How to find caregivers, much less respite care?

This is such an old thread, but I am in another care coordinator job, and I have learned so much more. Needhelpwithmom, first I just want you to know what a kind caring person you are. That you asked for ways to support the caregivers...well that touched my heart. So often caregiving is seen as a job, where one works and gets paid. But a great caregiver brings so much to the job, that the pay cannot begin to cover. Needhelpwithmom, the caregiver would appreciate some emotional support, mostly through open communication. It takes many months to really get to know a client. Some clients are easy, in that they openly appreciate the good work being done. They thank the caregiver appropriately, and are pleased when the caregiver does little extra things to make life more pleasant. There are clients who literally treat caregivers with disdain; ordering them around, humiliating them, and generally being miserable. Most clients fall somewhere in between these extremes. The caregiver will benefit from knowing that she is doing well. When the client won't or can't respond, the caregiver may worry that she is not doing her job correctly. I do well when I have someone in the family that I can ask when the clients response is ambiguous. Developing a rapport with your caregiver, and giving her a way to express her concerns, questions, and complaints is key. Be aware that there are caregivers who may lean too heavily on you for support, and that is not good. For the most part, having open communication, even about uncomfortable or unusual subjects, will serve to make the quality of care better. You will also end up with a dedicated and loyal caregiver that will flex with the client's needs.

I like Rabanettes suggestion of finding someone also caring for a LO and trading / sharing respite care with each other. I would like to find someone willing to share care also.

Since money is an issue, here are some suggestions. Call your local agencies that work with elderly, the Jewish Federation, your church, etc. Talk to the people in charge about your situation and find out if they offer any volunteer services, someone who could sit with your parent, even for short periods of time. Anything is better than nothing.

I also wonder if you could trade with another adult who is caring for a LO. Could you each watch both of them for a limited period of time, allowing the other to have a respite? Let's say it's from 11am to 2pm, so 3 hours. You make lunch, they take a nap, watch some tv or read, and 3 hours goes by. Just a thought.

I guess we were lucky. I found a companion service thru the Cleveland clinic that was monitoring Luz's dementia, etc. Nearly all of them were really good. Some never returned and near the end we were getting the same woman when I needed help.

PS, It took Judy’s sons 7 months of my consistent care for them to relax into truly trusting me. By the time Judy passed, they treated me with such kindness and respect. They were so right to hold back their trust and friendship because I could have taken massive advantage as any caregiver can. I had an open door policy. One of the sons would let me know, even when another caregiver was on duty, whenever a family member or friend was heading over for a visit. I told him emphatically that anyone could walk in at any time on me or any of my caregivers, because we were always ready. He stopped letting me know of impending visits. That really helped him develop trust in us as the house was always tidy, and his mother was lovingly cared for whenever anyone showed up. When you gradually develop trust in a caregiver, it is real and earned. Then you can allow them more responsibility and you can really relax. It sounds draconian, but there are a lot of deficient caregivers out there. I wanted the family to know that we were different.

Needhelpwithmom, it is a partnership, but you are the boss, and I think that needs to be established. It is fairly easy to go from structured, and requiring specific tasks every day to letting the caregiver direct more of their time. It is almost impossible to go the other way. Make your caregiver earn her right to some freedom of decision making. I think I indirectly caused the demise of one caregiver, because I was really nice, and I gave her all kinds of leeway. She was nearly perfect for 5 months, then she started almost regressing. She began to seek out the favor of the lady we cared for. She was grabbing hours from other caregivers. One of her responsibilities was to report the hours of the other 3 caregivers so that I could send payroll to Judy’s son. She started to slice an hour or two off of each of them, and add it to her time. She tried to get Judy to fire other caregivers. She tried to get Judy to cancel the family Thanksgiving, in lieu of a quiet Thanksgiving with herself, her children, and Judy. Finally I fired her for making a deal with Judy to have her daughter and niece clean the huge house for $300 a week. Except that they spent less than 3 hours a week cleaning, and the house just got increasingly dirty. $300 quickly turned to $600 a week. Judy was allowing her to take the debit card and withdraw the money from the atm. Judy’s Dementia prevented her from figuring out what was going on, and how much money was being taken every month. I feel that if I had managed her more, and trusted her less she may have continued as a decent caregiver. She may have succeeded if the temptation wasn’t there. After that, I learned. Don’t be afraid to hold to expectations. As a caregiver myself, I know that I am better at my job when I know exactly what is expected of me.

I am a private caregiver. At my last position I was in charge of hiring, training, educating, and giving support to 3-4 other caregivers. I don’t have answers but I do have a few tips. There are schools around that prepare prospective CNA’s for their certification, and MA’s for the same. Give them a call. In my CNA class, out of 20 students, about 7 were really good. Private caregiving is so far superior to NH employment, low wage or not, you may find good ones who are interested. Ask the owner to recommend some good students. Many will do it full time and more will do it part time. You may have to work with 3-5 caregivers a week. I found that as long as I scheduled them for the same days and hours every week, the lady I cared for was fine with the variety. Each one brings something different to the game. Also, I would suggest that you run background checks on everyone, DMV checks, and check their license if they say that they have one. Check that they have reliable transportation. You wouldn’t believe the days that I had to cover because A, B, C, or D had happened to their car. If you run an ad in the paper, be bold and list specifics. I didn’t accept anyone with a felony, or any misdemeanors having to do with abuse,or theft EVER, or drugs unless it is and old offense. If they have it ask for the numbers of folks they have cared for, or family members of the people they have taken care of. In my experience, a lot of references are friends set up to pretend, so unless it is someone they have cared for don’t put too much stock in it. See what you have to offer. I have worked in cockroach infested homes, and other unsavory places and was paid by Medicaid, so you definitely have something to offer if the home is pleasant. Like many other careers, there are awful caregivers. In the 15 months of coordinating the care for my friend, I hired 10 caregivers, fired 3, and lost 3 to my lady’s outrageous behavior. I finally figured out to ask everyone, especially home health workers, caregivers, and family of caregivers if they knew of anyone they would recommend. Train, train, train. Write out what is expected of a caregiver every single shift. I made sure that the morning girls made the bed, cleaned up her room, and cleaned and changed Judy into a new brief and clothes. You don’t want them sitting on the couch watching TV all day. Tell them how you want things done, exactly. Check up on them regularly. Be authoritative. They will respond. Give them a probationary period where you can let them go for ANY reason within a 30 or 60 day period. Put that in writing and have them sign it. Give them notebooks and have them document everything they do; what meds are given and when, what tasks are completed, what foods are fed, etc. Go over their documentation to be sure it is complete. You aren’t asking too much, and the pay is fine. Caregiving is a tough job that no one does for the money. But it is also a pleasant job where the caregiver has a lot of control over their time and activity level. It is also very rewarding.