Recently hired an in-home care agency to assist with my elderly aunt. There are two areas of importance: 1) stoma care & training; and 2) getting my aunt out of the house for shopping, lunch, etc. I left a notebook with all pertinent information - especially highlighting those areas. When I asked my aunt if anyone has even offered either of those things - she said "no." My question is: is it my aunt's job to ask her caregiver to do these things? Has anyone else dealt with feeling like the hired caregiver just comes in, watches TV and does the bare minimum - without even trying to engage?
Again, I'm new to this and any advice would be welcomed. Thank you!
Anything you are concerned about should be discussed immediately with the agency rep. This is what I do with my Mom's caregivers. Be clear about what the issue is, and ask how they intend to address it. Then you should follow up on it.
My Mom has only companion aids. The agency is highly rated, however some of the aids (subs) were dismal. Make no assumptions -- your Aunt is paying a ton of money for her care and you need to insist they live up to the fee.
Nonetheless, caregiving can be very boring so it's no surprise that aids will watch tv or be on their phones. You can always put out cards, board games, puzzles, and a list of light housekeeping, meal prep, hygiene help that the aids are allowed to do and then follow-up. You can communicate to the agency the night before if you want the aid to take her out or do something special. Even though my Mom bosses her aid around for 8 hrs a day, they still have "down time" because there's not much going on in the life of a 96-yr old. Even we don't entertain ourselves for every waking hour. But making suggestions on things to do would help fill the time.
Stoma care might be difficult to get because it may be considered a higher level of nursing care, plus with many agencies the person sent to the home can change without notice. Taking her out shopping is a niche task as well because of transportation and insurance difficulties, you need to make sure your agency offers this service.
So then I put an ad on Care.com. I found a CNA with excellent references. That was the key. She began twice a week, four hours, for hygiene care only.
She has been with our family now for two and a half years and has been wonderful. She is now our "lead" caregiver, does all the scheduling, orders groceries, ordered meds (before our parents went on hospice), meets with the hospice nurse. She would take my dad to the store or to just drive around. I live 800 miles away, so she is my main contact. She texts or calls me daily.
We had to hire more caregivers as our parents' health declined, eventually reaching 24 hours with three shifts. So I put another ad on Care.com.
We've had to let some caregivers go. Some lied. Some didn't show up. It was a learning process.
What worked best regarding hiring was that our original caregiver recommended other caregivers she was working with. Hiring weekends and overnights was a challenge.
As far as communicating exactly what you want, I speak to the lead caregiver and she then communicates to the other caregivers.
My parents' house has cameras in every room, and I can see everything. That helped me to reach out to the lead caregiver, when another caregiver wasn't being as attentive as I thought was necessary. Plus I have an unstable brother living there, and I can see his behavior too. He was treating a caregiver like a friend, monopolizing her time with conversation, and as a result she was neglecting my parents because she was not direct enough to cut him off. (Understandably she wasn't hired to deal with an unstable brother.)
The best advice I can offer is that communication is key. Communicate directly with the caregiver. Check in daily if you have to. The caregiver is the one who can give you detailed reports about changes in behaviors, medical needs, etc.
They also do light housekeeping. The caregivers who like to keep busy know that there is usually something that needs to be done in a home, like dishes, lots of laundry, sweeping floors. We do have an extra bedroom when there is downtime or when my parents (it's just my mom now) needed some space. But we got the caregiver a baby monitor so she can be in a separate room but also keep an eye on my parents.
I hope this helps you. It is not a smooth ride, but again, communication with the caregiver is what has helped the most. And in your case, communicating with the head of the agency.
So then I put an ad on Care.com. I found a CNA with excellent references. That was the key. She began twice a week, four hours each shift (the minimum), for hygiene care only.
She has been with our family now for two and a half years and has been wonderful. She is now our "lead" caregiver, does all the scheduling, orders groceries, ordered meds (before our parents went on hospice), meets with the hospice nurse. She would take my dad to the store or to just drive around. I live 800 miles away, so she is my main contact. She texts or calls me daily. The POA lives around the corner (my other brother) but we've decided that he handles the finances and house upkeep and I handle the caregiving.
We had to hire more caregivers as our parents' health declined, eventually reaching 24 hours with three shifts. So I put another ad on Care.com.
We've had to let some caregivers go. Some lied. Some didn't show up. It was a learning process.
What worked best regarding hiring was that our original caregiver recommended other caregivers she was working with. Hiring weekends and overnights was a challenge.
As far as communicating exactly what you want, I speak to the lead caregiver and she then communicates to the other caregivers.
My parents' house has cameras in every room, and I can see everything. That helped me to reach out to the lead caregiver, when another caregiver wasn't being as attentive as I thought was necessary. Plus I have an unstable brother living there, and I can see his behavior too. He was treating a caregiver like a friend, monopolizing her time with conversation, and as a result she was neglecting my parents because she was not direct enough to cut him off. (Understandably she wasn't hired to deal with an unstable brother.)
The best advice I can offer is that communication is key. Communicate directly with the caregiver. Check in daily if you have to. The caregiver is the one who can give you detailed reports of changes in behaviors, medical needs, etc.
They also do light housekeeping. The caregivers who like to keep busy know that there is usually something that needs to be done in a home, like dishes, lots of laundry, sweeping floors. We do have an extra bedroom when there is downtime or when my parents (it's just my mom now) needed some space. But we got the caregiver a baby monitor so she can be in a separate room but also keep an eye on my parents.
I hope this helps you. It is not a smooth ride, but again, communication with the caregiver is what has helped the most. And in your case, communicating with the head of the agency.
And yes I will say I have high expectations, after working in long term care for many years. I have lowered them, though.
A team of four alternates come for two hours in morning and two at night. Five days a week. This particular company does not send Caregivers on weekends or Federal holidays. For now that works. They will not do meds nor nail cutting. We considered doing our own hires but the risk of injury and/or being sued for such by an uninsured, unvetted person was not a risk we wanted.
The first several months was actually more time consuming settling on menus, and light cleaning schedules. That is evening out.
We do hope that Mom will slowly become more comfortable with them as far as bathroom assistance and weekly showers. As we live very nearby we wake her in the morning, give meds and visit the bathroom.
The Caregiver will make the coffee and breakfast, make simple side dishes for use with lunch and dinner plus pre-prepare the lunch sandwich. As the activity settled out now they also prepare two simple dinners a week and serve plus sit her. We come back before their leaving time and watch tv with her (having done her meds at proper time, before eating). Then we end of day bathroom activities and tucked in for the night.
We already had cameras going and a door alarm for night, she’s opened the door looking for her cat who sadly is no longer alive. When that happens it alarms in my house and I check cameras and go over if needed.
Saturday is shower day. There was a phase she refused to shower, causing us much angst. She’s better about that now but don’t want to rush with someone else doing it and setting her back.
I also took over all her bill paying and have Power of Attorney with one bank, was added as a cosigner on other accounts. So yes, busy busy. Just hoping her money lasts so this and more care can continue as needed.
Yes, there have a few wobbles but with the help of the agency all have been ironed out.
Best to you and your Mother. Caregiving is both physically hard, draining and mentally a challenge to keep calm, positive and conversation simple. Mom has dementia so complex series of explanations don’t work, it’s task by task. Stand up and walk to the door… turn right… enter the bathroom- let me help you get the pj pants down, now turn around and remove the pull up. This I take off her feet. Then wash my hands and prepare her toothbrush and then handwashing follows.
I am doing everything I can to keep my own mind and body healthy and stimulated. I really really don’t want to burden my own and only child with my care.
Long post, hope it will help someone, if not original poster. There are SO many variations of the Caregiving trip we’re on.
They take good care of him, help him bathe, feed him, take care of giving him his medications, play games with him (bingo, helps him do puzzles, word search etc.), and take him driving at least once a day. It helps that he has no idea where he is at any given moment or who the people are that are taking care of him but he has always been a kind, jovial man and has been very accepting of this situation. We are lucky (so far). I know this isn't the case for everyone!
Good luck. Never went through an agency (who, when I called, was at least 50% more expensive).
I'd recommend that you:
1) First talk to the owner of the agency and tell them your (aunt's) specific needs and ask if they have an employee (s) who can provide these services.
2) It could be your aunt or you who take charge and find the appropriate care provider. This is to be discussed with your aunt if she has the ability to manage and communicate her needs. As well, follow up, set boundaries and supervise. If she cannot do this, you / someone else will need to help her manage.
3) What is your role here in helping your aunt?
How involved are you?
Do you have any legal authority or responsibilities?
If it were me, I would put everything in writing.
List needs 1, 2, 3 (duties and specific times/days.
Give them a copy. Ask if they understand the duties and have them sign it, indicating they understand it.
After a few days or a week (or weekly), go over the list and ask how things are going and if they had any problem(s) areas. Discuss as needed. \
Yes, many care providers will come in and sit and watch tv.
This is why someone needs to manage / supervise and hold the caregiver accountable.
Some caregivers are able to do well as housecleaning, laundry, food prep.
Many are not educated and limited in employment opportunities so have to do caregiver work. Many are limited in communicating / understanding English as it is their second language - so this is a major consideration when interviewing.
Some are excellent and are compassionate; some aren't.
You might want to hire a (medical) social worker to assist you in managing this care. Or getting it set up.
Put everything in writing.
Always follow up and ask how things are going.
Be sure to have things to do when aunt may be napping.
Caregivers must be accountable.
Some really do care and are very capable; some do not care and have limited abilities.
You might want to try hiring an ind contractor (as I am) although you need to check personal and work references, work history, education, experience. As well, ask to see car insurance and DI (make a copy). I've had to provide-at my expense-a criminal background check (fingerprinting). From what you share, it sounds like you want someone vetted through a caregiving agency vs an ind contractor.
Gena / Touch Matters
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