At some point in the caregiving journey, most caregivers will feel they need help in providing care. You can enlist the help of family or friends, find some help from your local health system, or you can hire someone. If you are hiring someone you will most likely be hiring what is called a home health aide. Other names may be a companion, home care worker, Nurse's Aide or Care Aide.
There are three reasons for hiring caregivers:
1.Help with what are called the " Instrumental Activities of Daily Living (IADL)." These include shopping, housekeeping, laundry, and and meal preparation.
2. Help with "Activities of Daily Living (ADL)." These are personal care needs, such as dressing, bathing, toilet help, and mobility.
3.Companionship and monitoring.
Caregivers can be hired through an agency or privately. Some advantages to an agency are that caregivers are pre-trained and screened, their benefits are paid for, and there is back-up in case they don't show up. They have a supervisor who should be monitoring the care they provide. One disadvantage is the caregiver receives only a portion of the money that you pay. A second is loyalty may be more to the agency than to you.
Caregivers hired from agencies have various levels of training. These can correspond to the complexity of tasks they will be required to do. For companionship or housekeeping, you will not need a trained care aide. When you get into personal care tasks, you will. If you require medical tasks you might need a Licensed Practical Nurse (LPN) or Registered Nurse (RN). Make sure the caregiver's skills correspond to your needs.
You can find Home Care or Home Health agencies in the phone book or on line. You can ask your local health department, or the ombudsman, or even contact your local Alzheimer's Society.
If you use an agency find out about the agency's background. How long have they been in business. Who owns it? What kind of training does the agency owner have? Have there been lawsuits, or problems with it? Are they members of the Better Business Bureau? You might want to get references from them.
Some points on which to be clear with an agency:
1. What tasks you wish the caregiver to do--cooking, housekeeping, personal care, or others.
2. What kind of training will the caregiver have.
3. What kind of supervision will the agency do.
4. Ask for the same caregiver each week.
5. The skills you want--proficiency in English, or some one who is talkative, or someone who is experienced with the condition.
6. What you want to do if the caregiver days fall on a holiday, or if the caregiver has an emergency or can't make it. Do you want a replacement?
7. Do you want the caregiver to have a car?
8. Interview the caregiver first. This will cost you money, but you will be able to determine if the fit is good or not. Do not be afraid to say no if you do not think the person is appropriate..
9. Do not be afraid to interview caregivers from a couple of agencies. You do not owe loyalty to a company.
If you wish to hire a caregiver privately, you can find one online through a listing service such as Elderpost, a website specifically developed for caregivers, seniors, and providers of care and products. You can put an ad in a local newspaper, or again, ask the Alzheimer's Society. Adult Day Care centres often know of people, as may a nursing home.
Wherever the caregiver comes from, you should be monitoring what the caregiver is doing, or even if the caregiver is even showing up. They should sign in each time they come, and there should be some record of what they have done. You should go to the home while they are there and watch what they do and how they are doing it. Pay attention to the way they are interacting with your loved one/client. More important, watch to see how they are reacting to the caregiver.
Be sure to ask your loved on how they feel about the caregiver. He or she might not like anyone, or not like anyone coming into their home, but they may give you real clues as to what is happening when you are not there. Be aware of signs of abuse, emotional, physical, or financial.
You should be able to notice some improvement or changes from having a caregiver, which will correspond to the goals or reason for which they were hired. Is your loved one/client cleaner? Gaining weight? More animated? Are medications being taken at the rate they should be?
Finally--remember that is you do not like a home caregiver that you have hired, or that comes in, you can fire them or look for another agency. Try to work it out with the agency, but if you are not happy, you can walk.
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