or sleeping. PTST.So you need to vet them very well and I truly suggest going off the grid. They actually make more money as the Agencies not only screw the customer but also the employee. It may be a question of illegal hiring where i am. I am not alone in this very daunting experience.
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Thanks for the responses. I manage to squeeze out a monthly schedule template from HI. By the end of the month it is usually bleeding ink from all the changes. I literally think they go day to day with the scheduling. I will be away for 5 days next week. I give them plenty of notice but I don't think it even matters because I don't think they bother scheduling the extra shifts until a couple days before. Yes, they have the 3-ring binder. When a new person comes sometimes it doesn't even seem they have been introduced to the binder so I am actually showing them the sections. I just think they wish I would go away so they could continue the mayhem unimpeded. I feel sorry for the clients whose relatives are out of state and don't know what really goes on. As someone earlier said, they all talk a good game, but the reality is totally different.
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My Dad's two favorite caregivers were in their late 40's and early 50's, both had lost a parent or two to dementia, so they had personal hands-on training in the field. One was a certified nursing assistant so she could fill Dad's pill box and reorder pills from the pharmacy.

One evening caregiver had a strong feeling that my Dad should go visit Mom who was in long-term-care. Dad didn't want to because he already saw my Mom at lunch time [his caregiver would help feed Mom], he was tired. But she insisted and nagged him until he finally said yes. I don't know how that caregiver knew, but would be last visit to see Mom as Mom passed the next morning in the wee early hours. Dad was forever grateful that she convinced him to visit.

Dad's daily caregivers would eves-drop on telephone calls that Dad got. If it sounded like Dad was talking to a telemarketer, the caregiver would ask Dad for the phone to see what was this all about. Whenever the doorbell rang, they were very protective as to who was at the door. Both would also check the wastebaskets and recycling for unpaid bills as one noticed that Dad was throwing out unopened bills. Eventually those bills got transferred to my address.

There are a lot of good Agencies out there, it's just trying to find the one that works best for your situation.
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FF offers good insight into the level of training, or lack thereof. Newly graduated students or college students w/o training wouldn't make me comfortable, especially if they're not interested in a health care career and have no idea how to recognize emergencies or potential emergencies.

I think it takes a certain level of confidence to successfully work with and handle elders, especially those with dementia.

One agency with which I've been negotiating has minimal in-house training standards as well as 2 years of related experience. It's also the most expensive on an hourly basis.
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Tonadojan, can you ask for the printed out schedule for the week, that way you would have shift and who is covering that shift. It took a while for Home Instead to start that, but once they did it was great. It also gave Dad an idea who was taking the next shift, that is if he remembered what day it was. I put up the list on Dad's refrigerator, and I had one on my refrigerator.

I know it isn't always easy to get the same person each day, I just happened to be in the right place at the right time. As mentioned before, the 2nd shift the Agency couldn't get someone on a regular schedule. Dad sometimes got caregivers just out of high school, someone who was going to college, so this was a way to earn some extra money and to have time to study. Not much conversation going on, as the age difference was too great as my Dad was in his 90's, had a busy day with his first shift caregiver, thus was tired after dinner, so he would doze off in his recliner.

The Home Instead that I used, there was a company 3 ring binder that the caregivers would leave notes on what they did during their shift. Thus it kept the bedding from being washed twice in the same day, or other duplication on chores.
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Thanks for the input. I totally get that most caregivers aren't in it for the long haul and that they are always vacays, family emergencies, calling off sick. I am talking about literally an entire weekly day or night shift imploding. I am talking about me always having to call to find out who's going to be with my mom when there is a substitution, and sometimes not even knowing about a substitution until I call over. I need to know who's there for 2 reasons: (1) so if my mom references a different name I know she's not hallucinating and (2) if there is ever a security issue with something going missing I need to know who was there. I don't think this is too much to ask. It's like no one in the office knows what anyone else is doing. All I get is "I'm sorry." Trust me I am very hands on - I feel like I'm a HI employee!! The helpers appreciate the notes I leave about my mom - they say they go into some homes where they know nothing. The last two months especially have been like a revolving door. They claim they can care for my mom till "the end." I wonder. Certainly with all the people in and out, how does that help create consistency for an ALZ person? I am jealous of your HI experience, freqflier. I should be so lucky to have anywhere near that level of caregiver consistency.
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tornadojan, you might want to check for any new laws in your State regarding caregiver hours and overtime pay. There could be a law where a caregiver cannot work past his/her eight hours. Caregiving is tough work, and over eight hours the caregiver would crash and burn. Wouldn't be surprised if some Agencies would exploit their caregivers by forcing them to work extra hours.

I had excellent luck with Home Instead. They were a godsend for me. My Dad needed around the clock care. Thus, 3 shifts, 8 hours each. Dad picked out the caregivers he liked best and I asked the Agency if it was possible to schedule those two on a regular schedule [7a to 3p one person weekdays, the other weekends]. Bravo, Dad had these two wonderful caregiver for the same shifts over a year.

The evening 8 hours shift [3 to 11p] was more difficult to fill, so Dad didn't mind whomever the Agency sent him. The over-night shift [11p to 7a], he had usually the same two caregivers taking turns as all they did was over-night care, thus they were able to stay awake the whole time.

Once Dad moved to senior living, he didn't need the late afternoon and night shift, unless he had gone to the hospital and needed extra eyes and ears when he returned. Thus, he kept the morning shift.  It was a good routine for him as his memory started to slip.

On weekends and on holidays, the cost was time and a half. And Dad's favorite caregivers were more than happy to work the holidays. Dad was in his 90's, a fall risk, some dementia, but so easy going that caring for him was simple. Any time one of the regulars couldn't make it in, the Agency had no problem with filling that slot as everyone wanted to work with Dad :)

The 2 regular caregivers did buck the rules when Dad was on Hospice, as they didn't want anyone else taking care of Dad during his final few days. Each one took a 12 hour shift. Some how they worked it out with their Agency.
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I understand your frustration, as I'm trying to find an agency now and haven't been impressed with those available.

The only OT issue I've encountered has been addressed contractually, between the franchise holder and the client, with an additional charge of $1 per hour for weekends. I do recall one with whom I spoke did charge time and a half for holidays, but I don't know whether that remains with the agency or is paid to the worker.

I've learned that home health care companies address weekend work by using Independent Contractors as opposed to employees. Some of these IC workers have other full time jobs, some just work on weekends. But these aren't companies that provide staff on a continual ongoing basis, only for the duration of the home health care.

I'm going over all my notes today, to start over again and not waste time with ones I've already contacted. If I find any that sound promising, I'll P'M you. Regardless of how I feel about them, I wouldn't make public recommendations.

FreqFlyer is one of the regular and knowledgeable posters here. She's used HI for her parents. I believe she had 3 workers, each for a successive shift. I'll PM her; she might have some suggestions on dealing with the HI management, although, again, the local franchise management may have its own policies.

One agency that was recommended sounded perfect, individually owned, not a franchise, friendly owner, but they didn't cover our area. And that's one of the biggest problems - twofold, actually....I think the franchises have a dominance in the home care industry, and from what I've learned, aren't very flexible.
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All agencies and even nursing homes have at least 100% turnover each year. Changing agencies will not solve your problem.
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