SERIES: Why Can't Caregiving be Simple? (Caregivers in the Home)

CONTRIBUTED BY: GRETCHEN NAPIER - LIFELINKS CEO

This is a three part series. This article will focus on hiring caregivers in the home. Our previous article was on Assisted Living Facilities. It would be great if just moving dad into an assisted living community solved all the issues.  It would be great if you could just hire one good caregiver to move in with mom.  It would be great if the primary care doctor your husband loves could just prescribe the right combination of medications to solve her mood and behavior outbursts.  

It’s just not that simple. Here are some examples of how each of those “simple” solutions have gone wrong for other families.

Why just hiring one good caregiver doesn’t always work

Another downside to low unemployment numbers, is that it makes it really hard to find good people to do difficult, low paying jobs.  Like caregiving.  When jobs were really hard to come by, it was easier to find hardworking people willing to do a great, caring job.  Now that people can always find a job at a restaurant or driving for Uber or Lyft, there are fewer good people available for the often physically and demanding job of caregiving.  What is left are often people with no life or caregiving experience, people who can’t get or stay employed at higher paying and/or less difficult jobs, people who want to prey on the vulnerability of aging adults.

Some issues that you can face are listed within and below the examples following.

Examples

 

Unfortunately....sometimes no one shows up.

Michelle typically handled all caregiving needs for her husband who has Parkinson’s Disease. She was given an amazing opportunity to take an international trip.  All the experts had been encouraging her to take better care of herself and use this respite opportunity to recharge her own batteries.  She agonized over the details, screened many different caregiving companies and finally select the one that seemed to understand the importance of being on time to every shift.  Her husband must take his Parkinson's medication on time in the morning to avoid significant symptoms.  The only way she felt she could truly relax and enjoy her time away with confidence was to install cameras on the security system so she could be sure someone was there.  The first day, no one showed up.  She called the company at 15 minutes after the hour and this was the first they had heard of the problem.  It took 2 agonizing hours before someone finally showed up; her first day was ruined and she started seconding guessing the decision to come, deriding herself for indulging in this trip.  But the company bent over backwards, apologized profusely and promised it wouldn’t happen again and they would schedule a different caregiver.  The next day went well. The following day went well.  The fourth day, the caregiver from day one is scheduled again and doesn’t show up.

 

Poor communication and high turnover

Dan hired a company to take care of his mother who lives in the renovated basement of the home where he and his wife live. They had been taking care of her, but her dementia was getting worse, she was sleeping more during the day and then was up more at night. It was really starting to take a toll on Dan and his wife because they weren’t getting enough sleep.  At the initial meeting, the owner/manager of the agency asked great questions and Dan took a lot of time to go over all the details about the way his mother liked things, where everything was in the house, typical problems incurred (such as she often wakes believing her dreams really occurred).  The company promised one caregiver since Dan only wanted someone on workdays.  Dan was feeling good until the caregiver started telling him bad things about the company and explained she wouldn’t be working there much longer.  She said it every day for three days and then the following day it was a new caregiver.  The new person hadn’t been told all the things Dan showed the manager, so Dan was late to work that day because he stayed to orient her. Then Dan received a call from the previous caregiver who asked him  to hire her privately at a rate lower than he paid before (but she would receive more than she did before).  Dan forgot that would violate the contract he signed with the agency (costing him $5,000 and the nanny taxes he now had to track and pay).  After a few months, she found a “better” gig. Dan thought to himself, “I should have known that if she would be disloyal and dishonest to the agency, she would be the same to me.”

 

Employees didn't have the motivation to give mom the care she needed

For several months, Scott had been burning the candle at both ends; as a lawyer by day and husband and father by night, Scott’s mom had also been hospitalized for dehydration and a fall at home.  After the initial scare, she stabilized at the hospital and then discharged to a rehab facility for physical therapy.  Making all of those decisions, signing all the forms, paying all those bills, picking up needed personal items and visiting with his mom was really wearing him out.  Before Scott’s mom was discharged from a rehab facility, the social worker recommended caregivers to help with activities of daily living such as meal preparation, bathing, dressing and transportation, while his mom continued to recover.  The agency manager met Scott and his mom at the facility before discharge to go over details of the home, her preferences, discharge orders, etc. The manager assured Scott all of these details would be in the written care plan and an caregiver who worked with his mom would read it and be fully informed about the details.  Scott was beginning to see the light at the end of the tunnel. During the first shift, Scott meets the manager and the caregiver at his mother’s house, reviews all the details and heads to work confident this stressful period of caregiving is behind him.  Several days later one of the caregivers calls to say she noticed it seems like some of the medication hasn’t been taken.  After several calls to the agency manager, it is determined that some of the caregivers didn’t know the medicine could be crushed up in ice cream or applesauce, so his mom had refused to take it on multiple occasions.  But Scott knows that is in the care plan.  The next day, when he visits, his mom is there alone without a caregiver.  When Scott calls the agency they apologize and explain one is on the way, but the one who is scheduled got sick and the one who worked the last shift couldn’t be late to another client and had to leave. Another day, Scott received a call from the caregiver that his mom had soiled herself, but wouldn’t let the caregiver get her cleaned up.  Scott went to her house and showed the caregiver the way his mom liked to be approached for personal care and thought, “I know this was in the care plan.”  In fact, everyday there seems to be another problem for Scott to work through.  

 

Many families believe that getting one consistent caregiver will solve many of the above issues. This is a false belief for three reasons:

  1. It is unlikely any caregiver will stay with your family for an extended period of time.  If you need someone more that 40 hours per week, you will have to have multiple caregivers increasing the rate of turnover.
  2. What happens when that one person has car trouble, or a health problem, or her/his family has a need?
  3. Having only one caregiver increases the risk of manipulation and fraud, because there are no checks and balances and trust is an essential component of the caregiving/receiving relationship.

 

The best caregiving companies do a good job at the following:

  1. Creatively, proactively, constantly recruiting, screening, hiring and training new caregivers
  2. Scheduling caregivers according to some general personality preferences, your preferred schedule and the caregivers preferred schedule.  
  3. Anything else related to managing the care of your loved one will have to be handled by a family member, unless you enlist the help of a Aging Life Care Professional™ like LifeLinks.   

 

Click here to read the LifeLinks Solution to each of these incomplete solutions. (how LifeLinks Aging Life Care Professional™ saves the family time and money by completing the solution.)

Click here to read more about why just getting the primary care doctor to prescribe the right medications doesn’t always work.

Click here to read more about why just moving to assisted living doesn’t always work.

 

ABOUT THE AUTHOR

GRETCHEN NAPIER - CEO
 

IMG_5720.JPG

Gretchen Napier joined the LifeLinks team to fulfill her passion for caring for aging adults, and affecting change for the geriatric care service industry. At a very young age, Gretchen volunteered by painting fingernails for the residents in a nursing home, where she witnessed firsthand the shortcomings and "one-size-fits-all" mentality of many organizations and individuals serving seniors. With many years of experience as an assisted living administrator and a publisher of a resource guide for seniors, Gretchen saw how easy it was for aging adults to fall through the cracks of the healthcare system.  Additionally, she saw how long-distance and broken family relationships make caring for an aging loved one an overwhelming task.  This inspired Gretchen to improve the quality of life for older adults and their families across America by growing LifeLinks. In addition to the community leadership roles listed below, Gretchen is raising a 13 year old son and carrying out her vision for LifeLinks every day.