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Speaking of realistic expectations, is it reasonable to expect a caregiver to "lean on" the loved one to do things the loved one will not do when family members urge it?
My MIL was a strong-willed independent woman who had firm ideas about certain things. She also had the power to fire any caregiver that was brought in. So eventually she accumulated a short list of aides who would do what she wanted, not what the family wanted. And sometimes what she wanted them to do was nothing at all.
Now that MIL has passed, my SIL still thinks her favorite caregivers were to blame for not making her exercise. I am not sure. It seems to me that may be asking too much of a home health aide.
Opinions?
No. Those really aren't realistic expectations, though I think most family members go through a stage of having the same thoughts.
I was disappointed in my mother that she didn't "Work hard" when she first got ill to recover. But I didn't blame the caregiver for mother's lack of interest in being up and moving.
Whenever I did identify an obstacle (i.e. mom would want to sit up more, but the aide doesn't offer) - I would speak to the aide and say "Please offer mom the opportunity to get up/sit up" at least a couple of times a day. Then at least mom had the option. But if mom declined, that's not the caregiver's fault.
You can't force another human being to do anything. And caregivers shouldn't be caught between the family and their patient and forced into an impossible place.
No. Those really aren't realistic expectations, though I think most family members go through a stage of having the same thoughts.
I was disappointed in my mother that she didn't "Work hard" when she first got ill to recover. But I didn't blame the caregiver for mother's lack of interest in being up and moving.
Whenever I did identify an obstacle (i.e. mom would want to sit up more, but the aide doesn't offer) - I would speak to the aide and say "Please offer mom the opportunity to get up/sit up" at least a couple of times a day. Then at least mom had the option. But if mom declined, that's not the caregiver's fault.
You can't force another human being to do anything. And caregivers shouldn't be caught between the family and their patient and forced into an impossible place.
We settled this by having the in home nurse order physical therapy (through the physician.) My MIL is staying with us for an extended period after surgery and is refusing to do the walks she is supposed to do multiple times a day. She gives us every excuse in the book. "I'll do it as soon as I eat." "I need to let my food digest." "I need to call so-and-so back because she left a message." yadda yadda.
I told the home health nurse about the excuses and she said "I'll order PT to come and walk her."
When she told my MIL this, MIL said "Oh, good! I am glad about that!"
So she'll walk with a stranger but not us.
She's also going through the "I don't want to eat real food, only ensures and ice cream" deal. Even though she is supposed to be eating solid food per the physician.
We settled this by having the in home nurse order physical therapy (through the physician.) My MIL is staying with us for an extended period after surgery and is refusing to do the walks she is supposed to do multiple times a day. She gives us every excuse in the book. "I'll do it as soon as I eat." "I need to let my food digest." "I need to call so-and-so back because she left a message." yadda yadda.
I told the home health nurse about the excuses and she said "I'll order PT to come and walk her."
When she told my MIL this, MIL said "Oh, good! I am glad about that!"
So she'll walk with a stranger but not us.
She's also going through the "I don't want to eat real food, only ensures and ice cream" deal. Even though she is supposed to be eating solid food per the physician.
See if her physician will call her on the phone to check on her progress. Cue them in first about your concerns so that MIL does not try to con them.
My husband follows through much better if his doctor makes a personal phone to him. Of course, I only ask the doctor to do that if it is very important.
I will say from my limited experience that 24/7 care doesn't happen. My mom hired an agency to help her with my father that was supposed to help around the clock. I was there to visit for a few days and twice someone called out. The agency couldn't find someone else to come in so there was a gap.
My mom decided at that time she needed to put my dad into a nursing home. It was an extremely hard decision, but it was too much for her to do alone and stress whether or not someone would show up.
This has been a great conversation and I appreciate all of your feedback. Other than the starting hiccup, first few days have gone well, so fingers crossed. We will keep all of your good suggestions in mind as we go forward. Thanks all.
Am I unrealistic in thinking that the staffer should have contacted the AGENCY about the scheduling problem and that the AGENCY should have made alternate arrangements? Should we not be able to rely on staff will always showing up when scheduled or making the necessary arrangements with the agency to be sure that our loved one is cared for? Appreciate feedback on this before we go to the agency with complaint/concerns. Thanks so much.
The staffer is the one who is coming. You should be keeping their phone number in your phone as well. They likely are contractors, not employees of the agency. Staffers can be early and late depending on how their previous patients were.
Also, the first one is usually the admitting staffer, and might not be one of your "permanent" nurses. Someone responsible should be in the home the first time to greet the staffer and assure them of your expectations.
I myself am quickly learning this, as my MIL just moved into our home Friday night and I have been dealing with hospice personnel for four days now.
The staffer is the one who is coming. You should be keeping their phone number in your phone as well. They likely are contractors, not employees of the agency.
This is the part that may be confusing us...It's our impression that the staffers are actually employees of the agency, at least in for some agencies. Again, we are new to this and need to explore & understand the relationship(s) better. Thanks.
This is the part that may be confusing us...It's our impression that the staffers are actually employees of the agency, at least in for some agencies. Again, we are new to this and need to explore & understand the relationship(s) better. Thanks.
It may depend on the type of care.
We dealt with home care agencies when we first moved in mom and dad. The employees were just that - "employees" of the agency. They were NOT independent contractors.
Now for visiting nurses, or something like that (people who set their own schedules, etc..) - maybe being an independent contractor is possible/common.
But for regular home health care (showing up at the time the agency tells you, performing the tasks the agency instructs you to perform, etc..) there's nothing "independent" about that any agencies suggesting it are likely trying to make an end run around taxes. (i.e. the "gig" (1099) economy).
Part of what you're paying agencies for specifically is their handling of payroll (because if you hire someone privately you have to learn/figure out employer taxes including SS / medicare taxes) - so again, not an independent contractor (who pays their own taxes - usually at least quarterly - to the gov't).
Glad that it's settling down for you and that the agency is getting things squared away. I hope their services continues to be helpful for you/your family.
If no one had been available (i.e., in town) to receive that cancellation call, presumably that's what would have happened
We gave our agency four phone numbers -- first, second, third and fourth -- in order of who to contact. I don't know whether that "in town" reference mean you're out of town, or local family members travel a lot and so would be out of town. IF the local family member travels a lot when they travel they should try to have someone in town who can be called in their absence. If all family is out of town then is there someone -- ANYone -- who could be a local contact? Pastor, friend, neighbor? This is good to have in place whether or not you have an agency involved anyway.
Quote:
None of this matters. What matters is the paid caregiver the very first time is going to be two hours late, not acceptable. It's one thing if that happens down the road but not the first day.
Regarding elder being left alone, missed medical appointment, family member being late for work…..because of the late caregiver.
OK sure the caregiver said she was going to be late, but if the reason is legitimate -- I'll say to you that "crap happens ." What matters is what's the RESULT and ripple effect of crap happening….A caregiver being late on the first day -- just like anyone else being late on the first day isn't the best way to start o new gig. But, YOU could be late for YOUR first day at a new job.
Yes, clarify the agency's procedures for caregiver lateness. Certainly do that. But personally what would be most important for me would be what's the RESULT of having no caregiver for two hours? My mom with dementia could not be left alone. So might I be aggravated that a caregiver was late? Sure. I'd be MORE upset about ether that means I, my brother or other family member is late for work….or whether that means mom misses a doctor's appointment it took us three months to get!
Just saying'
Our aides were agency employees. And we also had their phone numbers. My mom had 24/7 live in care. One aide for 3 days, the other for 4 days. IF there was a change the agency (and aide both) called us. If one aide was late, the other one couldn't leave until someone came to relieve her. IF an aid- had to leave for a family emergency mid assignment they called the agency and could leave until their relief came. AND they called us to let us know. (perhaps one of us could get there sooner so she could leave) If not she had to stay until her agency relief came. We were very lucky. Our agency was recommended by a family friend of more than 30 years who'd used the agency for her mom. So we went in with that recommendation, and the agency lived up to that recommendation.
Yeah red flag. No doubt she was trying to avoid getting caught by her agency. The AGENCY would have called you and made their excuses as to why they weren't sending a replacement. Oftentimes they book in blocks of time and may not have someone available (no excuse).
Now, yes, agencies and facilities go through staff alot lately because so many people take the job just as a pay check with no work ethic or skills. Or WEIRD personal habits.
That being said, even the BEST facilities have had Home Health Aides and CNAs on staff who lied right to my face. Dumb lies. Like "I texted you but my phone's been having problems". As if I was born yesterday LOL. They think because I'm the client's dog walker that I'm gullible.
IME if it's a good agency, there will surface one or two staff members who click with your family member and become the "regulars".
Just keep on it.
IME, the best agency around here in FL also has hospice trained staff - those people are dedicated or they'd be doing a much emotionally easier job. Just something I've noticed.
My downstairs neighbor is a certified CNA from another state but simply chose to work as Independent because it pays better. She hasn't bothered to get certified and insured here. But she got clients through word of mouth. And of course it's not really a good idea to hire a solo person especially uninsured etc. She's an exception but probably more common than we know.
Her own wheelchair bound sister used an agency after her family bugged her to get in home physical therapy (she had a stroke 20 years ago at a young age)....and the guy wasn't using the gait belt around her waist and she didn't like him. Before anybody could do anything about it, the guy DROPPED HER and she broke her kneecap!
I see that all the time with my client who needs help transferring, too. The belt is sitting there on a table as two girls struggle to transfer him. Careless. I also see lots of stupidity when he gets new inexperience aides. You can tell. Like TWO of them are putting him through machinations twisting him all over the bed - making him hold the side rail etc.....to REMOVE HIS DEPENDS instead of simply ripping it off in 20 seconds like the experienced people do. It's pretty funny that HE'S the one telling them how to do things! (but not really)
It's annoying.
Last edited by runswithscissors; 10-18-2016 at 09:47 AM..
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So she'll walk with a stranger but not us. 
