Our first experience with home health is this week; a lady is coming out to assess mom, her home etc.
Ideally this is what we'd like help with, but not sure how realistic it all is:
- companionship
- check her bed - see if it's wet, if so wash pad/sheets & change & put nightgown in laundry
- weekly laundry
- check her Depends; if they're overflowing her bucket, put in trash and take downstairs
- persuade Mom to do her exercises (ha!)
- light housekeeping (sweeping around her chair where she eats, doing dishes)
We want to make sure we ask all the questions we should - any suggestions? Is this what a home health person DOES?
Thank you!
Helped her shower and dress.
Changed sheets on her bed.
Light housekeeping in mom’s room.
Prepared simple meals/washed dishes that were used.
They did not wash her clothes.
I kept coffee, tea and snacks in the house for them to enjoy with my mom.
I would ask how much experience the person they are going to assign mom have?
Will this person be able to manage if mom begins to decline?
What happens if mom or you do not get along with the person assigned?
How much notice will you get if the caregiver calls in sick?
How fast can they get a replacement?
What is the company policy on the personal use of cell phone?
Have background checks been done?
Are you expecting the caregiver to provide / make lunch for mom?
If so how much prep will you do? Or can the caregiver go through your fridge and pantry and make a meal?
Phone usage, because if she's on the phone all the time minimums of all those thing get done.
I would consider security camera and would let her know they are there.
That is I would install them BEFORE she assesses the house and tell her that you DO use them and that bathrooms are not monitored.
Just me, if you are not in the home and mom is alone.
How many hours are you doing? Is it daily?
Have you checked with your insurance companies if there's a caregiver without agency insurance who will be in your home.
How are you vetting this person and what references do you have and how thoroughly do you intend to check them.
How able is Mom to be a reliable reporter to you?
Just some thoughts piling in. Hope others give you more.
Our state allows cameras to be installed in facilities too.
My mom wouldn’t be concerned if they were running late or needed to come earlier but she did want to know what time they were arriving.
Ask the staff to tell you if they were coming a bit earlier than usual or later than the designated arrival time.
1. How will they communicate with you/your family and with each other (if there's more than one caregiver)? The agency I used asked their caregivers to call in a brief report from my dad's phone with each visit as they were leaving. It was recorded and I could call in to a number and listen to it. In addition, I left a notebook for them to sign and leave notes with each visit. I'd often see... "threw out spoiled food from fridge", or "needs different slippers- he trips often". Even if your mom is perfectly able to remember and communicate, there might be helpful observations and requests that the caregiver would like to communicate directly to you. Even though the agency preferred to be involved in communication I left my phone number and name and asked that each care giver add me to their contacts.
2. Companionship- only restating this because in the end it is KEY! What does your mom still enjoy doing?
a. Driving... do you want them to take your mom anywhere for fun? Or is this too difficult for your mom? Is their car insured and in good shape? How to handle payment? As an example caregivers would take my dad out for lunch occasionally. He was THRILLED when one took him to a new hot dog stand.
b. Cell phone and TV usage. Also key. I had one care giver who would turn down the lights and turn the TV on and my dad would sleep in his recliner for hours while they sat and watched TV and were on their cell phone.
c. Pets- would your mom enjoy visits from pets? Pets are a great social lubricant. One caregiver had a CALM, gentle, loving old retriever that she'd bring (with my permission) once a month or so.
d. Anything else your mom enjoys!! Cards, puzzles, sitting outside and watching the world go by... Be specific. I found that some of the less experienced younger caregivers didn't know how to engage as well. A list of activities would help. The "youngers" have their talents too and could help your mom use Facetime, or other engaging online activities.
I was so desperate for help with my dad and it was during the pandemic, so I forgot to carefully think through questions. I got lucky and had an agency that had an unexpected opening and overall did and amazing, professional job. There were three care givers that rotated and because my dad had no mobility issues (he had dementia), I got women who had been with the agency for years and maybe weren't so agile and able to help physically, but were phenomenal with my dad and his dementia. They helped ME figure out what to ask THEM! I stay in touch with a couple of them to this day.
The agency was not checking up on the aide's job performance by having them call from your father's phone. They were making sure they were putting all their time in.
You got lucky if your father had good ones.
Make sure ALL personal items are locked in a safe. One that is large enough that it can not be easily moved. Also place it in an area where the caregivers will not be. (basement, main bedroom closet, unless that is where mom will be)
Make sure ALL financial information is locked away.
If there are rooms that you do not want the caregiver entering the safest thing is to lock those rooms.
1) Do they have kids and will childcare ever be a problem. If you're dealing with an agency ask them to explain how their fill-in policy works when a caregiver calls out sick.
2) Do they own their own car? Then ask to see registration and proof of insurance.
3) Ask for personal references from clients and families they have worked for that you can literally call on the phone and talk to. This one is probably the most important one of all. If they've got no one who will personally vouch for their caregiving skills and work ethic, do not consider them.
4) Read ALL agency paperwork very, very carefully. Make sure you look at the fine print because often times it is worded in such a way where they may only cover say $1,000 liability on an employee. So you agree to cover liability if a caregiver gets hurt on your property. Or if they break something you sue the caregiver directly. This is how agencies operate.
5) The caregiver or plural if there is more than one is to record daily in a notebook at the end of their shift (just like in a facility) any changes in the client's overall health and well-being, and if there were any obvious issues going on like they're in pain or are lethargic or have diarrhea or an upset stomach. You can ask each aide to call you at the end of their shifts, but most don't.
It would be your responsibility to review the notes and act accordingly.
6) Define what you mean by companionship also. I find in my long experience of 25 years in service that there's often misunderstandings when it comes to companionship. Many people don't tell the caregiver they expect them to talk continually and keep the elder engaged and entertained. Then they get upset when they don't or when a phone comes out of a purse.
7) Really define what you want as far as housekeeping goes. You mother will also have to understand that the caregiver is not going to get down and scrub a floor by hand (you'd be surprised how many people expect this).
8) Of course everything you expect gets put in writing. Also, let the caregiver know they cal call you if they need to.
Follow this list and you'll be fine.
I rarely had any reason to complain but whenever I did call our agency to report an incident, I was satisfied with how it was handled.
There was one caregiver that gelled with mom the best and at my request the agency sent her to us on a regular basis.
Our caregiver went above and beyond for my mother. She was very patient and caring.
Mom was very slow and rigid due to her Parkinson’s disease. A shower would wear my mother out. She generally took a nap afterwards.
The caregiver even asked if she could help me when my mother was napping. I never asked her to do any additional work for us. She seemed to be the type of person who preferred staying busy over sitting.
I do wish caregivers were paid more. I can understand why there is a shortage of help at times.
Sometimes a job applicant will volunteer the status of their children in an interview situation.
That is okay if they voluntarily bring it up.
It is not illegal if you are hiring privately. Private hiring has different rules than agency hiring.
If you are hiring privately, then you are the employer, it is still illegal to ask marital status, pregnancy status, childcare status.
We pay privately. We do not ask applicants their childcare status. We also pay workers comp, vacation time, and social security.
If you pay cash then you are still an employer. You are at risk with entanglements from the IRS for not reporting income. We've had two caregivers who worked other caregiver gigs in cash who were subjected to IRS fines of $6000 in interest and penalties for not reporting their cash incomes. Both were depositing their cash income in banks which is how they were tracked by the IRS. I'm sure the employer also was penalized but I don't have the details.
You can site legal statutes until you are blue in the face. We all know that when a person is hiring a private-pay caregiver they can make all kinds of demands. I've had private-duty assignments where families simply would not hire a caregiver with tattoos. Or kids. I was turned down for a position once (by an agency) because I was a smoker.
I worked for an agency that found high-paying private assignments for caregiver CNA's. Let me tell you, the potential employees had to look perfect in every way. Perfect face, perfect body, no tattoos, very strict. I took work with that agency for over ten years. I tried to get a fellow aide that I had worked with a job with this agency. She was experienced and had excellent references. She wasn't attractive enough and was overweight. So she didn't get a position with them.
You can say no one is allowed to deny someone a position, but we all know it happens all the time.
Companionship. Define that. Would she be fine with caregiver on her mobile? Because that’s how ppl read books now. Or does she need to be only focus of activity for the whole shift?
The exercises can be set up as an incentive.
Wet Bed Check, laundry and trash are typical caregiver duties.
It should be understood in writing beforehand that a caregiver not take gifts and that they can’t bring minor children to work. Confirm to the agency that this is their policy, and if that’s not a strict yes I’d remove them from consideration. Same with an independent caregiver.
Hiring help needs due diligence. You must prepare a detailed job description for the aide and must go over it with them to make sure there is common understanding of the terms. Based on my 18 years of experience caring for my wife at home, I suggest that you should make an activities list in detail, covering what should be done and at what times. Do not leave anything to the discretion of the aide. And based on the description of all the activities, have a chart to record those activities and times by the aide on a daily basis, and review it every night after the shift is over to make sure everything has gone according to your plans.
In the interest of making this post not too long, I will not go into the details of these activities and the chart documenting them for each shift, but you can find the details in my recent book "Dementia Care Companion".
I just copy a section specifically related to aides provided through service providers:
Home Care Providers
If you need to hire staff to help care for the patient at home, a service provider company can help you with the process. These companies usually have a standard contract; they provide the workforce and in exchange receive a finder’s fee and/or a monthly commission.
· Before signing a contract, have your family lawyer review it and make sure that your interests are protected.
· Make sure that the service provider company does a thorough background check of any candidates that they introduce to you.
Service companies are convenient in that they introduce you to candidates; if you are not satisfied with a candidate, the company will send someone else. Keep in mind, however, that changing caregivers is stressful for both you and the patient. Training a new aide in your care routine, daily schedule, nutrition and medication regimen, and so on will be time consuming – and your responsibility.
I have never heard of a company like you are describing. I only know about home care agencies like we use that charges us for the hours the caregivers actually work. I have never heard of a finders fee or monthly commission for caregivers. If we ever privately hire a caregiver they send to us we would be subject to a high fee as a result.
I am in South Carolina, USA. Where are you?
Are they okay with running errands -- i.e, picking up something from the supermarket. My parents had a supermarket up the block so it was easy for the helper to do.
Doing laundry or helping put laundry away. My parents sent theirs out. The helper needed to put the laundry away when it came back.
If helper notices that prescription pills are running low that they inform you. Ours filled them for the week. We were usually on top of it but sometimes it happened that we were running low.
Walgreens, Target and Cub Foods supermarket home delivery are well worth the delivery fees, I always get the "free" or lowest fee by ordering extra things that I'll always use. I shop LOTS on the web.
I have been living this way for 10 years as my MS progressed. I am 80 years old, have had MS since 1978 and live in a 1-floor house with my husband and grandniece. My husband helps me in so many ways.