How to manage when home health care aide is not available?

I had the same problem w/the agency. Now I have ppp for my father I can hire whoever I want.

It’s unfortunate but a widespread problem right now that Aide availability is difficult. Many Aides are mothers with young children who they now have at home because schools and day cares are closed. Most Aides have schedules that have them seeing several different clients in a day and are afraid of being exposed to the virus and possibly transmitting it to other clients or brining it home to family. Agencies are struggling to keep Aides that want to work full because clients are turning away Aides at the door because they are afraid. Agencies are also struggling with the added expenses and difficulty obtaining PPE for their worker. Maybe look into Consumer Directed Care where your parents hire their own Aides and the CDC program acts as the employer, collecting time sheets and processing payroll. Are you just working with the Aides hiring agency or working with and Area Agency on Aging (AAA) or Aging Service Access Point (ASAP). The AAA or ASAP would assign a Case Manager to assess Mom’s needs and assist in finding a caregiver agency they contract with. They will also offer support for you and your father as Caregivers. Hopefully as things begin to return to normal after this is over there will not be such a struggle to find Aides.

I found that the agencies that paid at or near minimum wage have really awful reliability. It is a chronic problem.

I found a wondeful woman through friends. I told the agencies to hire her, AND pay her $18 per hour. As the insurance company was willing to pay $25 per hour...the agency would still make a profit...maybe not the massive one they could get...but still a profit. I told the agency owner...if they didn’t want to do that, I would take the business elsewhere. I wanted a reliable, dependable person...and I know that it is t possible on a wage that the aide could not live on.

to florida DD. I agree cameras would have been helpful to verify the details of what goes on at my parents house. it is their house after all-not my house where cameras would be in place for sure.

I've had the same Home Care Agency for 7 years. Rarely do any of the aids call in and say they can not be in on a certain day. I think you need to find an agency that has more reliable staff. None of this day off, etc. A commitment is a commitment. to be there and on time. See what Medicaid can do for you. Be specific about what you need.

Yes don’t rely on one agency & days when nobody shows up, leave her in bed. Does she have hospital bed, chucks under her in order to reposition her in bed? Hospice can order any supplies needed. There’s going to be days nobody shows up because that’s how most Home Health Aides are. Hugs 🤗

My parents, in their 90's, have 24/7 care now for the last several months. They refuse to go to assisted or retirement living. Mom has gone thru a lot of the agency caregivers for one reason or another. Some care givers have been very ill even before corona and came to work. Others were lazy, sleeping most of the day in the back room, or had a bad attitude-aka abusive. One lady was very young and I thought she was energetic and sweet but that wore off in a coupe days when she refused to do anything my mother asked. Caregiver said I can only do what dad needs not what mom wants-needs, also setting what time was break time, lunch time and for how long. The care manager even filled in while she rounded up a replacement for someone who called off. There is no perfect solution here. It is extremely tough exhausting mentally draining for one person to do all caregiving-as seen by many who post here about being the sole provider for family member. It is hard to size up-interview people first to weed out all the bad apples-I have seen in multiple environments-hospital care, rehab care, home care and nursing home care. My dad has memory issues and did not remember or report that caregivers were not being nice. Mom was afraid in the beginning to complain-that caregiver would get angry or leave or thought maybe the caregiver was having a bad day. Mom did not set the expectations up front-she even let caregivers set the limit what they would or would not do-so caregivers got away with doing almost nothing most of the time-parents were at the mercy of a new caregiver every day. Team is more stable now bad apples have been weeded out for the most part. If you can choose interview caregivers ahead of time do that for sure-don't know if agency will let you do that. Call off days are going to happen no matter what and might be some lag time before a replacement can be available for call off person.

I would say an adult foster home is best for your mom. With lots of caregivers from outside, this is not safe. With good checking from both sides regarding the Covid before admitting, your mom would be admitted and the staff (only 2 caregivers ensuring constant care and not much exposure) would offer the best care. Adult foster home are regulated by state and respect county/state policies. We are not allowing any visitors from outside for now. If families want to visit, they can see their relatives, but at the window wearing masks. We can talk more if interested. Please visit casashattuck.com for more details. Thank you!

Ask the Agency what they are suggesting during this Novel Coronavirus.

Unfortunately with the virus, this is probably the norm. Just make sure you are keeping a calendar of when they do/don't come to make sure Medicaid is billed correctly.

Is there a family member who can go help dad out until things return to normal? Also talk with the agency to find out if they are hiring additional fill-in workers or just waiting on regular employees to return. That might be an indicator of how long someone needs to go help dad out.

The problem of the virus will be with us for a while so I trust you will be able to find someone who truly is "Called to Help" and not someone who is 'just there.' My friend has two children at home and she stopped working during this time to assure that she does not carry it home. With more testing been done and restrictions being lifted we all need to do our part in responding to this health crisis. I understand that a second wave will hit us and we all need to be prepared. May you find someone to help - you've got a lot of suggestions. Thank you for sharing with us.

Wow! Tough situation, during this Covid crisis. The agency should provide a replacement, BUT if they have no one else...
I would ask the agency what they suggest
Also, look for another agency that accepts Medicare.
Do you have a relative that may help in a pinch?
Best wishes to you and your family.

Complaining isn't going to do any good right now. No one cares about your complaint because everyone seems to be in the same boat. All the agencies are overwhelmed and understaffed. Call around. Get your parents signed with other agencies. I wouldn't hold my breath. You may have to go private pay when an aide calls out.

It may be time to hire a fulltime caregiver and allow the agency to be the back-up.

My MIL had round the clock home health aides until a place opened in an adult day program. Then, she switched to ADP and a night time caregiver, When COVID-19 hit, she switched to 2 caregivers - 1 for daytime and 1 for nighttime. Maybe one of these options will work for you.

it is going to be very difficult to find anyone to work (other than people already employed) because of the additional 600 federal unemployment (on top of regular state), until 7/31.   I don't like paying off the books, but you may have to.  If your church or community has an electronic bulletin board, might try that.

My coworker dealt with this years ago. It is all too common a problem....a worker calls out and there is no one to fill in. Often the senior NEEDS someone there and the family is not available to fill in. What is the point of hiring a carer if you still have to be on call when they call out.

I agree with the poster who said with so many out of work maybe you could privately pay and extra set of hands.

With so many people out of work, you should be able to find someone to help out, especially if you pay cash.

Is there any way you can take a leave of absence until you can get this situation straightened out? Nobody will be as reliable as you. Just wondering. Good luck.

I worked with a company for a short time ( 3 Yrs)was paid horrendously low wages. I quit taking clients from the company and began working with people Who contactEd me personally. I begin by interviewing potential client and tailoring shifts and care around their personal needs I usually have a few clients at a time. I’ll take an admin salary for the month and coordinate seven other care Caregivers to cover shifts at both clients. The girls and young man I work with are working around other jobs/school they have. I train them for the clients changing needs. Caregivers text me when they arrive and when they leave, They all write in a group Google doc about their shift and if anything has changed. family members have access to cameras in each room, to see How mom is being cared for. I like the accountability in the system that I have set up. If family has a concern or clients needs change I am there with each caregiver teaching them what is expected for the next phase for this person. I have never had a no-show. I’ve had a very close call when a caregiver had automobile problems, I took that shift immediately. Usually I’m contacted a day or two before they have a conflict and need to call off so I can switch them with another caregiver or take the shift myself( I never penalize them for needing to switch their shift) I’ve even had one of the family members who is going to cover a day contact me after getting sick, again I was able to get a caregiver in there without much delay. Families pay $20 an hour and I charge a monthly admin rate. We cover 14 hour care a day with one client and 3/ 7 hr shifts with another one. I insist Families have cameras on their parents so while they’re sleeping/ alone they’re able to make sure they’re safe. At some point both these clients I currently have will need overnight care. I’m trying to save the family money by looking for one of the young people to possibly stay with the client instead of on the college campus. There are people out there, to stay with your parents that are reliable, But it is expensive. The girls understand they are really not employees they are simply contract laborers and it is their responsibility to take care of any fees they may have with the government. Because I work with so many helpers That our students rarely is one doing more than two shifts a week, during Covid four of us were all that was left it was working because so many have other family members who needed help we have had to work over our normal amount but we have continued to have coverage . Working with a company in my opinion is Hard for a good caregiver, and they don’t stay with the company long( Smart families hire them away). When I worked with a company, I was frustrated to come in after a caregiver who left a mess or be asked to stay longer shifts because people are so unreliable. It’s even more frustrating to show up after someone else’s shift and find they did not cover their responsibilities. Worse they’ve stayed around to talk or gossip, that does me in. if the caregiver ever has me concerned about the client safety I would simply not put them on the schedule, I have never been put in that position yet and been doing this on my own for three years after having two relatives live and die in my home with hospice over the 10 years previous to that.Talk to people you know at church or senior citizens centers, look on boards at both places. Ask around at Parkinson’s support group, dementia support group. I was found at a Parkinson’s breakfast when I attended with my aunt who had lived with me. After my aunt passed away, I began helping families To see what can be done in their home with appliances, programs in the area, friends they may know that are willing to help, who just need small amount of training, or area nursing schools are helpers that can be found that are reliable. I do not work with someone I do not know unless they are referred by a friend. It’s a journey blessings.

I just left a facility with COVID-19. I entered a SNF in early February before disease spread was known. It was frightening as the facility worked to get proper PPE and testing for patients and staff. There was virus when I left. I tested negative but I'm in quarantine for 14 days in a board and care before even thinking of going home.
So if you look for facility check out how they are handing COVID-19 issues. Such as no visitors, masks and gloves at least on staff, and restrictions on patient movement. This is life in the time of COVID-19. F you don't like the restrictions, then ask the people in Washington state SNF where the delightful St Patrick's day dance and party turned into to a horrid disease spreader and resulted in many deaths.

In the time of COVID-19, all bets are off regarding healthcare workers. I just spent 3 months in a SNF as the news of virus gradually grew in our understanding and PPE available for staff. As the crisis progressed, the fear of staff grew and grew. Their lives are at stake. I praised them for showing up.

Please find another agency.
I was a CNA for several years. I was never allowed to call my client. I could call my supervisor and another caregiver would be sent to the client.

Good luck. I live in Pa. , and caregivers in this state are either calling out sick or quitting their jobs because they fear the Covid-19 problem, My wife has Parkinsons and I am taking care of her. I had to quit working to care for her, but I still would like to find an agency caregiver. My wife has to take her Parkinsons meds. every 4 hours, which is burning me out. Good caregivers or even a half good caregiver are a rare commodity. Good luck.

Aides can be flakey, but please know that there are dedicated and reliable ones out there. The idea of working with a couple of different agencies might be helpful, being sure that you hire from both agencies enough to be worth their while, of course. There are good agencies, and I hope you can find one. I live in a small, not fancy, not wealthy town. One agency who helped us a few hours a couple of days a week was exemplary. As an example, when my mom (primary caregiver of my stepfather, though others in the family were significant helpers/caregivers as well) had to be hospitalized, the _owner_ of the agency appeared at the house the minute he heard that. It wasn't just greed. He was genuinely concerned and wanted to make sure a legally blind frail diabetic was not all alone with no care. If an agency has an emergency/afterhours number they are willing to give you, and a human who is not just an answering service answers the phone, that is a very good sign.

I have the same problem with my mothers aids .
These people are not reliable, also they earn minimum wage, so tjey are not motivated. I call the agency numetois times and complain,

I went through four different agencies before finally finding one with reliable caregivers. I recommend asking thorough questions of each agency, the current one I'm using raised pay and increased minimum hours to keep caregivers showing up.

If you're thinking of placing them both together, it might take a while to find placement. Unfortunately, it is very common for aides to call out. Is there another agency you can use? You could call the hospice company and threaten to transfer your Mom's care to a different agency if they call out like this on your Dad. They get big bucks reimbursement for Hospice care; try to put your foot down on all the calling out. I'm sorry this is happening!

Di, I think that flaky aids is a common problem no matter what else is going on.

Find out if you can employ 2 separate agencies to ensure that your mom is getting the care she needs. This would give you a larger employee pool to choose from.

I would also encourage dad and mom to tell you the names of the aides they like best and then see if you can request those aides specifically.

This is a difficult job and it hugely underpaid, so unfortunately it doesn't really draw people that have lots of ambition to be there no matter what and be stellar while there. Not saying that there aren't some amazing people doing these jobs, saying it is difficult to find them.

Best of luck and thank you for stepping up and doing your essential job so the rest of us can continue to have the essentials right now. Everyone doing that has my gratitude and admiration.

Certainly, call other agencies if you're not satisfied with who you have. Don't assume they all have the same staffing problems.

My MIL is in an awesome facility and have been covid-19 free...until today. One of their employees has tested positive. In your case I think it is going to be a challenge to keep up steady staffing and you should plan to be their help, if you can. If you've been quarantined and healthy for 2 weeks, you can consider this pretty safely. If this isn't an option I really don't have any other ideas, but maybe others on the forum will.