Should a health care agency call a head of time to inform you about the aide who is coming to a client's home?

Yes I would feel the same way; and I would shop around to see if there are any alternative agencies.

The trouble is, they might not be that much better. Everyone working in elder care knows that continuity - having the same few people - is important. I haven't yet met an agency that managed to put it reliably into practice.

So do see if you have options; but at the same time call the current agency and have a polite but serious conversation with a senior manager about your concerns - give them another chance to do better.

I was a homecare RN & would either call the night before or early the next day and provide a 2 hour window when I would be there. As Jj states above, the patient is after all homebound. But of course out of courtesy I did call in advance if I could. And if I were running late because my cases before them turned out to need more of my time, I would call if I could.
As for sending the same aide, that in most cases doesn’t happen. Home care staff too call in sick, have car problems, etc & flexibility on the client’s part is necessary. But courtesy from the home care staff is necessary as well.

Homecare aides are not required to make and keep appointments because only homebound people qualify for this service, and they are expected to be at home. That said, most companies try to set a time range that works for customers. The VA will allow you to change companies if there is a problem. Call your VA case worker.

I had a homecare aid that came the same time and would call to tell me if she is running late. I asked that no therapy be done until after ten. Mom was not good if woke up. I needed time to get her up and dressed and breakfast. My husband thought I was being pickie but I was the one doing the caregiving.

I worked for a nonprofit visiting nurse facility. We sometimes worked with the local Homecare out of the hospital. Usually people go back to their homes. So, the homecare tends to just come. Probably because if having therapy at home, you should not be leaving your house. Me, they were coming to my house to care for Mom. I told them I needed a schedule and what was good for me in the time they had. I was flexible as long as it was 10am or after. I Didn't want people coming and go in my house. I would have expected the same from Hospice. It only takes a phone call.

Yikes! I would feel the same way. The agency Medicaid suggested (not VA) sent the same aide each time, and she arrived at the time expected. When she had to miss some time for a school conference she told me in advance and we rescheduled. My husband really liked her.

A difference might be the length of the visits. Is your aide coming for short care visits? We had ours 32 hours a week. It was her job and she treated it professionally. An agency is going to have a much greater challenge staffing short shifts. If an aide is serving more than one client in the same day there is the logistics of travel time, trying to be equitable in who gets the short shifts, and difficulty of last-minute fill-ins. Also, if our aide missed a day it only impacted our schedule, but for short-shifts several households would be impacted.

For short shifts I think you need to be a little more flexible than if you had an aide for an entire day. But I would expect the day of the week to be honored absolutely, unless prior arrangements are made. "We are short-staffed next Wednesday because area schools are having teacher conferences. Would it be OK to come M, Th, and Fr this week?" Obviously they can't schedule illnesses in advance! But they should do as much advance planning as possible.

For short shifts I wouldn't expect the exact same time each day, but I would expect that a time range could be given, and you should be called if it isn't going to be within that window on a particular day.

I think you should talk to the manager at the agency and see what they consider to be fulfilling their contract. Also ask about the minimum training of their aides.

Our Hospice visits were irregular. Days changed, times changed, and occasionally staff changed. I think this is to be expected. After all, if a nurse is with a client who is actively dying she probably isn't going to say, "Well I have another client. I have to leave now"! I imagine it is similar for aides. Because of the nature of the situation they probably can't always follow the schedule exactly. Also the person on hospice is supposed to have 24/7 care, so it shouldn't be as if they are going to be alone if the aide doesn't come when expected.

Statewise I hope you can get this worked out. Let us know how it goes!

Yes, I can relate to this. My MIL's hospice nurse & the home health aides never give an exact or approximate time of arrival, I'm wondering if this standard procedure? The aid comes 3 times a week and we were told it would be M-W-F 2 weeks ago but she came on Sunday this week and yesterday the nurse said they would get her set up for MWF visits even though that was supposed to have been done already. We usually know which days she will come but they never give a reasonable ETA. It does it make it hard because the home health aid spends around 90 minutes with MIL and it requires privacy. She was coming around noon so we thought it safe to visit on Sunday late afternoon and she was still there bathing MIL when we arrived. We don't want an exact time of day but it would help to know if they are going to come in the morning or afternoon. I think you should contact the VA and request another agency--and find out ahead of time who the agency is & contact them before the first visit.

If you don't feel comfortable then it sounds like time to find another service provider.

If I was in your situation I certainly would like to know when to expect people to arrive, even if it was a range like 'between 7 - 8am'. In my mind it should be an easy thing to ask what sort of training these aides are certified for...your husband has very specific needs after all.

Could you maybe raise these concerns with the VA directly? They might have other agency options for you to look at.