What do you wish you had known when hiring home health aides for elderly relative?

[Anonymous]

Be aware that you get what you pay for. Aides who work for agencies end up making minimum wage, and may not feel particularly committed to their job.

We initially worked with agencies, but then hired someone privately. SO GLAD we did. Cost more, but we were able to attract and retain someone really, really good. She appreciated being paid well, and she went above and beyond, over and over. Worth every penny.

[Anonymous]

Anonymous wrote:A lot of LTC policies only cover people hired through an agency, not independent people you find on your own.

Some will pay if you have proof they are certified nursing assistants.
Check for this, and whether their hours on record are current.

[Anonymous]

PP again. If you’re nice, they stay longer.

[Anonymous]

Anonymous wrote:PP again. If you’re nice, they stay longer.

It's not just if you are nice, you have to have an easy parent. Even if you pay double, if your parent can be nasty, they quit or just don't show up.

[Anonymous]

Anonymous wrote:Make sure the person is bonded and insured.

Honestly I would start looking into residential, ideally CCRC (continued care from independent living through nursing). The social part is key and peers help you exercise your brain because they aren't paid to kiss up to you. You are guaranteed meals and while many are understaffed at least there is someone there. No shows at home are a nightmare and even with adaptations a home can turn into a house of horrors.

The sooner you rip the bandaid off and have her adapt to a CCRC the better. Much easier to adapt when still quite capable and when social skills are somewhat in tact. Once they adapt my experience has been they do perk up A LOT! The activities make a difference and having some friends to eat lunch with makes all the difference.

Where I live the wait lists for CCRCs are usually 2 to 10 years, depending on the size of the apartment you want, and they expect you to be fully independent when you enter. Their doctor examines you and reviews your records. I'm guessing not driving may not be a deal breaker, but unless OP expects her MIL to make a full recovery the window for applying to these is closed or is closing rapidly.

[Anonymous]

Anonymous wrote:She plays cards with people on her street, goes to church with a neighbor, goes to the hairdresser with a different neighbor, etc. In the rehab I encouraged socializing as did the activities director, but no luck. She did not even hang out around the nurse station as many patients did. 20 years ago she was social in her 55+, now she just does not seem interested in large group socializing, seems to find it draining. She spent a lot of time on the phone at the rehab. So, for now, going with staying in her house but with more help and support. If the caregiver is not available, the agency provides a different one. They will also drive her to appointments, the store, activities, etc.

I think CCRCs are much more “home” and neighborhood-like than rehab facilities. I don’t have a ton of experience with them, but the couple I’ve seen were very medicalized and institutional. I’m hyper social and I’d want to stay in my room in a place like that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Make sure the person is bonded and insured.

Honestly I would start looking into residential, ideally CCRC (continued care from independent living through nursing). The social part is key and peers help you exercise your brain because they aren't paid to kiss up to you. You are guaranteed meals and while many are understaffed at least there is someone there. No shows at home are a nightmare and even with adaptations a home can turn into a house of horrors.

The sooner you rip the bandaid off and have her adapt to a CCRC the better. Much easier to adapt when still quite capable and when social skills are somewhat in tact. Once they adapt my experience has been they do perk up A LOT! The activities make a difference and having some friends to eat lunch with makes all the difference.

Where I live the wait lists for CCRCs are usually 2 to 10 years, depending on the size of the apartment you want, and they expect you to be fully independent when you enter. Their doctor examines you and reviews your records. I'm guessing not driving may not be a deal breaker, but unless OP expects her MIL to make a full recovery the window for applying to these is closed or is closing rapidly.

Where is that? Is that common?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Make sure the person is bonded and insured.

Honestly I would start looking into residential, ideally CCRC (continued care from independent living through nursing). The social part is key and peers help you exercise your brain because they aren't paid to kiss up to you. You are guaranteed meals and while many are understaffed at least there is someone there. No shows at home are a nightmare and even with adaptations a home can turn into a house of horrors.

The sooner you rip the bandaid off and have her adapt to a CCRC the better. Much easier to adapt when still quite capable and when social skills are somewhat in tact. Once they adapt my experience has been they do perk up A LOT! The activities make a difference and having some friends to eat lunch with makes all the difference.

Where I live the wait lists for CCRCs are usually 2 to 10 years, depending on the size of the apartment you want, and they expect you to be fully independent when you enter. Their doctor examines you and reviews your records. I'm guessing not driving may not be a deal breaker, but unless OP expects her MIL to make a full recovery the window for applying to these is closed or is closing rapidly.

Where is that? Is that common?

You are thinking of the very fancy pants communities where I think you pay a lot more and yes, you start out totally independent. They won't even call themselves CCRC. They usually have some euphemism and photos of glamorous people in their late 50s to early 60s. There are plenty of places that offer AL, Memory care, Nursing and sometimes Rehabilitation, just not independent.

[Anonymous]

Anonymous wrote:We are in the process of hiring a home health aide for an elderly parent who is giving up driving. What tips or advice do people who have been through the process have? What do you wish you had known?

She is getting out of a rehab stay so initial plan is 6 hours a day, 6 days a week. She also has meal delivery (new) and a twice a month cleaner (longstanding). No cognitive issues yet but frail. Hoping the HHA can encourage eating regularly and daily walks.

When in rehab she did not seem to want to socialize with other patients/residents. She used to be social in her 55+ and still is friendly with close neighbors. It almost seem with energy level she has skipped over assisted living. She likes to socialize in her home one on one. Hoping the HHA adds a bit more safety, convenience re: driving in addition to car services, and companionship + help with daily tasks, esp now when still recovering.

What is realistic to expect? What are the downsides?

I’m someone who was asking, “How do we get my dad two hours of homemaker support per day” about six weeks ago. And now he’s in memory care, and I’m not sure he’s truly functional stuff to stay in memory care.

I’ve shifted from thinking that home care is better to thinking that facility care is better for people with money who aren’t getting out much on their own anymore. The people at my father’s facility are great, they’re providing care he clearly needs, and they can adapt when his care needs increase. Maybe he’ll have to move to another level of care, but at least there won’t be any insane gaps.

I think the cutoff for staying at homes the ability to use a phone reasonably well and change the TV or radio cha

[Anonymous]

Anonymous wrote:

Anonymous wrote:We are in the process of hiring a home health aide for an elderly parent who is giving up driving. What tips or advice do people who have been through the process have? What do you wish you had known?

She is getting out of a rehab stay so initial plan is 6 hours a day, 6 days a week. She also has meal delivery (new) and a twice a month cleaner (longstanding). No cognitive issues yet but frail. Hoping the HHA can encourage eating regularly and daily walks.

When in rehab she did not seem to want to socialize with other patients/residents. She used to be social in her 55+ and still is friendly with close neighbors. It almost seem with energy level she has skipped over assisted living. She likes to socialize in her home one on one. Hoping the HHA adds a bit more safety, convenience re: driving in addition to car services, and companionship + help with daily tasks, esp now when still recovering.

What is realistic to expect? What are the downsides?

I’m someone who was asking, “How do we get my dad two hours of homemaker support per day” about six weeks ago. And now he’s in memory care, and I’m not sure he’s truly functional stuff to stay in memory care.

I’ve shifted from thinking that home care is better to thinking that facility care is better for people with money who aren’t getting out much on their own anymore. The people at my father’s facility are great, they’re providing care he clearly needs, and they can adapt when his care needs increase. Maybe he’ll have to move to another level of care, but at least there won’t be any insane gaps.

I think the cutoff for staying at homes the ability to use a phone reasonably well and change the TV or radio cha

channel. If a parent can’t change the TV channel very easily or hang up (or turn off) the phone after using it, that’s it for voluntarily staying at home alone.

[Anonymous]

Remove valuables and things like checkbooks from the home. We had a whole debacle where we discovered after the parent died that they'd been stolen from (though I think that was by the hospice people vs. the regular aides).

[Anonymous]

Anonymous wrote:PP again. If you’re nice, they stay longer.

Unfortunately, my mother is a narcissist and quite mean. The rest of us are very nice. Every week the HHA comes back feels like a win.

[Anonymous]

Don’t trust them further than you can see them. Put in cameras and watch what they are doing or not doing and how they treat your loved one.

[Anonymous]

I would also have a nanny cam.

[Anonymous]

I had one grandmother who had agency help bc of where she lived, and another who had direct hire help in her home. The agency would send very inexperienced and different people all the time--I showed up unannounced and my grandmother was in a terrible state and I had to call 911. We eventually got two wonderful people thru the agency that job shared for 24 hour care and were wonderful, but it definitely took time. We gave all the furniture in the apartment to one of them when she passed and she gave a lovely speech at the funeral.

The direct hire people we had "stolen" from the rehab facility after a stay there. They were good at their job, grandma liked them, and they did agree to administer meds despite it being out of their scope of care. But they started calling off a lot, and one of them asked for an advance to pay her bills. We gave it, but then asked for another one, and it was a kind of spiral on that end of things. Long term, we ended up paying my cousin to live there--she was unemployed and working thru some stuff, and that actually worked out really well in the end.