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I was my moms primary caregiver for the last five years both unpaid and paid. A injury in October, my 4 year olds development along with my moms temperament (due to the progression of her dementia) had me burnt out and I knew I couldn’t continue being her caregiver. I went agency directed in Feb. she had a aide who was phenomenal who left us the end of last month. Her new aide has been with us for two weeks, she’s nice but I don’t find her doing enough. I find myself more tired and now I’m not even getting a paycheck whatsoever. She also has another aide who comes on other days that I felt ok I can deal with her work ethic because it’s only two days. I’m thinking about trying a different agency but idk if I’ll have the same issues.

Just read one of your responses

"I wash my moms clothes, make her food, clean her room and have made myself available if needed."

The aide should be doing the above, not you. Thats what their training entails, whether a CNA or HHA. They do everything for the client. You should not need to make yourself available. You should be able to come and go while the aide is there. She is there to give you a break.
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I've read over the answers and your responses to those answers. What I understand is that currently there is no care plan in place. This is on the agency and not the aide. It sounds like someone from the agency took a short cut and bypassed proper protocol. This in itself will confuse an aide especially if they are accustomed to working with agencies that have care plans in place before accepting a case. An RN or a representative from the agency should have come to your home and assessed your mother, and a care plan would have been created before assigning an aide. Without proper supervision from their agency, an aide may find themselves doing things outside of an established care plan. Aides must abide by a care plan because it is a legal document.

I've been in situations where the clients or family members have tried to add things that were not listed on their care plan.

I had a case once where no one did an actual home visit and the client's family had expectations outside of the norm. I quit that case. I don't work anywhere where the client does not have an established care plan, and there is poor communication between the aide and their agency. It leaves too many doors open that can lead to exploitation and burnout of the aide. If something were to happen and we ended up in court, it would have been a mess. Agencies must abide by proper protocols set the Department of Health and the Board of Nursing.

I think in your case, I would interview more agencies, and ask if they will send someone out to do an assessment of your situation, and create a care plan that would be suitable for your situation. This is the correct way to open a case.

I would fire this current agency.
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BurntCaregiver May 9, 2025
You are right, Scampie. The careplan is a legal document and the aide on duty is only supposed to do what's in the agency care plan. I too have been on cases where a families tried to make demands on me that were not in the careplan. When I went private-duty I came with my own careplan stated in plain English what I was willing to do for a client and what I wasn't.

This OP should really call her mother's doctor and ask them to send visting nursing to assess her. If she's got bedsores now she needs skilled care.
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If the aide isn't living it to what you require then it is more than likely that she doesn't know exactly what you DO require of her. I would start with a sit-down and written instructions; it is always difficult to lose the "perfect" help and you may be down to having one less loved; that's simply the nature of home help.
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Hardjourney May 8, 2025
I actually have a schedule posted in her room and in the kitchen with a biography on my mom as well as things like we do what works and the disease changes day to day. I think that my problem is how well the first aide caught on to routine and made it her own and how different it has become to the point that bedsores are now an issue. Thanks for the response!
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The first thing to do with both of the aides is TALK to them
Tell them EXACTLY what needs to be done, what you expect them to do.
If they are not doing what needs to be done you talk to the supervisor and ask for replacements. make sure the supervisor is fully aware of what needs to be done. they should have done a home assessment and discussed with you what you require and the care needs of your mom. If this agency can not meet those goals then you can try another.
If you want to hire privately (there is a bit more paperwork involved) the 2 BEST caregivers I hired I found through the local Community College. The college has a CNA certification program and these 2 people had completed that and were waiting for the Nursing School Program to start. I knew they had background checks done because all the students do a clinical rotation so they had to be fingerprinted and background checked. ( this is just an idea if you do consider hiring privately. )
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Hardjourney May 8, 2025
Thanks!
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I want to start my response to your post by telling you that I was a homecare aide for 25 years and now have my own homecare agency.

What exactly do you expect from your mother's aide? You don't find her doing enough. What do you mean by that? I'm sure you already know that the homecare aide is not at your service to take care of your needs. She is not a housekeeper or childcare provider. She is also not a paid entertainer for your mother. Look at careplan folder the agency gave you. It will explain exactly what the aide's job is and what it isn't.

How about sit down and write out a detailed description of what you think your mother's homecare aide should be doing in your home. Then take this description to the agency she works for. I actually had a client's daughter come in with a written description of what she expected from her mother's homecare worker. I explained that her expectations would require the hiring of a staff of domestic servants including but not limited to a housekeeper, maid, cook, nanny, landscaper, personal assistant, and nurse. Then there's the paid entertainment because the aide just wasn't keeping her mother engaged well enough because she was still bored.

Unfortunately, my employee can't juggle flaming chainsaws while riding a unicycle, and have a grizzly bear wearing a tutu dance on its hind legs. Neither can your mother's so chances are she may have a moment of boredom during the day and not be engaging with her aide.

As a former homecare worker and business owner, if your mother's aide is doing a decent job you're lucky, don't complain or knit-pick. She probably makes minimum wage or maybe just above. You get what you pay for. If what you expect is the work of a staff of domestic servants, hire a staff.
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PeggySue2020 May 7, 2025
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Maybe the old aide went above and beyond. Scampie gave you the discription of what an aide does. They are jot there for you but for the client. They also get Mom her meals, breakfast and lunch and should clean up after themselves. Soiled bed and clothing, they was. Mom has her own bathroom, the aide cleans. Call the agency and ask for aides job discription.
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Hardjourney May 8, 2025
I’m well aware they are there for my mom, I had the position for five years.
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The primary duties will be for the care of your mother such as personal care, bathing, dressing, toileting, medication reminders and etc. Aides can do light housekeeping, but the primary care is geared mainly towards the client. Housekeeping is confined only to the areas the client occupies. They do not clean entire households.

I'm not certain what areas you feel the aide is lacking and not contributing her due dilligence.

Go over the care plan with the agency. Aides must stick to the care plan.
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Hardjourney May 8, 2025
Thanks for the advice
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Give very specific care plan instructions which is a routine of the day.

I would talk to the agency first before switching agencies.

Also be aware that many agency caregivers work 2-3 jobs to pay the bills.
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Geaton777 May 7, 2025
Respectfully (and as a former employer myself)...

"...many agency caregivers work 2-3 jobs to pay the bills" is not the client's problem. They either do the job or they do something else,
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Let the agency know specifically what you feel is lacking with the aids. If the agency doesn't know something is wrong, they can't address it with the workers.
The agency should have developed a care plan for your loved one. And it should have been developed with your input. The care plan will list all the tasks assigned to the workers. Get and review a copy of it. If you'd like tasks added, talk to the agency staff who develops the care plan.
The workers should be completing the tasks on the plan, or providing a reason the task was not done.
Some workers are very committed to the care of their patients. Some less so. But try to address your concerns before switching agencies.
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BurntCaregiver May 7, 2025
@JanPeck

They did develop a careplan. There would be a welcome folder for new clients that has the careplan. This folder would also have a detailed description of what the homecare aide's duties are and just as important, what they are not.

Any homecare agency that does not have a supervisor go over the careplan with the family when te contracts are signed is not a reputable agency, and the people should take their business elsewhere. I used to open every new case personally with a visit to a new clients' homes. I don't have to anymore. My staff supervisor does most of them now.

The workers do complete the tasks on their careplan and the ones they can't they explain in their documentation.
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Yes, but keep giving feedback to the current agency and give them a chance to provide who & what you need. That's what I did for my Aunts. I went through 3 aids: the first was young and nice but she got pregnant and left. The 2nd didn't speak clear enough English for my Aunts to be able to understand. I finally hit the jackpot with the 3rd aid and they had her for 30 hrs a week for 6 years. She came to both Aunts' funerals and her nickname was Barbara Angel (because she came from Visiting Angels).
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Hardjourney May 6, 2025
Thanks for the advice!
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