Why does the home health care agency send different personal care aides to your home without advance notice?

Shad, your comment reminded me of something I wrote here, perhaps on another thread, but it addresses the management aspect of these agencies. As I wrote, I found that some are merely assumed names (d/b/a/s) of the national franchises, and as I also wrote, perhaps not managed or run by qualified people.

I thought that when I called one agency and the male manager said he had "12 girls" to choose from. I almost told him I wasn't looking for a harem of potential lovelies.

I doubt if the managers belong to any employer organizations, have professional HR managers, or really make an effort to make their employees feel welcome and cherished. And I think the so-called training is nominal, if it even exists.

That reminded me of some of the law firms' activities to support their personnel. It wasn't uniform, not by a long shot, but some of them did make efforts, beyond good raises and bonuses at Christmas.

One had a policy of periodically having pizza parties at work. In retrospect, I think the HR manager took the pulse of the staff and when it was getting low, the firm closed the doors, invited us all into the kitchen and we had pizza and salad.

Another firm had monthly educational sessions for the attorneys and paralegals. The food was always excellent, with plenty left over. Not only did it give the paralegals a chance to interact on a social basis with the attorneys, but it was just a nice relaxing luncheon while learning about some aspect of the various practice areas of the firm.

And the food was always good, especially when I worked for Jewish firms and we got the best food from the local delis. But the absolute best was the leftovers from the Bar Mitzvahs!

I doubt if any of the caregiving agencies even think of doing things like that.

Many home health care agencies have a hard time retaining employees.

I understand your frustration. My MIL is on hospice and has home health aids coming 3 times a week. They never give a time-frame and we didn't always know which days they would come. Some aids are not as efficient as others and would spend 30 minutes with MIL and be done. One of them spends 90 minutes cleaning her & talks to her unlike the other aids so we've requested for her to be the only aid who comes but we'll see what happens. An aid is supposed to come MWF but there's been an issue getting that set up. If you have in-home support services in state & your husband is approved, you are the one who hires the aides, no insurance necessary & the program pays for the aide. They only pay minimum wage though.

Statewise, I can sympathize with your frustration. I felt it too, but I don't know what alternatives there are other than to hire someone yourself, but if you do, it will cost you in workers' comp insurance that you would have to purchase to cover yourself in the event an aide was injured.

Sadly, there are no good solutions.

Eyerishlass, excellent analysis and insight into the problems pervasive in the private duty home health care industry.

In my limited experience, I saw the client's side of this and was equally frustrated and discouraged. We only had one aide out of 3 who was reliable and competent, and she was in the field only during the winter as she was a small business owner whose work was seasonal. The other two were clearly losers, yet arrogant and disillusioned as to their ability.

I honestly don't know what I would have done if Dad hadn't declined and entered professional care through a SNF. I had to spend more time babysitting disinterested "caregivers" than I did before, so it was no relief for me, and the care for Dad didn't even "meet standards."

I think this whole issue and aspect of caregiving is one that is literally a timebomb - eventually something will happen and the liability issue will be litigated and widely publicized.

At first I had this problem with my parents and the agency.
I spent a bit of time, and found two ladies from my social circle (sister of a contractor who did a lot of work for my parents, and her niece). Both were introduced to my parents...it went very well.

I offered to them to get hired for $15 per hour with the agency. (The insurance company required I use and agency for home aides). The agency said they would only hire at $9 per hour. They would charge $20 per hour..but only pay 9. No way. So I told them...you can accept $5 per hour profit off these women that I FOUND...or I would go to an agency that would. So, they were hired.

Wonderful ladies...both a godsend. And they covered for each other too.

Consider a different path to covering home aide need. Check with the church, friends, etc. BUT, be prepared to stand up for them and demand a decent wage.

I worked in hospice for a company that had home healthcare aides and I heard the same stories from my clients. Many times my patient will have had a few years of home health aids prior to being put on hospice and this was one of the biggest complaints I would hear about.

It's the nature of the business. Say Aide X is scheduled to see Mrs. Smith. But Mrs. Jones has called the agency and requests Aide X. Mrs. Jones needs more hours than Mrs. Smith which makes more money for the agency so Aide X goes to Mrs. Jones and the agency sends in Aide Y to Mrs. Smith who has never met Aide Y.

It's a terrible business and it's difficult to find good aides but the aides are only as good as the agency trains them to be. Many times an aide will have no idea what her patient's needs are. She'll just get a call to go to someone's house at a certain time with little to no information to go on.

Hospice is different. Hospice workers are well trained and understand what their patient needs. Often there is family coming and going and they're all grateful to the hospice worker. The family can spend their precious time with their loved one without the added stress and anxiety of caring for their loved one because that's the job of the hospice worker.

You wondered what you could do to make this better for all seniors who need home care? They need more money and tighter regulations. Home health aids get paid about as much as someone who works at McDonald's. The industry attracts people who have difficulty finding good jobs. The agencies don't care about their aides, there are rarely any incentives or bonuses and it's a dead-end job. Once someone becomes an aide there's no place to go from there. Agencies don't offer tuition reimbursement or any assistance at all for education and the schedules are awful.

I've heard talk of unionizing the industry but no one cares enough about their job to go to the lengths one would have to go to in order to unionize. There are no industry leaders or mentors, no one to go to with issues. It's a terrible job that most aides hate doing. But they're stuck in it.

Statewise, check out the answers written to your other similiar question: https://www.agingcare.com/questions/Should-a-health-care-agency-call-a-head-of-time-to-inform-you-about-the-aide-who-is-coming-to-a-clie-438076.htm