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Mom had alzheimers. In general we found CNA's were better with Mom than the PCA's. CNA's have training and pass a state test. PCA's are unskilled.
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"PCAs are typically unlicensed and do not have as much training as certified nursing assistants (CNAs)"

There are people who just have a knack as caring for people but are not certified by the State. I worked with one who had been doing that work for years. The other one came and bathed my Mom for me. She ended up being asked to be in charge of getting aides set up for a clients mother and overseeing them. She also worked a shift. No certification but good at her job.

Because these people are not certified they are limited in what they can do. A CNA is certified by the state but even then they cannot handle medication. Word of month is the best thing.
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Deb5354, welcome to the forum. Back ten years ago my Dad had caregivers from an agency and it worked out great. He had 3-shifts per day, and there wasn't one complaint from Dad. Dad's 1st shift caregiver was in her 50's and his weekend 1st shift was in her 60's. Dad liked that, as they were within my generation so Dad could relate. A lot of the 2nd and 3rd shift caregivers were younger 1st generations living in the United States, these wonderful people from around the world.


Like I said, that was ten years ago. As Geaton777 had mentioned, there is now a shortage of people wanting to do this type of work. What is happening here in the States is scaring away people from other countries who like doing this type of work. And with me now pushing 80, my generation may not be able to find good help, and that is scary.
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I’d say they’re much like the population as a whole. Some are highly motivated, some will do a passable job, some will work hard to not work at all, and some are simply awful. I interviewed several for my dad and found that to be true. We were very blessed to find an excellent one who consistently worked well with dad and did a great job. It’s also a job with a high rate of injury to those who do it. Many burn out of doing such physically demanding work.
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Geaton, too funny that your Mom thought she needed to be the caregiver.

When Grandma was 98 she had a couple of caregivers that were in their high 80's.

When Mom had caregivers I always assumed we would have nice elderly ladies in the home. That was not the case. Mom lived in one of the poorest counties in her state where health care is poor and people are morbidly obese and pass away at a young age. Most of Mom's caregivers were in their 20's. We had two that were in their 60's.

It was a tough time and peak covid. Banners were everywhere outside of facilities hiring CNA's.

One caregiver kept getting beeps on her phone every 15 minutes. I asked her what the beeps were about. They were from medical recruiters recruiting for CNA jobs in a tri state area and listing rates of pay for jobs.

Many were simply poor. One CNA was rough around the ages. She ubered to work and ubered home so she could not have made much money after paying uber fees. I asked where she lived. She had a room on the poor side of town. Another CNA complained to me that this girl was rough around the edges. I ignored it because she did a good job with Mom and she was reliable. She ultimately moved out of state.

I never turned anyone into the agencies or reported anyone for borderline situations. The agencies were simply too short staffed. They could not guarantee staffing.

During peak Covid I called Mom's estate lawyer. He was also POA with me. I told him I was worried about staffing. He told me I had to lower my expectations and not get too picky and understand most were high school graduates and worked very hard. He asked how much we were giving for Christmas bonus. He had me raise our Christmas bonus to a big amount. This really stabilized our staffing.

One positive is that we had 3 get college degrees while working for Mom.
One got her RN, one got her Social Work degree and one got her Mortuary Science degree. Another is working on her RN.

Almost all that worked for us were working 2 or 3 jobs. i.e. 35 hours working an assisted living and then 30 hours working for us. They worked 2 or 3 jobs for years. One was a day care teacher during the week. She worked an additional 25 or 30 hours at a memory care. Then she worked 20 hours working for us. I asked her when she sleeped. She said she napped while the day care kids were napping.

Most were working and trying. Some were exceptional. A few (small few) were shockingly bad. The bad ones washed themselves out pretty quickly.

In general, treat people well and the good ones will stay.
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It seems you have had bad experiences. I'm not sure "most" is a fair description. That being said, this past 2025 I had to hire paid agency caregivers for my Mom due to injuries when recovering in her home. We had a mix of experienced, smart aids and some shockingly bad ones. Right now we are in a sustained labor shortage due to the large, retired and aging Boomer population and much smaller following generations (and to be honest, not enough young people being allowing to legally come into the country). It's not a job for everyone and the entry-level requirements are pretty low so it attracts people who aren't very employable in other fields. My Mother, a RN in her youth, was appalled at how bad some of them were. Some were trying hard but were old enough to have their own age-related health problems. My Mom is close to 97 and she commented on one aid that she felt like she's the one who needed the caregiver! yikes
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