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

[Anonymous]

Anonymous wrote:

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.

I think you are deluding yourself. If you honestly believe the above, please read the book, "On Being Mortal."

[Anonymous]

Our experience is your loved one is better off in a facility where you visit and then if needed maybe hire a personal aide down the line.

Alone in a home the lonliness and nutty behavior increased. Grandma became enmeshed with a provider who played into her neediness. All seemed fine when we visited. Then the provider started telling sob stories to get money. The first time it was noticed grandma wrote a check, we let it go and told the provider not to do it again, but because she was so good to grandma it would be seen as a bonus. (Grandma was difficult so it was hard to find someone willing to deal). Then things got really disturbing. long story short when there are witnesses around this is less likely to happen. Also, grandma aged backward once she had to interact with her peers who wouldn't put up with her BS. It was tough at first, but eventually she made friends and got a new lease on life.

Sure the facilities are understaffed. Think of it like when you send your kid to daycare. It's understaffed. Things will go wrong. The people are underpaid and you need to reward the good ones. Your kid may be miserable at first. Your difficult kid may be angry and sit in a corner, but then...over time you see why they must be with peers-more smiling, more engagement, a new lease on life. The activities and outings bring excitement.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

I think you are deluding yourself. If you honestly believe the above, please read the book, "On Being Mortal."

I think you misread pp’s post.

[Anonymous]

Similar issues with home care raised by PPs in our experiences w grandparents and parents.

- telling sob stories to get money
- stealing
- calling in sick/lack of dependability
- one aide sued my grandmother claiming she slipped & fell in the driveway
- meals are still an issue

Agree with PP who said getting into a facility early is the best course of action.

[Anonymous]

We had a wonderful experience with Comfort Keepers in NoVa. Quality workers who didn't turnover frequently, very good supervision, weekly nurse visit. I recommend them.

My mother is in an Independent Living community that also has an Assisted Care wing. She's totally independent right now, and the meals and activities have been absolutely wonderful for her after the solitude of COVID. (She moved there in late 2021).

Biggest issue there is the cost. We're working on that.

[Anonymous]

My relative refuses to go to any type of facility at this time and would not be found to be incompetent so it seems that there is not a way to force it.

[Anonymous]

Have nothing to say but great things about her caregiver from an agency. The first one they sent was a horrible match. We expressed our disappointment immediately and were even clearer in what we expected/wanted. We were very blunt and said please do not ever sent that person again when they wanted to discuss things with her and send her back to try again. The second person they sent was better in the beginning but then slacked off. Third time was a charm.

It’s not easy finding a good person for this job.
It is hard thankless work for little pay. Our family is very very nice to the caregiver and show our appreciation for her dedication. We don’t have a nanny cam because the family
Member really didn’t want it, but we stop by unannounced and let ourselves in, and we’ve only overheard positive interactions. In fact the family member talks more
With her than us even because she knows all of her stories are new to the caregiver.

Don’t just talk about tasks. Make a list of the personality characteristics that will mesh with your family members. For instance our family member responds better to lightheartedness and humor but hates it when people are “fake nice”, “throwing around ‘honey’ and are “huggy” (their words). Our family member is also intolerant of our people who are late, hate any mention of religion or god (the first aide sent quoted the Bible all day even though we said the family member despises it. They don’t care what religion anyone is, they just want them to keep it to themselves. Stuff like that.

The aide we have no, the terrific one, sometimes slips on the religious thing but she isn’t pushy about it, and she’s so good with everything else that the family member is able to just grit teeth and bear it

[Anonymous]

OP here. Glad you found a good match, PP.

[Anonymous]

Anonymous wrote:Have nothing to say but great things about her caregiver from an agency. The first one they sent was a horrible match. We expressed our disappointment immediately and were even clearer in what we expected/wanted. We were very blunt and said please do not ever sent that person again when they wanted to discuss things with her and send her back to try again. The second person they sent was better in the beginning but then slacked off. Third time was a charm.

It’s not easy finding a good person for this job.
It is hard thankless work for little pay. Our family is very very nice to the caregiver and show our appreciation for her dedication. We don’t have a nanny cam because the family
Member really didn’t want it, but we stop by unannounced and let ourselves in, and we’ve only overheard positive interactions. In fact the family member talks more
With her than us even because she knows all of her stories are new to the caregiver.

Don’t just talk about tasks. Make a list of the personality characteristics that will mesh with your family members. For instance our family member responds better to lightheartedness and humor but hates it when people are “fake nice”, “throwing around ‘honey’ and are “huggy” (their words). Our family member is also intolerant of our people who are late, hate any mention of religion or god (the first aide sent quoted the Bible all day even though we said the family member despises it. They don’t care what religion anyone is, they just want them to keep it to themselves. Stuff like that.

The aide we have no, the terrific one, sometimes slips on the religious thing but she isn’t pushy about it, and she’s so good with everything else that the family member is able to just grit teeth and bear it

I am glad you found the unicorn agency that has countless people to chose from. Our experience is they are revolving doors and cannot keep people. If your parent is nice, then you might luck out. If you have a tyrant, good look. The agency may in fact fire your parent.

[Anonymous]

Anonymous wrote:My relative refuses to go to any type of facility at this time and would not be found to be incompetent so it seems that there is not a way to force it.

Once there is a fall or something else that lands parent in the hospital, you make it clear what the living situation is and that you will not be available to assist. They will not release your parent to a dangerous situation. They will try to pressure you to make it all better and you turn it back to them and let them know what facilities you think might be a match.

[Anonymous]

Make sure home owner's insurance is paid and talk with a lawyer about what happens if an aide makes an accusation of a fall at the home because of say a bump in the walkway or of your parent with dementia being verbally abusive.

[Anonymous]

Anonymous wrote:Make sure home owner's insurance is paid and talk with a lawyer about what happens if an aide makes an accusation of a fall at the home because of say a bump in the walkway or of your parent with dementia being verbally abusive.

Sorry-tp be clear..make sure you are protected if an aide sues. Times are tough and an elderly person with money to pay for at home care who lives in isolation is an easy target.

[Anonymous]

Anonymous wrote:Have a plan in mind for when your aide is sick or has a conflict. If you're hiring directly rather than an agency, what's your backup plan?

Also, on the other end, it helps to think in advance about what happens if your parent goes into the hospital unexpectedly and doesn’t need the aide’s services for a length of time. My mother spent more than a year developing the relationship with her aide, and then she almost lost her when she had to spend 2 weeks in the hospital. The aide supports her family and lives paycheck to paycheck, and 2 weeks without pay is a long time. She’s hired through an agency (paid for by Medicaid) and luckily was able to make do with a combination of touching it out and covering some shifts for other aides who were out. But the situation caused a lot of stress during a bad time to have extra stress. Especially if you’re hiring someone directly and in charge of the payment terms, it’s useful to talk about plans for this type of situation *before* it arises.

[Anonymous]

Above is a good point. Even with LTC, they won’t pay for non-contact time. You cover or don’t cover the rest.

[Anonymous]

Thanks, everyone, for sharing your experiences on this thread.

My elderly parent seems to be getting on with her HHA from Visiting Angels, so we will see how it plays out over time. The neighbors are relieved.