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Up until now, we haven't had any really big problems with our home care agency, because we have had a long-time caregiver through them, who has been so dependable that we seldom had to ask the agency to solve any problems. Nancy has been an absolute godsend for my 98-year-old mom, who has advanced Alzheimer's and requires a lot of care (and more heavy lifting now). She's been doing 4-hour morning shifts with us nearly every day, plus we've added two nights a week, for which we pay the agency extra. She has Tuesday and Thursday mornings off, and the agency has been sending two other caregivers to fill those shifts. The Thursday morning caregiver (Debbie) is really good with my mother, very competent with lifting my mother, etc.... and when Debbie started with us, we thought that she would be able to fill in more days when needed, whenever Nancy needed more days off. So next month Nancy is finally taking 3 weeks off. I am glad the agency is giving her the time off, because she really needs it. I had thought they would ask Debbie to fill in some of Nancy's morning shifts while she was gone. But when I asked the agency's contact about that, I was told that Debbie would definitely not be available for anything except her 4-hour Thursday morning shift per week. My sister asked them the same thing, and was told the same. The agency said that they did not yet have anyone in mind.... and that they would probably have to hire someone brand new, and have Nancy train them on how to lift my mother, etc.

This morning (Thursday morning) Debbie was here working her shift, as friendly as always. We just happened to be talking about my mother's care, as we always do, and I mentioned that Nancy would be gone for 3 weeks, and Debbie said that the agency had not yet asked her about doing any of Nancy's shifts in March. I was curious, so I asked if she had any open days where she is not scheduled for anyone, and she said yes, there are several days every week in March when she would be able to do Nancy's morning shifts.... but the agency had not asked her.

I think I know why the agency does not want to commit to sending Debbie.... because she is one of their best, most experienced caregivers, and they want to be able to save her for other clients, like the 12-hour clients that would pay more than we do (because our insurance company covers only 4 hours). But we feel that it is not right for them to deny us Debbie (because we were led to believe that she would be a back-up for Nancy, although we did not have that in writing) and it is not right for them to send an unexperienced new hire for my mom who requires special lifting.... after all, we have been a faithful client for years, and we have paid them extra for the night help.

The tricky bit is that we sort of broke a rule by asking Debbie about working the shift. The agency has a rule that we have to ask only the agency about scheduling, not the caregivers. Also, we are afraid that we might get Debbie in trouble if the agency knows she talked to us about it. So we could insist on them sending Debbie, but they would just keep saying she is unavailable.... and it seems like we are stuck. My sister wants to tell them that we talked to Debbie about it, because it would be our fault, not Debbie's, and she thinks they really need to send Debbie. But I'm afraid to risk getting Debbie in trouble.

But on the other hand, it's not right for them to send an unexperienced new hire. If this were you, how would you approach the agency about this?

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This is a tough one. You may move her to a different facility. Or, just let it be.
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All homecare agencies operate like this. The reason they aren't asking "Debbie" is because she worked for you before and everyone liked her. Homecare agencies don't want families getting friendly with their employees. I'm surprised "Nancy" has been with you long term. A very real possibility is that "Nancy" will not be returning to your service after her vacation. Care agencies do not like to keep their caregivers on an assignment long-term because it means they can get friendly with the family. They change the hours they work, or they lie and say the family no longer wants them as their caregiver.
I've personally had this happen. A client's family member would get my home phone number and call asking why I don't want to work for them anymore. I always told them the truth. No agency contract that any employee agrees to ever states that their employee must lie for the agency to cover their a$$ with clients and families. A scenario like this is likely what's going on with "Debbie" and "Nancy".
Agencies say everything must go through them and that you're not allowed to ask the employees who are in your house for hours on end taking care of your loved ones a question of any kind.
Everything doesn't have to go through the agency or be reported to them.
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Get rid of them completely.
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I also had a similar experience with an agency that was hired to care for my husband. I had no problem speaking to the aid that I wanted to pick up extra shifts. There is no law or rule saying that you can’t speak to the aid and ask her if she has availability. You are not scheduling anything with her you are simply asking her a question which is not against any rules. The problem here is that you caught him an a lie. I would be honest with them and tell him that you were having a casual conversation and the aid said that she did have availability and hadn’t been asked to pick up those shifts. You are not going to get the aid in trouble she did nothing wrong and she simply answered your question. I would insist on having her come to your house. Do you have seniority over a brand new client. Good luck I hope you’re able to get the aid you want. I would explain to them that it’s difficult on your mother to have different people come in but she doesn’t know. And it’s true it will only add to her confusion and anxiety.
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TXcoasterfan: You must abide by the agency's rules. Just because the Thursday morning caregiver was deemed good, it is the agency's protocol which caregivers will cover the shifts.
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I read through all the comments but may have missed this. Do you have a contract that mandates you stay with the agency while your moms cna is away for three weeks?
If not, I think I would do the same as the agency and shop around. You could use this time to see if there is someone else out there that might provide a better service and be committed to your mom. I would just say you were also taking a three week break. Without the commitment of Debbie, a known and family approved replacement, you might as well take care of things yourself. Just leave it vague on who would be doing the caregiving. You or someone you hire privately or from another firm or respite. Nancy does a great job. Debbie does a great job but since learning that Debbie won’t be available, you might as well find a replacement you can train and have confidence will be returning the next time Nancy is away. Of course, you would reconsider if Debbie could be committed for those three weeks. But the respite sounds good as her cna, mom and you and sis could get a break and the agency can have Debbie free for all the other more important clients they are saving her for.
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You need to abide by the agency's rules. You do not know all the information behind each person they send; not do you need to know. You only need to have somebody competent and reliable. Seems like they are working that out.
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Your money, your choice. How about another agency like "Visiting Angels?"
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Put in your request for preferred caregivers. You will get some other ones.

For three weeks you can get by.
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Have you considered temporarily placing her for the period she will be away if no one steps up to the plate? That may solve your problem.
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New does not mean inexperienced, just new to the agency. I would think the agency hires people who have worked other places. Like said there is a big turn around with aides. Doesn't mean it is inexperience. Means they are looking for higher pay. Some places give hiring bonuses.
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Remember, Debbie works for the agency, not you, and they decide her schedule -- period.
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Clairesmum Feb 2022
exactly...and letting it slip that Debbie shared schedule availability with you despite it being against the contract you signed with the agency (and her terms of employment), then Debbie could lose her job.
Go with the flow...aides come and go. They do have lives of their own.
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I wouldn’t say anything about knowing Debbie is available if you have agreed to the rules she probably has too and even with you bringing it up and breaking those rules she is the one who will pay for the discussion one way or another. So unless you discuss it with her and get her permission for telling them about the discussion while taking on the blame for starting it I would leave that part alone. Dealing with an agency now myself (though we don’t have a rule like that) I would push them a bit more. I would be clear that it was your understanding from them that Debbie would be the one to fill in for Nancy and while you don’t want to take Debbie away from her other regular clients you aren’t happy with the answer that a new hire, who hasn’t been hired yet, will be the one to fill in. You have been long time clients…use that angle to push and keep pushing, ask every week if they have found someone yet reminding them that you want enough “training” time and time to see how this new person will work out. Again you have been long time clients and up until now had planned to increase care time when that became needed with them and your current caregivers but if you can’t count on getting the quality caregivers you have had until now you will have to reconsider the extra expense of using this agency… Save the last part though in case you need it after a couple weeks of not getting what you need. I would gauge the pushing based on the response you are getting, you don’t want to sour the relationship you have with the agency scheduler and end up having to start all over again with another agency.

They may very well be holding Debbie’s schedule either for those new 12 hr clients or to fill in for 12 hr clients (maybe they know of clients coming up that she doesn’t) since she is so experienced and you can’t really blame them for that. If they don’t end up finding somebody acceptable to fill in for Nancy they might end up using Debbie anyway, opening up her schedule you never know. As you say Nancy needs and has earned the 3 week vacation and while 3 weeks sounds like a long time and it is for you, contributing to her vacation if you will by working with the agency, within reason, is something to consider too as you gauge how, what on and when to push harder.
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Don't tell the agency you talked to Debbie. That may get you in trouble. Place your request for her to fill in for Nancy, because your mother knows her and she can work with your mother, and leave it with that. If Debbie trains the new person, hopefully the new person will also be good. It's not easy to get healthcare staff right now, so you may have to do your best with who you get for the 3 weeks. Hopefully the person will be good. All the best to you.
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I think you are being a bit unfair as other people need help just like you do you can’t demand that you get a certain carer just be grateful that you have them at all as it’s a thankless and hard job there are lots of people who can’t get or can’t afford carers the agency must have their reason for doing what they are doing
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Interesting issue. When I read CM’s response, I thought Whoops I got that wrong! Then I read Bundle’s comment about high turnover which meant she was constantly “explaining to new people what needs to be done”.

So what happens if OP and family have actually gone away and can’t train up the new person? And what happens if Bundle’s agency work out that sending new people to Bundle and her mother gives them free training, while Bundle still pays for it? My guess is that CM's agency is a bit more ethical, but how do you guess?

It sounds like it could be a bigger problem than just prohibiting the client and the staff from talking about it!
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hi OP :),

in my family also, we had strong preferences for certain regular, replacement caregivers.

we had no choice - it was completely up to the agency who came.

we got many unexperienced, incompetent ones.

we did ask if we could have our preferred one. (1 caregiver explained that the agency doesn't want caregivers to get too emotionally attached to LOs, that's 1 reason agencies often switch caregivers).

our preferred caregiver was also available, but also explained to us their schedule is out of their hands: the agency decides.

----
our solution?
in my case, i stopped with the agency.
i found private, excellent, consistent caregivers.

much less stress now.
before, i was constantly/daily, many times a day, explaining to new people what needs to be done please.
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TXcoasterfan Feb 2022
Thanks for your input, bundleofjoy. I'm glad you found that solution.... later on when Mama needs more hours of care than her insurance company will cover, we might need to hire a private caregiver for some extra hours.... it would probably we worth it.
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Please follow CountryMouse's advice as she's in this business for years and knows from where she speaks.
Good luck
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Countrymouse Feb 2022
Thank you for the compliment Lea - only two years as a worker! But many more before that for family reasons (as a client) and working in recruitment.
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Perhaps one approach would be to have Debbie talk to management and say that your family is worried about the agency sending someone new with no experience who would have to be trained. They aren’t sure it will be safe. That is a perfectly OK thing for you to talk to Debbie about. She can raise scheduling - ‘Is there any reason why I can’t do it? I’m sure that would set their minds at rest’.
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TXcoasterfan Feb 2022
Thanks MargaretMcKen, I appreciate your input. Debbie said she wouldn't say anything at all to management, and that's okay, because we want her to keep her job. We are sending an email to management with a list of what we need on the shifts to be filled, stating clearly all our preferences (taking Countrymouse's advice).

Another thing I thought of.... after we give the agency our list of shifts and our preferences, if the management cannot commit to providing a caregiver fully experienced with lifting, etc., we can send my mother to the hospice respite center for a while during Nancy's absence, and take her off the agency during that time. (The respite center only can do a week, but at least that would be a week.) The agency would lose a full week of money if we did that. We'd have to work it out with my mother's insurance company, but it might be a better option than having an inexperienced caregiver that one week.
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You will get Debbie into trouble. Whoever started the conversation she had no business to be discussing staffing issues with you and she will be neck deep in the doo-doo.

Moreover, you and Debbie between you have demonstrated one of the reasons why staff are prohibited from discussing agency business with clients (we all are, and we're all as apt as Debbie to forget the rules too). Here you are speculating about Debbie's hours and your requirements and the agency's staffing needs - but you have no reliable information to go on.

Be constructive, and be clear about what you want. Write down the shifts you want covered. Call the agency, offer to email them the schedule, and say that you would very much appreciate their continuing their strong commitment to continuity of care (cite Nancy) and have a strong preference for Debbie's covering Nancy's vacation. Give them dates by which you need confirmation - after all, there isn't a whole lot of time now - and be positive about it. If they still won't commit, ask them what they will be doing to continue service. But do not breathe a word about Debbie's having said she is available: for one thing there may be other contracts to be fulfilled that she doesn't know about, and for another she shouldn't have told you that.

It's twenty past five in the morning and in less than an hour I will be setting off for my early shift - best of luck, I hope this all falls into place for you.
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TXcoasterfan Feb 2022
Thanks everyone for the helpful replies. And Countrymouse -- I'm going to follow your advice!
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