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My mother went on hospice 6 weeks ago at her nursing home. The hospice I show which has been around for years and affiliated w the local hospital subcontracted her hospice aide out to another hospice agency. Nurse told me that was the first time she had ever seen that happen.


I was very happy w the person she sent but unfortunately she decided to move to another agency, I was so sad as she was excellent!!


Today unfortunately her replacement showed up wearing flip flops, chewing gum and on a tank top w her scrub bottoms. Didn't give me a great feeling. So I asked the nursing home supervisor about the flip flops and she said she thought it was unprofessional and she is going to call the main hospice.


Anyhow my question is who is supposed to supervise the aides when they are subcontracted out and who supervises them when they are from the same agency as the nurse? The subcontracted agency has been calling me over the last few weeks if there was a schedule change. Then I was letting the nursing home know. I was so thrilled w the last aide that I didn't really think that much about it but now I'm questioning this whole arrangement, I'm also going to call the hospice about this aide. I just don't have a good feeing about someone that would show up to work dressedine this especially when o found out, she told me she used to work at this nursing home a few years ago! I kind of am afraid to inquire as to why she stopped.


On top of this issue Mom seems to have taken a downturn and has become non communicative.

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Devoted, there is a severe shortage of people who are willing to work with the dying patient. Overlook the couture du jour, August has been H-O-T. If she is good with mom, who cares what she is wearing?
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Devoted, you'll need to read whatever you signed to see if there's provision for subcontracting out to another agency. If there is, and if you signed it, you've in writing agreed to allow subcontracting.

If there's no provision authorizing this practice, I think you have a valid concern. But not only would I raise the issue by phone, I would document and start a paper trail especially if whatever you signed committed you to use the first agency's service, including for a given length of time.
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Thanks Maggie and Sunnygirl. Maggie, yes, we signed w one what I thought was a well established agency and they subcontracted the hospice aide out. The nurse said she had never seen that happen before. It didn't bother me at first as her aide was amazing until she left. Sunnygirl - We are in the northeast and her attire would not be allowed if she was an aide in mom's nursing home. The fact that this aide told me she worked in the nursing home a few years ago just makes it worse- there really is no excuse as she knows the standard. Anyway I called someone I know who works at the hospice after the nursing home supervisor did. She doesn't manage the aides, but is a mgr there and was very great w me on the phone and made some calls on my behalf and assured me the aide will not be back. She also told me she had just heard that mom's aide was being subcontracted and was surprised to hear that and she also mentioned that they were hiring. However it's been six weeks now since Mom was put on hospice and rather than subcontracting again I'd like to think they could handle this themselves. I'm going to call the aide coordinator tomorrow and talk to her directly about this. I need to understand what their conditions are for hiring subcontracted aides and yes how the heck are they vetting them? Again, if we still had the aide extraordinaire or another wonderful person came in then I wouldn't care, but unfortunately that's not what happened. Part of me thinks they should not have accepted my mother to their hospice if they couldn't provide their own aide.I will try to find out why they had this breakdown in the first place. Anyways...I like the nurse a lot and know a few higher up people in the agency that are wonderful, which is one of the reasons I chose them so I'm willing to hang in a bit longer, but if another aide issue arises I may have to reconsider.
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Devoted, you sure have a valid concern. I would follow up to see what options you have. You aren't in the southern USA, are you? Many employees here feel there is no place where flip flops are not appropriate. They show up in court, office, stores, etc. It's so bizarre to me. It seems few people know what appropriate attire is anymore. She may be a good Hospice rep, but when you are distracted with her lack of poor judgment, it may be overlooked.
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Just so I understand...you signed up with one hospice agency (the one you're very familiar with) and they subcontracted mom's care out to another agency? I would not be happy with that arrangement. If the agency you contracted with cannot care for mom directly with their own vetted and experienced people, I personally would ask at the nursing home for their recommendation.

That you had to call on this new aid does not bode well for your future with her. How happy is she going to be that she was called on her unprofessional attire?
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