What should I expect a caregiver to do or help with?

I get caregivers for respite. My husband has Parkinson’s as well.
I do not expect them to do anything. Actually the don’t have to, my husband is perfectly capable of taking meds, dress himself, go to toilet.
I was pleasantly surprised when one lady did dishes!
Realize they are not maids so why would they clean up or do laundry which usually will be for entire household.
If I want housekeeping done then I hire maid, cleaner and I can tell them exactly what needs to be done.
Recently I paid $500.00 for deep cleaning after moving out of our house.
It is simply not fair to expect people to do both housekeeping and caregiving.

I assume each person has different needs, here is what my caregiver does for me.

I cannot drive anymore. My caregiver takes me where I need to go, we use my car. I can take care of my own bodily needs . She makes my bed, does my cooking, I hate to cook and it hurts my back to stand for long periods. She makes my bed and keeps the floor clean. I use Instacart for groceries, she puts them away and takes out my trash. I have a cleaning lady that comes once a month to deep clean my apartment. I hired my caregiver through a service. it is expensive, but if Yolanda cannot make it they are the ones who find a replacement for me. Also, she has workman's comp and other insurance.

Caregiver should help him
clean himself: shower/bath, hair, teeth
groom: comb/brush hair, shave, put on deodorant, cologne
help him dress
help him toilet: transfer to and from commode, wipe afterwards, clean hands
meals: prepare his plate of food, light cooking only, feed, clean up dishes afterwards
remind him to take his medications - only a nurse can dispense medications
check his blood glucose - you will need to give insulin
socialize - talk to him, help him with hobby/activity
light housework - straighten up room, clean up messes made by hubby at the time it happens, empty garbage can when full, wipe counter/table after meal/activity

Hello Sherry6510,

I am not sure if I understand your question well. However, in my view, you have to decide who is the main caregiver, you or the hired hand? The roles must be well defined, and you have to provide proper supervision to make sure everything goes as you have planned it.

I was 65 years old when my wife was diagnosed with FTD. I knew that I was not going to be able to care for her alone. That is why I got started with hiring and training aides to provide proper care for my wife at home. I chose the more difficult alternative of hiring directly rather than choosing the service providers route because I thought I could manage the process more effectively.

I quote a few paragraphs of my recent book "Dementia Care Companion", available from Amazon which I consider related to your question:

Do Your Due Diligence
Remember that you are inviting this person into the inner sanctum of your home and entrusting them with the care of someone extremely vulnerable. As much as you may be eager to get started, do not lose sight of the fact that a bad match can be a lot harder to undo than you might expect.
·      Ask the applicants about their previous work experience. Ask for references and contact them to get their views about the applicants and their abilities, personality, and work ethic.
·      When you find a suitable applicant, do a background check to make sure everything is as it appears and there are no hidden issues or unpleasant surprises down the road.
Prepare and Sign a Formal Contract
·      Write up a job description and go through it in detail with the candidate. Discuss work hours, what needs to be done for and with the patient, any cooking or cleaning, and so on. This job description must be flexible so it can be updated as needed over time.
·      With the help of your legal advisor, prepare a contract spelling out working conditions, responsibilities, compensation, justified and unjustified absences, the existence of a monitoring device such as a closed-circuit television (CCTV), and so on.
·      Have the contract signed by both you and the applicant, and witnessed by at least one impartial body, before having the applicant come to work.

Train the New Staff Properly
The training period for a new aide will vary according to the complexity of the work. Caregiving is delicate work and learning to do it safely cannot be rushed. Take the time to make sure the new aide learns the nuances of care, such as the intricacies of how to handle, move, and feed the patient.
·      Before you leave a new aide alone with your loved one, make sure that they know what their duties are and can perform them well.
·      Train the new aide in emergency procedures, such as falls and fires. Periodically review the procedures with everyone to make sure they know what to do in case of an emergency.

Provide Clear Supervision
An experienced aide understands the caregiving needs of dementia patients and is familiar with most of the issues that are part and parcel of this condition. However, even experienced staff need proper supervision to make sure that everyone is pulling in the same direction, and everything is done according to the broader roadmap.
·      Have a single person in charge of supervision and management of hired staff. Do not let friends and family members bombard a new aide with a request here and a critique there.
·      Let everyone know that all suggestions or comments regarding the care process should go through a single individual tasked with supervision and management of the hired staff.

Stay Vigilant
·      Use closed-circuit television (CCTV) in the rooms frequented by the patient and the aides. Let the new aide know that you have a monitoring system installed, and preferably, state this fact in their contract. Unfortunately, patient abuse is a reality and people with dementia may be unable to report such cases to anyone.
·      Keep expensive items, jewelry, and cash in a secure place. will help gi

Wife told me that I was to do whatever her husband could no longer do. That's exactly what she said. She wanted me to go take the bulbs out of two large Candlebras over a huge dining room table, climb up a ladder that I was told to get from the garage, unscrew the bulbs along with the shades, Wash rinse, dry, and put them all back. I was also to mow the one acre and pull the weeds. I reported this to my office. I got a call back from my office stating that she's told them she never asked me to do any of this!!!! This could have cost me my job and my livelihood. And she said she was a christian!!!! I had a son tell me that I was to ALSO take care of his mother while his father was my patient. He got angry with me when I told him I could not do that. Two for the price of one!

So much of the time I am told by wives to NOT take care of hubby, but there had to be some reason that he got all these hours of care ok'd by the VA. I am sure the wife didn't say I'm just gonna have her come in here and clean the house because that would not be a legit reason to get home health. We are to do LIGHT housekeeping... We don't come in and clean the whole house. We don't come in and clean kitchens and bathrooms and other areas of the house that are filthy. What we do is this: We are to clean up after ourselves, We clean up what we have used, messed up while taking care of our patient. We don't make meals for everybody. We don't do everybody's laundry. We are not to clean up after everybody's messes, including their dishes and the kitchen or anything else the family does. We do not make meals for everybody in the household And we do not go get fast food for everybody in the family. We are not housekeepers. Please do not take advantage of aides.

Yes , There are care plans on every patient but I have families much of the time claim that what I tell them is on the care plan is not what they said they asked for!!!

Just to let you know-- I have been doing this for thirty years and I am now 71 years old. I'm still working doing this and they still try to get me to do things they have to know that we're not supposed to be doing??? . It is sad. And caregivers get abused. And by the way , I have also been a nurse and if they end up finding out, they try to get me to do nursing duties.

Sherry6510: The caregiver's duties are established by you via a care plan.

It sounds to me like you want a caregiver for your husband and a housekeeper for yourself. Two different jobs - two different hires. You have to be clear as to what you want from each person. Nobody can know that without clear communication from you. Both of these positions are hourly minimum wage jobs so you have to have realistic expectations of what they should be doing. You don’t get a skilled private nurse at minimum wage.

What does the careplan say the caregiver's duties are? If you went through a homecare agency there should have been a care meeting where the careplan was made and any documents and contracts are signed before any caregiver is sent to your home.

You should also have an information packet which explains about different kinds of caregivers and who does what.

CNA (Certified Nurse's Assistants) caregivers are the people who do personal care (bathing, washing, incontinence care, personal hygiene, and some even handle and administer medications if they are specially certified). Some CNA's will throw in a load of laundry or make a light meal for a client. These people are not housekeepers, cooks, or drivers. Their job is the personal care of the client they are hired for.

Homemaker/Companion - These people do not do any hands-on personal care for the client. Their job is LIGHT housekeeping (vacuuming, dusting, mop floors, change bed). They also do laundry (foor the client only). They shop, run errands, cook, and drive, and accompany the client to doctor's appointments or other outings. They work for the client only.

The caregiver is not a full staff of domestic servants for the whole family in the form of one person. Many people make the mistake in thinking they are.
It is not any hired caregiver's job to clean a home that requires heavy duty professional cleaning or to do for the other family members.
Many clients are beyond the scope of practice of a CNA or a homemaker/companion. If such is the case they need a higher level of care.

Thank you for your question. I am in a similar situation and am not good at delegating so I appreciate and plan to use some of the suggestions others are giving. I think it is harder for caregivers to step up when the patient is living with a spouse. We tend to do things automatically and are there to pick up the slack where if the patient is a living alone, it is more obvious how a caregiver can help. Right now I am using an agency because the VA provides caregiver hours. We are to the point I am considering hiring privately to get extra hours and I realize if we do that, I will have to better organize and communicate my needs more clearly. Whether we use the agency for the extra hours or not, it will be coming straight out of our pocket so my expectations will be higher. I have asked several caregivers not to be sent again after feeling they did not earn their salary the first time. For that reason, I may only use an agency because I am sure firing will not be pleasant.

Burntcaregiver should chime in

Was aide hired for both of you or just your husband. If just your husband, than she only does tasks for him. If she makes him meals, she cleans up the mess. He soils his clothes, she throws them in the washer and washes them. She cleans up after him. Keeps his area clean. Should change the bed he sleeps in and clean the bath he uses.

Now if you are paying for help for both of you, she should be doing for you too. As listed below, she should be doing laundry, dishes, shopping and light housekeeping. And also helping both of you with physical help.

I would suggest you start here: write down everything you need done. Put in order of priority. What is most important that needs to get done that day? Add those to that day's list. May have to add doctor's appointments, grocery shopping, pick up prescriptions, haircuts., etc. Every week, on Monday do laundry and change bed linens, shower day.. Every Tuesday do some vacuuming., do mopping. Every Wednesday make sure bathrooms are clean. Thursday, another shower day. Every Friday check patient supplies such as Depends, wipes, pads, etc. Caregiver comes 5 days a week- have a list of things you want done each day. CG checks off what she got done. Every day I am there, I clean kitchen, gather garbage from bathroom and kitchen, take out to bin. And of course, this list is NOT WRITTEN IN STONE. THINGS HAPPEN. Making Meals, feeding him, changing, turning him, brushing teeth, shaving are priority and done throughout every day. He needs to be turned every 2 hours while in bed. May want to keep a daily log. The caregiver can do this. After the caregiver has been there for awhile, more and more you will not have to be "around" telling her what needs to be done. Please get out of the house! Take care of yourself! Put in cameras!

First you ascertain if the caregiver has experience working with a person with Parkinson's, diabetes, and vascular dementia.
* Don't take 'yes' as an answer.
* Ask them how they worked with people with these needs. Ask for examples.
(Critical thinking is required; they have to be able to think on their feet - and this comes with experience. How much experience do they have in these specific areas?
* Can they support / lift as needed?

You write down exactly what you want the caregiver to do.
Create a list of 'to do's' and go over it with her or him.
When in writing, it should be clear what your expectations are.

If you/r husband is sleeping or doesn't need care-giving at times, you find 'choices' that you want done, i.e.,
- wash the dishes
- do laundry
- shopping
* Do NOT allow a person to 'seat there' and be on their phone. Give them a break as needed although caregiving should be more than 'sitting' and waiting.

* If you need a SPLIT SHIFT, ask them if then can do.
* Find things for the person to do when 'direct' interaction is not required.

You check references (ask for them).

You ask for a copy of their driver's license and insurance.
Most facilities require yearly TB tests. You can ask for TB testing and/or Covid testing results if you want.
* You ask for a criminal records check (fingerprinting) at their expense.
This is required at many elder care communities / facilities.

You create an Agreement, in writing, that both of you sign.
"I understand the above requirements and agree to them."

* You offer a two week trial period to see how it is going and review the list - with them - and access how they are doing. This is a business.

You either hire independent contractors directly or through an agency.
If you go through an agency, they will do - or should do - the pre-screening.

Gena / Touch Matters

The contract should spell out what the caregiver’s job duties are.

The best caregivers can figure out a lot for themselves, but you will have to do some work to show them what you'd like done. Companionship is just as important as the chores, so allow some time in the schedule for just sitting and talking. Basically light house keeping (things that are wearing you out perhaps could come first), cooking, grocery shopping, taking to appointments (if your input isn't needed), and general looking around for what needs done. One caregiver took it upon herself to clean out the frig, organize the pantry, and do laundry, though I never asked her to do those things for my mom. You should use the time the caregiver is there to get out of the house and enjoy yourself.

First hand off any tasks that are getting more difficult for you to manage.
Changing bedding
Cleaning the bathroom, in general light housekeeping is normal for a caregiver.
Changing your husband when he is wet or soiled.
Just having someone there so you can run to the store.
Having someone there so you can go have lunch with friends, attend a Support Group, get your hair done....
And maybe get your husband out for a walk (only if it is safe to do so. He could be pushed in a wheelchair, or if using a walker make sure your husband has a Gait Belt on to make it safer for him and the caregiver)

I used to fix my husbands lunch and the caregiver would heat it up and give him lunch when I was out. I would make a LOT of soups and freeze them in pint jars and take a few out and thaw them in the fridge, the caregiver would pull one out, heat it up. Easy lunch.

The caregiver can also be tasked with giving your husband a shower a few times a week. That is one less stressful thing you have to do.
(sometimes caregivers are a lot better at giving showers than a family member is.)

What are the tasks causing your stress? Those are what you need to consider having the helper do while your husband naps. You should also leave the house sometimes when the helper is there if you’re not already, even if it’s going for a walk outdoors. When my dad hired his helper, they agreed he’d shower when she was there, she didn’t help as he could do it, but she was close by for safety. She made his breakfast and lunch, and prepped a dinner for after she was gone. She took him to buy groceries and pick up meds, and to some appointments. She did light cleaning and laundry. She also read to him and was a great encourager. Ask for and expect the things that will help you and husband the most. I wish you peace in a hard time

Good for you for asking this. The more detailed you are, the better you can define the job to clients.

What does dh need, precisely, when it comes to toileting, feeding, bathing and transferring? What isn’t your caregiver doing regarding these?