Hi. My father will be discharged from rehab to home where he will have a 24/7 caregiver. What should I arrange in advance, with respect to daily schedule and the caregiver’s obligations/expectations? I’m aware of the categories of work to be done but I believe it would be good if the caregiver and my father (who is able to participate in these discussions) could adjust needs and expectations over time. Also, what should I expect the caregiver will need for him/herself? (Food provided, other items?) Can they be expected to help my dad in the middle of the night with bathroom/personal cleaning needs?
I would think they can’t be expected to be work without a reasonable amount of sleep. However, my dad is incontinent and I don’t know how that will be dealt with at night. Also, I’m finding it difficult to locate objective reviews of caregiving companies. Any suggestions for finding this type of information? Finally, is it necessary for the company to provide case management services? A company I know of charges a lot just for speaking with the case manager. Thank you very much.
I know this caregiver passed the virus to my mother because she also got Covid and was the only one who did.
I didn’t hire her........my brother who has DPOA did & I don’t have any say in the matter.
This caregiver is living rent free with many amenities that my mom is paying for such as internet, contour TV, food & more.
Also, she won’t quit because she got evicted from her last residence so she has no where to go. My brother had her move in because he didn’t want to care for her & removed her from the nursing home where she was doing well. She has dementia........and if she didn’t she would never want someone she didn’t know living in her home.
He knew her for a short time before she moved in & never did a background check on her & she is not licensed, certified or insured. She has no qualifications to be a caregiver!
There still is a pandemic going on if you’re not aware!
I will be totally honest with you and having been in senior in-home care for a very long time, I can tell you hire two caregivers if you need 24 hour care seven days a week.
One who works during the week and one who works on week-ends. Or you can do it where they each work half the week and split it. This is a good way to do it because you won't have to arrange other help for your father because the caregiver has the day off. That's another point you should know about live-in caregivers. A day off is 24 hours. Not the daytime off, 24 hours unless you work out some other arrangement with the caregiver. Speak with the potential caregivers that you may hire, and ask them to write down what their expectations will be.
The expectations that go without saying, is the caregiver will have their own bedroom in a house that is safe and clean. If you expect them to also do cooking, then a working kitchen with usable cookware appliances that work. If your caregiver is expected to clean and do laundry, then cleaning supplies and appliances that are in working order. Many times elderly people's homes have been let go over time and things like washing machines, vacuum cleaners, stoves, etc... don't work. I had an assignment where the washing machine the client owned was a ringer-washer from the 1920's. I had no idea how to work that and refused for my own safety to try. The family couldn't understand why the client's clothes and bedding weren't being washed.
You can expect the caregiver to help your father in the overnight. If you're only hiring one person, their days off will also include their nights. People can only go so long without a night's sleep.
Other than groceries, private room, and a workable environment the caregiver will unlikely expect more.
As for the job adjusting over time. That's reasonable. If his condition changes the job does. That being said, the pay gets adjusted too. You may also have to bring in additional help.
If you have cleaning service coming once a week for the big jobs, the two day time caregivers could have a list of light housekeeping chores to complete each day such as cleaning his bedroom area, wiping down bathroom after bathing/showering, wash all of the towels and items used during bath, preparing meals, doing all the dishes before end of shift. If you won't have a cleaning service, just create a list of all chores to be done daily, weekly, every other week, monthly. Then divide all the chores evenly into two groups of time spent doing them and level of physical strength. Then swap the two lists once a week so that each day shift person does about the same amount of work. Like both day shifts would have meal(s), the AM person dusts everything today and the PM person vacuums, the AM person thoroughly cleans bathroom today and the PM person cleans the entire bedroom, etc. They have to have time to tend to dad in between chores. They should be expected to be working - you get paid XX per hour so should be working - not on the phone the entire time they are there. If you balance the chore list, part of their time can be sitting on the couch as long as they are interacting with your dad.
I would look for an agency that can provide the 24 hrs of care you need and, up front, find out what happens if the next shift person fails to show up - does the previous shift person stay and wait on replacement or do a double shift (OT at agency's expense because these employees belong to THEM). The agency who sends people, like visiting nurse, to see my parent will take any call that I make to them and get answers.
When considering the job task list, definitely ask dad for his input. And let agency know that he may change it up from time to time. I also strongly urge someone in the family to drop by from time to time, unannounced, to see what's going on. Too common to get in home help that is addicted to the phone/social media/movies. Since dad is of sound mind, this will irritate him to no end when he sees someone being paid by the hour out of his pocket and they aren't lifting a finger. You want to meet these people and let them know you'll provide certain snacks or food they may like if they will give you a list.
Get groceries delivered to the house so that a caregiver is not leaving for shopping trips or the problem of trying to keep up with someone having his credit card or cash - that's a whole 'nother can of worms! Many drug companies can do mail orders as well. Call his to find out what they need to set it up. Then you are in charge of placing the orders and can keep a better eye on when drugs delivered versus what is left in the bottles on any given day you visit. Especially where pain pills are concerned - the sweetest old lady in the world to your dad could be addicted and pills come up missing.
If you hire privately, what will you do when the 1 caregiver gets sick?
My mom had 24/7 care at home and we had a team of women.
About the night time toilet issue...when they checked on mom at night, if her gown was dry (she wore diapers) they were to just let her sleep. If her Otherwise she would have never had a full night's sleep. She never had skin issues from it, and most people don't wake a sleeping baby in the middle of the night just to change them either.
What I found worked great with incontinent clients who were diaper dependent, is to literally use a trimmed down baby diaper as a liner in their diaper at night. Baby diapers are made of different material than adult ones are. They can be totally saturated and yet the surface stays dry.
The problem was that she regularly went out whenever they were there and socialized with all of her family from multiple households.
3 days after Christmas she got Covid and gave it to my 98 year old mom.
So, where's the problem of her leaving when they were with your mother? These were the terms and conditions under which you hired her. It wasn't her job to be there when your other staff was with your mother. You say so in your post.
How do you know she infected your mom with Covid and that it wasn't one of her CNA's or someone else?
If you were concerned with her possibly bringing Covid into the home, then you should have told her that she isn't allowed to see anyone other than your mother and must stay isolated in quarantine in her house. That she can see no one other than your mother and must stay in the house at all times.
This of course sounds unreasonable because it is, and no one is going abide that. Your caregiver would most certainly quit if this demand was made.
It sounds to me like your private hire did her job exactly as you hired her to do it, but you want more. You expect your hire to be in the house 24 hours a day and have no other life outside of providing companionship to your mother. It sounds to me like you don't want a caregiver/companion for your mom. You want a saint. Sorry, ain't gonna happen. Saints don't work for caregiver wages.
Typically a Live in caregiver will work 4 or 5 days and they have an 8 hour sleep or "off" time. If your father needs care during the 8 hours the caregiver is off will someone else be there? And when the live in is off for 3 days who will take over the care?
I am sure if you are going through an agency this will be covered.
If you are not going through an agency you might want to "interview" one just to see how the time off and days off are handled.
When i finally found a caregiver who related to my husband (I went thru 4 from the same agency) I told her that her first concern was my husband's well-being. If all she did was sit and talk with him, and help him dress use the bathroom, and eat, that was fine with me. I left a schedule of house cleaning, IF she got around to it; laundry and straighten up kitchen as needed; mop his bathroom every day, clean sinks, toilets, shower on Mon and Thurs;;vacuum on Wed and sweep and mop on Tues and Fridays.
She would have done all of that everyday if I hadn't broken it up. (She still does what she wants as far as house cleaning everyday, but I've told her not to overdo it. She just smiles!)
Lorraine has such a rapport with my husband that I pretty much let her do what she wants. She can cajole him into showering, taking his diuretics, going for a walk, everything to keep him safe and as healthy as he can be. When he is in an ugly mood, (I am a heartless bich, he wants a divorce, he's going to move out, etc) she can redirect him into a calm happy state. I wish I could adopt her.
Hugs!
They do need a break and they can not work longer than is legally permitted. So you will need at least 2 caregivers.
It might be best to have one day and one night. This way no one person is working 24/7
The person that comes in at night does not need to have the same qualifications as the one doing more of the caregiving. (unless there is a medical reason like dressing changes and administering medications that your father can no t pick up and take himself)
The person that is there at night IS expected to care for your dad if he needs it. They should be taking him to the bathroom if it is necessary. Or they should be doing a brief change and repositioning him if needed. If your dad wants a glass of water at night then someone needs to get it if he can't get it himself.
Expectations...
If the caregiver is from an agency they should have a list of typical tasks that a caregiver is responsible for. Light housecleaning, laundry, meal preparation, interacting with your dad. If you expect them to take dad to the doctor then make sure that the person has a valid license and if they are insured. (your dad's auto insurance will cover an authorized driver)
Interview SEVERAL companies and when you select the agency I would also interview the caregiver along with your dad to see how they get along. If it does not work out you can always ask for another caregiver.
(by the way if your dad is a Veteran check with the VA to determine if he is eligible for any programs. might be faster to check with your local Veterans Assistance Commission Office. they do this all the time and the services are free)