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Also, how do I know if the hired home health agency is doing their job?

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thanks for all the responses. It helped clarify things for me
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How can you make sure that local college students are able to properly supervise a dementia patient though? I would be concerned that they might turn their back or forget to secure doors. Are these students who have some training? And are they insured? I guess I'm too wary to trust someone who isn't trained to understand the patient's condition. And what if they just don't show up one day for work? What are your options?

I think I would be more inclined to go with an agency. We had one that came to assist my cousin when she fractured her foot. This was before she got dementia and it worked out okay. I would be concerned with someone tending to a love one in the home though. I would need to thoroughly vet them and then build on that trust.
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I liked hiring my own help from local college students. They were much better, kinder, and more reliable than the "professionals." The "professionals" were inflexible, totally erratic in their schedules (they wanted to pop in any time which prevented us establishing a daily routine), they changed faces ALL the time, because the agencies require the 'head" nurse and the "head" PT and the "head" OT to come for an hour each -- then you never see them again! -- just a procession of other faces, which was very confusing to Mother's mind and disturbing to her comfort. I asked for "continuity of care" so we could at least have the same faces. They all say they have that. But they don't.

With helpers you pay yourself -- yes -- ouch -- it costs. But you have much more control over when they come, how long they stay, and what they do while they are here, and how they do it. In my Humble Opinion, that is money WELL spent.
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Thanks!
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Agencies offer several levels of care, from companion to RN. First they do an evaluation to see what the patient needs. They look at what the MD has ordered. And you keep in touch with them on a regular basis to be sure they are meeting your expectations.
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