When we decided to bring in home care for my Dad, there were a lot of things we didn’t know. Like most families, it was our first time dealing with home care. Based on our experience and what we learned, I’ve compiled a list of what everyone ought to know about home care. I hope it helps you!
Our Home Care Experience Round One: Expectations
We started out asking friends for recommendations. Our initial plan was to hire a caregiver who’d helped Dad’s neighbor. We met her and everything seemed good so she started working with Dad a few times per week.
Quickly, we encountered a few issues. Dad complained that she wasn’t doing anything most of the time. We realized we needed to give her more direction and set expectations. Dad thought she would do laundry and clean while not busy with other tasks. But, she didn’t automatically do that. And, truthfully, it wasn’t her fault. When we spoke to her about it, she was glad to do what we asked. Her previous client’s family had a separate person to do those tasks and preferred her to socialize with the client.
That was lesson #1 we learned about home care. Don’t expect your caregiver to read your mind. Set expectations. We later learned the value of a care plan and the need for management. What a difference this made! You don’t realize going into this that you are employing someone and it’s like running a business. This means you should be creating a job description, providing orientation and monitoring. You might also have to deal with sick days and employment problems.
The Risks We Didn’t Know We Were Taking: Privately Hiring v. Home Care Agencies
Unfortunately, we didn’t think about risks beforehand. When your friend tells you they had a good experience, it all seems easy enough. When we started having issues with the caregiver’s reliability we began to worry. She asked to be paid for some time off due to back pain. We didn’t know how to handle this and it made us nervous. What would happen if her back got worse? Was she capable of continuing to help? What if she came after Dad for compensation for her injury?
My brother also brought up concerns about taxes and insurance. So, we made some calls and found out about the differences in hiring a caregiver through a home care agency. Living in Florida, Dad could have hired a state-certified home health agency. They would have done background screenings as well as offered liability insurance and worker’s compensation.
My brother insisted we needed to make a change. Our sister who had helped find the caregiver was irritated. Fortunately, Dad hadn’t grown very attached and actually had some complaints about the caregiver. The agency also said they could possibly work with our caregiver (in other words, hire her on). If the caregiver was their employee, they would manage payroll and taxes, PTO, sick time and backup care. The company would be responsible for the health insurance, worker’s compensation and other requirements. Though we didn’t do this, it might be a good option for others who find themselves in this dilemma.
The Skills and Tools Needed for Quality Home Care
We also came to realize that home care requires a skilled caregiver. Dad’s caregiver had a lot of experience but she wasn’t particularly well-versed in some of the things he needed. The back issue also got us wondering if she knew proper lifting techniques. It may have just been her age and the strain of the work. But we later noticed a big difference in how her new caregiver helped Dad get up from his chair.
We also realized that Dad’s home wasn’t well set up for home care. When we changed to an agency, they did an assessment and initial home visit. They recommended minor changes for a safer environment. For example, we got a shower chair, making it more comfortable and secure for Dad’s bathing. They suggested a pillbox to organize Dad’s meds so the caregiver could easily keep him on track. The agency made sure the caregiver had gloves and kept us informed of any cleaning or household supplies needed. Caregivers need the tools and environment to do the job well.
What Happens When Things Go Wrong
We were able to switch Dad’s home care over to EasyLiving. For us, this wasn’t a big deal and we had no major problems with the caregiver. Dad wasn’t resistant to this change. As we talked to others, we realized just how vulnerable elders and their families can be. It can also be very hard on the elder to change, so you’re better off if you know this stuff up front. It’s a lot easier to set things up the right way to minimize the risks.
One friend realized their caregiver was purchasing numerous personal items along with Mom’s groceries. The police took a report, but nothing came of it. Because she didn’t work for an agency and had no criminal charges, they realize she’s probably gone on to work with other elders. Another neighbor encountered just what my brother worried about...their caregiver injured herself on the job. She came to them demanding they cover her chiropractic bills, which were already running into the thousands. They found out this wasn’t covered by their homeowner’s insurance.
Setting Yourself (and Your Caregiver) Up for Success
The EasyLiving supervisor came out on the initial visit with the caregiver and then followed up immediately. The caregiver had guidance from the personalized care plan, which even took into account Dad's likes, dislikes, and routine. Her supervisor called us to check in and we made a few schedule adjustments. As Dad began to have memory problems, she shared with us the dementia training the caregivers participate in and offered tips. We added a caregiver for dinnertime when Dad was restless.
Based on our experiences, we’d recommend everyone use a licensed home care agency. Each state regulates them differently. But generally the licensing board does regular inspections and you can find information online. You want to be sure your home care situation is covered with liability and worker’s compensation insurance. An agency will handle employment and tax issues.
A quality agency will also take a huge weight off your shoulders. You won’t have to handle every single task yourself. When you have problems, help is only a phone call away. When the caregiver gets sick or something changes, you have a team to assist.
If you find yourself asking one or more of these questions, talk with our team about how to get the most out of your home care experience.
What kind of help does my loved one need?
Can my loved one be cared for at home or do we need Assisted Living?
What skills does a caregiver need?
How (and what) will I communicate with my caregiver?
What will the caregiver do while there?
What can (and can’t) a caregiver do?
Does the state have certain requirements for home care agencies or caregivers?
Do I need to buy any supplies or equipment?
What do I do if the caregiver isn’t right for me?
Is my loved one protected if something happens?
Be prepared for all stages of caregiving: Click Here for the Aging Wisely Comprehensive Checklist.