Hello, I've been the sole caregiver for my 79 year old husband who had a serious stroke 3 years ago. He's paralyzed on the left side of his body. He can't walk or transfer by himself. I want to keep my husband at home as long as I possibly can.
I've recently hired an in-home caregiver through an agency. The caregiver comes to our home 5 days a week for 6 hours a day. Although he has very little experience (and questionable common sense) he has a great attitude towards caregiving and he tries very hard every day. He's slowly learning how to do the caregiving basics. I'm training him!
My question is this: he informed me that I need to provide all his disposable gloves and that I should also pay to keep the fridge stocked with his favorite foods and drinks for his lunches. There's nothing about this in the agency contract and I'm wondering whether this is the commonly accepted practice. I'm ambivalent about this caregiver but I don't want to get him in trouble with the agency by asking them about this. I'm also reluctant to ask the agency for a replacement caregiver because the glass is half full with the current one.
Advice?
Thank you.
And no, you do not provide him his favorite drinks and food. Like any other job, he packs his own lunch. Now if he makes lunch for the client I would say he can make something for himself. But from what u already have in the fridge. I think its nice if you want to provide lunch but I don't think it should be mandatory. If not in the contract. call the agency. I would also tell them he does not seem to be trained for the job. You would like to see his Certification with the State. This means he has a certain number of weeks training and he passed a certification test. In my State the Nursing Board certifies aids.
I am not saying that there aren't people out there that make great aides that aren't certified. But an agency, IMO, should be only hiring Certified aides.
Have you thought of hiring an independent caregiver? There are pros and cons to every situation. Agency caregivers make so little money.
My concerns are that I have no reliable methods to verify their qualifications or skills. Also, I want to avoid dealing with tax issues involved with having the caregiver as my employee. (I wonder whether independent caregivers are hired on a contract basis?)
It hurts my feminism to even ask these questions, but they may be worth considering before giving up on this person.
I do think your having to provide training is going to be something of a norm. It might even be easier than getting someone "experienced" to deviate from their ways of doing things.
Recently post-hospital an OT ordered showering help for my mother. When I called the agency (to which OT had referred) to set it up they were very candid about the fact that the aide would not necessarily have any experience with showering assistance--certainly nothing beyond my own.
The sad reality is that much less stressful jobs pay much more than what the agency is paying home health aides. I doubt there are even any significant pay increases for experienced/long-time employees at most agencies.
I don't think gender is an issue for a replacement caregiver. My husband doesn't need a buddy, he wants to spend a lot of uninterrupted time at his desk on his computer. But for brief periods, it would be a real plus if the caregiver could play cards well enough to challenge my husband, and also have the capacity to engage in a genuinely interesting conversation. The current caregiver can't do either of those things.
I'm okay with training a new caregiver with our routine, but I'm not okay with explaining the same things over and over and over again, like how to put a gait belt on someone, or how to dress someone, or how to transfer someone safely. After 3 weeks on the job (90 hours), caregiver should be able to handle this stuff independently by now. I have the patience and I'm willing to train someone but the caregiver needs to have the ability to learn in a reasonable amount of time.
I agree with you about the grim reality of the caregiving profession. We all need to have low expectations at the start, but in our case the caregiver continues to make life harder for our family. I need a caregiver that makes our life easier.
My next question on AgingCare's forum will be how to fire a caregiver in the most gentle way possible. Stay tuned for that new thread.
I sent you a message with some info I hope you saw it.
Thanks for letting me know that you sent me a message. I've just looked at it and I replied to it.
Cheers,
LostinPlace
I have seen ads for agency employees that specifically said, “No experience necessary.”
I was told from home health companies that the aides were trained a tested.
Home health companies are run a bit differently than agencies who provide caregivers.
Home health companies provide physical therapy and occupational therapy for patients. They do provide aides to assist with bathing and so on.
Home health also provides a nurse to oversee a patient’s progress. A doctor orders home health services for their patients.
It makes me feel like more people should ask their doctors if they feel home health care is appropriate for their family member’s needs. Then they will have trained aides to assist them over an untrained caregiver.
During certain times we automatically received home health care for my mom due to her having Parkinson’s disease. I know that home health isn’t applicable in all situations. Mom’s insurance paid for it.
There were a couple of times when I asked for home health care from my mom’s doctor and it was ordered.
Food no.
Speak to the agency about this untrained and needy "caregiver."
Your frankness is so refreshing, Alva.
As far as "training" goes, I was never trained by the agency who hired me. They had no idea what I could or could not do, just that I had a car with a valid license and current insurance so I could drive a client around if required.
That said, I feel like you're better off training this person to YOUR standards, personally. However, if he does not possess common sense, that's a worrisome thing in my book. Common sense is more important in life than SO many other skills. It's what guides us to call 911 in a crisis or to know not to move a fallen elder for fear of causing more injury.
Between lacking vital common sense, which cannot be taught, and thinking he's entitled to a selection of his favorite foods from your fridge, I'd fire him and ask for another caregiver for DH. Preferably a woman who's had children who are now grown. We KNOW they have life skills built into them from experience.
Best of luck to you.
Right, I think my current caregiver was hired based on automobile qualifications. He was obviously not trained - he didn't even know how to put on a gait belt.
Agreed, in many ways it's better that I've been training him to our own specific requirements- that is, if he could actually learn. Unfortunately he seems to catch on for a day, but by the next day he's forgotten how to do it again.
You are 100% correct about the common sense issue. What simply seems quirky now could be a matter of life and death later. This is a bigger health red flag than I realized. Thank you for bringing this to my attention, This is IMPORTANT, so much more critical than gloves or lunches.
I will follow your advice and request a replacement caregiver who is a woman with grown children. Exactly.
Thank you so much for your reply.
I am glad that you that you have help with your husband.
You shouldn’t have to train a caregiver, nor should you have to provide his favorite meals and beverages for him.
I did keep snacks and beverages for the caregivers that cared for my mother. They were allowed to eat meals with my mother but they ate whatever I had prepared for mom.
How do you feel about this situation? If you don’t want to buy additional food, ask your caregiver to make sure that they bring their own meals and beverages.
Keep all of the supplies on hand that are necessary to care for your husband. An agency isn’t responsible for providing gloves or anything else.
Have you spoken with the agency about your concerns? I wouldn’t be concerned about getting anyone in trouble.
A good agency will want to hear feedback from their clients. If they don’t want to hear, scratch them off your list and move onto another agency.
You are not responsible for this person’s wellbeing. You are hiring someone to help you care for your husband.
Have you considered contacting Council on Aging to get an assessment of your husband’s needs? They can help guide you through this difficult time.
Best wishes to you and your husband.
Thanks for clarifying that I'm responsible for providing any supplies necessary, but not the free lunches. Good to know.
I agree that I shouldn't have to train a caregiver. In fact, in my initial meeting with the agency, I was asked what my most important criteria was for the caregiver that they would provide to me. I told them that the most important thing I needed was a very experienced caregiver who knew how to handle all the ADL's and who specifically had experience with transferring people with mobility problems. Then they sent me this caregiver who they said they trained but obviously didn't...But the main mitigating thing about this caregiver is his eagerness to learn and to work hard. A very nice guy with a good heart. Sort of a sweet clueless guy who has real trouble with things as basic as dressing my husband, or running the dishwasher.
And also - -there recently have been a series of articles in the NY Times about how hard it is to find an in-home caregiver anywhere in the US currently due to low wages, few benefits, and poor working conditions. Apparently most Americans with health issues are unable to find or afford a good in-home caregiver. These articles frightened me, so I hesitate to do anything that might cause the caregiver I have to quit, because the replacement could be so much worse.
Your comment also hit home about not being responsible for the caregiver's well being. Right now I feel like I'm caregiving for 2 people: my husband and his caregiver!
I guess I need to gird myself and set boundaries, etc. But this is tough to do as I desperately need any help I can get.
Thanks again - I'll try to do tough love.
Stocking the fridge with food for the caregiver is not your responsibility.
TRAINING the caregiver is NOT your responsibility.
The agency should provide a caregiver that is able to care for your husband in a safe manner.
It might also make things easier if you can get your husbands doctor to order appropriate equipment that would make caring for your husband safer and easier. A Sit To Stand or a Hoyer Lift might make things easier for you and the caregiver. (although the agency may say that with the use of a Hoyer Lift you would need 2 caregivers making it more expensive for you)
And because it is me responding...I have to ask, Is your husband a Veteran? If so the VA may be able to provide some help, some equipment and they may pay you to care for him. If he is a Veteran contact your local Veterans Assistance Commission and they can help you determine what benefits your husband might be eligible for.
Thanks for your helpful reply. All good suggestions that I've already been exploring.
My husband's Primary Care Physician is willing to write a prescription for a Hoyer lift, but Medicare will only provide a manual lift, not a power lift. (I'm 74 years old and I can't work a manual lift). My secondary insurance carrier won't offer anything at all.
My husband is a Veteran. I've been trying to get his service number from the VA for over 6 months. I need his service number to find out what benefits he may qualify for. You wouldn't believe all the steps I've gone through trying to get his service number - the official websites, many forms to complete and send back to them, slow (or no) replies, the demand for me to fill out more forms, and then even more forms again, but we still haven't gotten his service number yet. It's absolutely shameful (and a bit scary) that the VA is such a mess that they can't find any information as basic as my husband's service number. I've spent so many hours chasing my own tail with the VA. Don't get me started.
Thanks again and best wishes