Tasks and house rules for home care aides?

ButterflyWings

We have finally found a reliable home care aide it appears, after several months of the agency not having anyone to send, or no shows. 

For someone coming in 20-30 hrs a week, what are the tasks and guidelines you have set for home help that you recommend? 

DH is Stage 6d with anosognosia, very mobile and a wanderer. I expect the best but know there are also precautions I should take. Also, what kinds of things do you all have the aide help with to lighten the primary caregiver’s load, not just “watching” the PWD while I run errands. 

Thanks for any and all ideas. Having trouble organizing my thoughts about this. I don’t want to have to train someone but I need to give them some direction I realize. It is so stressful being homebound (he refuses to go out except solo & spontaneously which is a no, of course!) I will be SO glad for the extra body here every day starting soon (just need it to be more than that).

ButterflyWings

Found this great advice from SBall on another topic, in the CG forum! I’m still looking and taking notes/creating a list before aide starts next week. Will keep adding on here, whatever tips I find in case it is helpful for others too. 

Thanks to SB for posting this tip:

Create a hotel like binder (Caregiver's notebook) containing all key info (POA, DNR, medical insurance, medication and associated scheduled, doctor's visit summary, history of medications used and negative reactions/ side effects, her likes and dislikes, favorite food, emergency contacts) 

JoseyWales

I have someone with DH 8.5 hours a day while I work. They do nothing but take care of DH. They might help dress him in the morning if he's not changed by the time I leave. They help him use the toilet (basically show him where it is, help with his pants). They feed him and do activities with him. 

That's it. No household chores, unless DH wants to do it and they help him. 

Right now I'm just happy he's taken care of during the day and I can work without that worry. He usually enjoys the time with them. I have given up on keeping an organized house. I put everything in the dishwasher and hand wash almost nothing. I throw in laundry on the weekend, and it often doesn't even get put away. I haven't dusted in months and there are rock piles everywhere in my house. I figure there will be time to do all that later.

LadyTexan

I put together a Binder of Important Information which also serves as a Caregiver's Notebook. It includes an explanation of Alzheimer's and the stages. It includes meds, key contacts, DH's likes and dislikes, potential topics of conversation etc. On day one, I instructed the CG to read it and become familiar with the contents.

The agency CG comes once per week for 5 hours. I have a one page sheet I give the caregiver at the beginning of each visit. The one page sheet includes:

• health condition, such as changes in mobility, falls or if DH has not had a bowel movement yet that morning,
• what's for lunch, there's always enough for the CG and DH - QUESTION: does anybody else provide meals for the CG?
• instructions on reminding DH to take his meds,
• light housekeeping requests such as washing the linens, and making the bed,
• instructions to call me anytime for any reason, 
• sincere thanks and appreciation for her hard work.

extex

I pay my wife’s aide a set hourly rate for “caregiving”, that is direct care including showers, dressing, hair, nails, meds and lunch.  I gave her the option of keeping the house clean for extra pay.  I pay her the same amount I would pay a house cleaner over and above the caregiving rate.

Farm Gal

Butterfly,  I have had caregivers for 3 1/2 years and my husband is now in stage 6 but different than your DH in that he is not very mobile so therefore not a wanderer.  He uses a walker and even has trouble walking at time using the walker.  I'm sure we are headed to being bedfast within a few months.  

When I started out with a caregiver she came 3 afternoons a week and I expected her to clean the house but only one or two rooms each time she was there.  Only light housecleaning-- dusting, washing or putting dishes away, dust / mop floors etc.  And of course watch over my husband.

Now that he is much less  mobile things has changed a bit. I have 2 caregivers with a total of 12 hours each week.   He sits in his chair dozing all day and only gets out of his recliner to go to the bathroom or to the table for a meal.  I still expect housecleaning as needed, wash bed sheets on Monday and remake the bed, wipe down grab bars, handles, faucets, door knobs etc with disinfectant. If I am gone over the noon hour then  I will have is lunch laid out in the fridge for them to heat up for DH.  I have repeated many times to them that if they get hungry they can look through the fridge or pantry and get something to eat and this includes lunch.  

 I am very fortunate that the private caregiver has turned in to a great friend and she does above and beyond what I ask her.  The second caregiver is from an agency and she is a lady I knew from church.  I pay the private hire caregiver extremely well and both receive a weeks salary as bonus at Christmas.  I am fortunate to have both of them because it is so hard to find capable caregivers.  

I still have a lot of cleaning and chores to do through the week but this makes a world of difference to me just to have these chores done by the caregivers.  I have told them that my husband is their first priority and if they get nothing done it can be done the next day.  I was very specific - even writing out a paper for them to follow at first but now that they have been with us for quite a while it is not necessary.