Does anyone struggle with aides becoming "like family" and then backing off from most of their duties?

Well, perhaps that's not so uncommon in any personal service - housekeepers slack off, gardeners do, hairdressers fall into a rut

Mom's favorite caregiver is fairly lazy as well but I just try and overlook it - I'm sure she thinks she's irreplaceable and frankly I depend upon her

I do think it is fairly typical.

You need to develop the habit of asking her to do things. Like..on the way out to run errands...."while I am gone will you change Mom's bed and get all her laundry and sheets into the wash"? Things like that. 

When you think about it...it is sort of the same way you would ask your sister to do helpful chores if she came and visited for a day or so.

I also have "family like" help coming in. This is how I solve it.

This is why I preferred to hire through an agency and why my preference is for more than one person as a caregiver, even though we had someone in for only a few hours a week I was constantly irritated by the little things she did. It is only natural that the more someone is in a home the more they feel free to remake it into an extension of their own personality, but the longer you let the little things slide the more entitled she will become. Beware the caregiver who feels "like family", while it seems a nice sentiment she must remember she is not family, she is a paid employee and what you ask her to do is not a request, it is one of the terms of her continued employment. I do believe that sometimes employers and employees can be friends, can indeed become like family, but only if each of them understand and respect their place.

I had that problem with a caregiver a long time ago and I just had to let her go.

She just got lazier and lazier and I lived too far away to constantly supervise her.

CADAMS --your post reminds me of the time I was sitting with a group of women who were all talking about their cleaning woman. One told of the woman who came 3 times a week (for a couple!) and 'cleaned' the bedroom with the TV on during her soap operas. The other mentioned she served breakfast upon arrival and then served lunch later on. The third talked about nothing ever being moved away from the walls. See Katie's suggestion to have the to do list and feel free to mention it. As for your chatting with her. - after the introductory 'how is everything'. Get busy and say you both have a lot to do so you will leave her alone now. Also, this is your time to regenerate, so do your errands or take a nap. That is part of the benefit of having someone come in.

We also need to realize as time advances forwarded that the elder needs more care... thus less time to do light housekeeping. My own Dad became more and more of a fall risk, so his regular Agency caregiver use to dash to change the bed linens while Dad napped in his recliner after lunch. There was a lot of dashing going on trying to get things done... eventually she couldn't keep up. She was great with Dad so I never said anything about the housework, chances were slim that Dad's house would be in a Better Homes & Garden photo shoot.

Dad's two favorite caregivers were like family after a while, and I appreciated it. One caregiver had her retired hubby come over to chat with Dad to help give her time to do other things in the house. Dad enjoyed the chats. When Christmas came around, Easter, Thanksgiving, or Dad's birthday, the two caregivers always had something special for Dad, a gift or candy or homemade cookies, etc. Any time one caregiver went on a holiday trip, she always came back with something for my Dad, like a baseball cap :)

Hi all, love all the replies, each covers a different angle. cadams, you might have your best strategy already, if you're chatty she's going to respond where the 'implicit request' is. She chats and hangs out with your mom, too, I hope? After that intro chat geewiz names, say Well, I'll let you get to it, stuff always needs doing, doesn't it?! I think the family thing is nice, it doesn't imply lazy or productive. Keep her role clear in your mind, and make the effort to identify and do the things you'd want to do if someone had you covered ('cause they do).

I would be direct....and gentle, just as you have been here...
Let her know, no shame, no blame, just time for change.
Perhaps she will will hear you, and if not, then it's time to let her go.

I have come to accept that even people being paid can't be all things to everybody. I need an aide to take care of my wife but would love if they cleaned better and meal prepped too. In the past I would search for the complete package and/or try to "mold" them into being something they were not. Neither of which worked out too well. I accept finding the caregiver that is friendly & compassionate to my wife because that is really what is most important. The other "stuff" can get handled by others if it gets to bad but a smile on her face and being cared for emotionally and physically is what's really important to me.

Interesting thread, for I worked in home care for decades, after learning the importance of continuity, and how to distract, persuade, find safety and community supports for my own brother with disabilities of brain injury. I also owned my home, so I understood issues around home maintenance.

And, i learned when I cared for an elder man for 3 years, helping him live and thrive during those years, when his only daughter lived across the country - I learned to watch for continuity, noticed when RNs came to handle an issue like bedsore care, and they just took current condition for granted, and the sore did not heal, but they just noted, "patient non-compliant" with their directions to leave the bandage in place for 4-5 days. I worried, and when I brought him for different reason to skin MD, I asked if he had any ideas - he showed me a different way to put on the bandage, leaving longer strips of skin tape, not just surrounding the bandage, which fell off, if he removed his trousers. Once I saw the improved method, I had to stand on my head with repeated notices to get anyone to change their methods, eventually I said, "I'll handle this part" and did the care as MD taught - and the wound healed.

I agree with perseverance, that different aides bring different skills, best to pay attention to what each one brings, and re-plan as time passes, noting how different talents make up a comprehensive whole. Other aides working with the same elder, were better cooks than I, sometimes better entertainers, and I had to learn some habits from them. But what I brought, kept the man alive, and motivated and cheerful, with any glitches being addressed, and informal remedies added.

I had caregivers coming into my home to help care for my mother for a few years and had a similar experience. It seems like some of them became more and more complacent in their jobs over time and did less and less. I tried to be organized and from the beginning I had a list of daily chores. Each day there was a list of the things to be done. This list included each specific step to dressing my mother such as washing her face, putting on lotion, cleaning her up and putting on fresh clothing, helping her to put on jewelry, comb her hair, etc. I had similar lists for meals and for bedtime. It was also listed that the caregivers were expected to prepare her meals and to unload the dishwasher each day. I also had extra chores listed for each day of the week. On Mondays, the bedding was changed and washed along with towels. On Tuesdays, the bathroom was wiped down, etc. I created checklists to make sure things got done.

Sometimes, I would have to remind the caregivers to do these things but I tried to make my expectations clear. It always irritated me when I had to remind them. I understand that some days were busy with just caring for Mom and that was ok but if the chores weren't getting done and my caregiver was just on her phone looking at Facebook, it bothered me.

I'll add a reply here again, Livesforcolor - I've found over time, that I've sometimes dropped some procedures, felt more lazy, yet I'm grateful to my current elder lady, that she understands that each caregiver (she uses about 6, on a regular basis) brings different skills. If I've done things that really motivate a client - I put my energy there.

I have judged myself as lazier at times - yet when I've seen some other aides, I have been appalled, for they brought so little - but often were the best at chatting with family or my company, and being the most respected.

I'd go by the reactions of the elder, the reactions you see when the caregiver arrives, or what you hear when they leave. That's not a 100% validation, for many elders have developed a habit of seeking reassurance by criticizing whoever is not in the room.

And some caregivers have learned how to act all cheerful when they arrive, so a forgetful elder brightens up to see them - but that same caregiver may neglect them through the day.

Maybe one thing to notice, if you hire someone, they are the ones involved, and the lists of chores are for you, while other work aspects are for the elder. Both needs are valid - yet there are times when the elder's needs change and evolve, and it matters to notice if a caregiver is able to shift gears when this happens, and that can be a good caregiver, even if some of your lists and chores are skipped.

Some successes are harder to see: I was fired for an arrogant attitude from a job, but I was the only aide who took as long as it took, to persuade the heavy woman with alzheimers, to actually get up for her shower - even it I was soaking wet often at the end of my time helping her in the shower. Other aides, just wrote "patient refused."

After I left, same patient developed major sores, because she was rarely having showers.

Some periodic questions and conversations - AND notes in an ongoing notebook left in the home - require those notes of all caregivers, for those notes provide the structure of their job, and also require that each arriving caregiver reads the prior caregiver's notes, and adapts their focus to areas indicated by prior caregivers.

There are many approaches and you must gauge it on your style, and your relationship with the help provider in your home.
One suggestion:
Just make a list of chores, or items, like you would for a brand new person coming in, and then post it in the room of the person they are taking care of and/or hand them a copy.
You can ease the awkwardness if you like by saying you found your original list, or found a guideline list online and thought it was a good idea to use to help keep everything in a 'good routine' for the patient.
If after the list is given as a refresher and things continue to be 'family like', just gently say there are a lot of things that need to be caught up on the list, if still not done in a day or two, then ask if they are up to the daily/weekly task list. (if not, you can reduce their hours to have someone else come in for the 'heavy lifting', but Mom can still have some hours with their favorite companion).
And as always, get out your mental scale and weigh the value of a trusted companion vs competent help.
You may replace them with someone who will do everything on the list, but may not be a good fit, or worse, may not be trustworthy. (we have had pills, cash, jewelry and keepsakes vanish, even when we were right in the house with Mom, including one helper who didn't realize I was in the side room, she left Mom alone in the bathtub and helped herself to my purse---- when I alerted her to my presence, she stumbled, fumbled then said she was looking for a pen.... it was also her last hour in our home and with her service company)
And no matter how much like family they are --- never let them have easy access to controlled prescriptions.
Use a pill organizer to put out the day's supply of pills, then lock the rest in a filing cabinet (we had one really good person that after about 4 months got lazier and lazier, and began to sit around watching tv or playing solitaire - then we realized pills were missing, I put them on a shelf in my closet, but more went missing in a few days, then I moved them to the back of my closet, that is when she knew we were on to her, she took the whole bottle and never came back, this was no kid, this was a 'very nice' lady in her early 50s, which is how she fooled us for so long until she wasn't managing her pill problem very well and exposed her issue by her lethargy.

I've had caregivers in the home for 7 years. At first it was a "24-hour" caregiver--two men took turns a week at a time. My hubby although in need of nearly constant supervision because of his cognitive disability was able to do all his personal care and more, so the caregivers took on all the housework & maintenance (without even being asked) which helped me tremendously. As time progressed, however, my hubby needed more assistance and now needs help with everything so I have two people on in the daytime and one overnight. They all have different personalities and abilities and skills, and housework isn't as rigorously done as I might like these days but they never neglect hubby and are unfailingly cheerful and attentive to him. I believe he thinks they ARE his family, which is a blessing really. They treat him with love and laugh at his jokes and get him to shower daily and clean up his increasing fecal incontinence episodes with efficiency and good humor. One man loves to clean, one woman is 6' tall & big and strong and can literally lift hubs up, one is handy and is always looking for stuff to fix (he installed multiple grab bars and stability poles so hubs could keep making his way around the house), they all take him for rides in the car whenever he wants to go (used to be walks in the park), they make sure he eats & is hydrated, they have an uncanny knack of knowing when he is getting a UTI, and many other things. They also cover for each other in the crunch and work with each other's schedules--in 7 years I have NEVER had a "no show". I can go anywhere & do anything any time I want to, and I can spend all my time with hubs snuggling him and leave the physical caregiving to them. The man who's been here the longest has become a friend, really, along with his wife (who runs the agency). I can't imagine life without them. They are very special people. We only had one crazy one, and we got rid of her (she was two-faced). I do bug them about stuff like keeping the doors locked at night, wiggling the toilet handle when it continues to run, & so on, but whether or not the dishes get washed before bedtime has fallen way down on my priority list! Hubs isn't easy, he's a strong man & doesn't do anything he doesn't want to do so they've all developed their own unique ways of getting him to eat, drink, shower, let them clean him up after accidents.I've learned to just let a lot of things go. They do the wash, shop for & cook & feed hubs, keep the house reasonably clean, and focus their attention on him. I feel very fortunate to have them.

I also had that issue because I actually hired long time friends to take care of Mom. I had three different ones and one of them at one time had been my roommate. He really started to take advantage of the situation. I would find him asleep most of the time and that was really upsetting me, I did finally make an excuse and replaced him.
I decided to hire next a friend of a friend thinking that I would not have a hard time with that since I did not know her personally. Well it was a short time and it started all over again!! This time I brought it to her attention, I told her that I was very busy at work and I was counting on her for help. I made a list of items that I expected her to do and hung it on the refrigerator. I think she realized and she did straighten up. the third Caregiver had listen to me complain about the others so this one I actually had no issues with until I found out that he was using my Moms credit card for personal use. Its very hard to trust caregivers. So if you find a good one I would treat them like Gold and make a list LOL

Perservance, I like your outlook.

I think you can have a good working relationship but...they are employees and should be treated as such. Make sure they know what u expect out of them when hired. Have a "contract" that lists this and both sign. Nothing wrong with a "chat" just keep the personal stuff out of it. Don't treat them like family. A bonus during the holidays would show how much u appreciate them even birthdays.

We never hired independent caregivers, we went through agencies and it was the same. We had several health aides, some only worked for a month or two, some longer, etc... We were polite to them, but never treated anyone like family, but it seemed to us that caregivers have a tendency to act like family with someone they're caring for, especially elderly. It's easy to understand why, but you have to really be careful too about people who works in your home. We had one who tried to get our dads house from him, we had one who was asking for money to pay her mother's way to Missouri. We had one who was stealing just junk from our house and selling it back out, one dropped my dad on the floor, none of us smoke, so we asked that no one smoke in the house, and one was anyway, every time I'd leave to run an errand. And most of them didn't really do anything. It doesn't take much to become a caregiver through a company, they have a hard time filling their positions. Just saying.

Yes......my MILs healthcare worker just helps herself to food in the refrigerator, has MIL pay for her breakfast and dinners, has brought her child over three times to eat, and the clincher was when she left her child with MIL for three hours while she "took care of another patient who was having an emergency"......MIL puts gas in her car, also. This is pretty disgusting to me and unprofessional. MIL acts like it's her best friend rather than someone who works for her. Interesting, she never used to put any gas in our cars when we were taking her everywhere, and paying for our breakfasts and dinners?????please.....I think this healthcare worker should be ashamed. If I was employed by an elderly person (no dementia), I would never accept daily offers of food, etc. MIL feels awkward eating in front of her, but doesn't want us to say anything......

Joy, is this caregiver hired directly or is she through an agency? If the latter, have you complained to the staff?

I'm interested b/c I'm in the process of hiring private duty care and have a lot of reservations as well as concerns about getting through the "we're the best" attitude of some agencies.


Joysuthe

To add to my post from the previous page.... we need to remember why we hired a caregiver.... it was just too much work for us to do. Thus, we need to realize that the same work will be placed on the caregiver(s).

If you have a really good caregiver, an excellent match, you don't want to burn that person out. My Dad's two regular caregivers were with him for over a year.

I also had to realize that it was Dad's decision on whom he liked, and that was the most important thing.

The answers here are helping me as I interview for private duty support. I don't expect a workaholic, but I also don't expect someone to be playing and texting with their smartphone unless it's an emergency. We had an interview earlier this week during which the individual stopped to check 3 messages, responding only to one.

I've decided I'm going to include a clause in any service contract that no photos may be taken of my father or the home, and that no Facebook posts are allowed about any aspect of his care. Doing so will be grounds for termination. I'm not going to tolerate anyone posting photos of my father or his house online.

When I've mentioned this to some of the people during preliminary phon discussions, the good quality firms haven't had any issue and some even said they prohibit home care workers from posting on FB. I don't know how they monitor, but at least they agreed with me.

GardenArtist......she is employed by an agency. MIL complains to us about these issues, but doesn't want us to call the agency. She has no dementia, so she is well aware that we can put a stop to it. Also, this woman seemed to be just watching tv over there (and getting paid for it!!!!), so we are going to make a few lists for things for her to do, and then try to change her service time so she's not there at dinner or lunch. Maybe that will help. This is still fairly new. My husband and I did everything for MIL until we couldn't do it anymore as her demands got greater and greater. She would do things like call us when she knew we had company and tell us we needed to come over and take her garbage out!!! She is also a hypochondriac in a major way. When she gets a clear bill of health on one thing, she dreams up another issue. It never stops. In addition to being unappreciative, she is very passive aggressive and makes rude comments often. Her only grandson (my son) was out of the country for a year on a scholarship. When he returned, she did not ask one question about his life in another country, but started in on her health issues!!! Her self-absorption makes it very difficult to want to be involved with her. The day we planned my son's graduation party (planned for 8 months) she fell, ended up in the emergency room and made it very clear that the guests should spend time with her at her bedside. The party was crashed and....never an apology......I wished I liked this woman....

Call the agency and have her replaced, but make up a good and reasonable justification to tell your MIL. I'm not sure though whether in the latter portions of your paragraph if you're referring to your MIL or the worker.

GardenArtist.....I'm talking about my MIL and why we felt like we needed help with her. She's very difficult. The more we would try to keep her involved, the more needy she would become. Taking care of the elderly is definitely not for sissies!!