Rules for a new caregiver

Kay82

At the insistence of my brother's wife, because this is friend, an outside the family individual has been hired.  

I would appreciate suggestions for rules.  I have jotted down a few such as not going into the bedrooms,  basement  or garage as there would be no need. She must bring her own food. 

I am very concerned as she gave me the impression she just wants to read to my mom.  I want to get across the point that this is a PWD and no 2 days are alike.

Thank you 

zauberflote

Kay, I'm sorry but I can't find any of your posts (not sure if my phone will even do that) to learn a little more about your situation. Is this new person from an agency? Has she given good references? How can you be assured the rules would stick, and what will you (or whoever's responsible, maybe your SIL?) do if rules are not followed?

I'm wondering if your family dynamic would allow for you, the actual daughter, to over-rule the DIL. If mom is in your home, and the person is not immediately the best caretaker you ever saw, you could send her away. If at Bro's house, the rules are up to them. If at mom's house with no supervision and no agency/references, that scares me. 

I would be concerned about No Smoking, kitchen use for mom only (if she's fixing meals) no eating on the job if shift is 4-6 hours or less or she is eating with your mom, using designated hand towels in washroom, always wash hands, no coming to work sick even a teensy bit.... just some thoughts. 

ladyzetta

Dear Kay,

I had a caregiver from an agency come in to care for my DH. I did not find a need to set any rules. I think the agency trains them well. The only rule I had was please don't let my dog or my cats out. As far as the food went the caregiver fixed lunch for my DH and I made sure he knew he was to include himself in the lunch. My DH may have been uncomfortable if the caregiver was eating something different. I trusted the caregiver and I wanted him to feel comfortable in my home. If you're using a family member you may need to set rules. I hope this helps but a good caregiver is hard to fine. I was lucky. 

Kay82

This new caregiver will come here to my mother's where I reside as well. She is not associated with an agency.

Jo C.

Hello Kay and welcome to you.   I wonder if you can provide a little more information so we can be more helpful.  Does your sister have the DPOA for your mother?

1,  Can you tell us where your mother is; would she be in her own home or living in one of her children's homes, or perhaps in an Assisted Living Facility in an independent apartment?

2.  Can you also give us some information regarding your mother's condition and capabilities; how independent is she in various functions, how high functioning is she; what about her ability with bathroom visits, is she incontinent, is she able to see and hear and communicate clearly or not, able to follow directions or not, able to discern and communicate if the care aide is problematic or not . . . how are your mother's behaviors and if they are an issue, will this person understand dementia sufficiently to know how to work around said negative behaviors?   Hopefully your sister has addressed this. 

When we hired care aides, we permitted the aide to eat the same meals as our Loved One (LO) while at work, I did not ask them to bring their own food.

I did not restrict the aide from any room in the house; after all, our LO would wander into various rooms and may need monitoring there, nor did I find a reason to restrict going into a garage if necessary although there was no reason to do so, we had no basement.  IF one has items they are concerned about, then it is best to take jewelry, cash, and financial papers or other important documents and put them in a closet where you have put a locking door knob on the door so that the aide and the LO cannot access those items.  Saves a lot of concern.

I did have a strict rule that under no circumstances was the aide to have any personal visitors whatsoever for any reason; not even outside on the front porch for short periods.  

I also had a rule that using the cell phone was to be done only on breaks and not at any other time and no using the cell phone for games or movies while on duty.

Had a strict no smoking rule  in the house or anywhere on the property whatsoever.

Also had a rule for no alcohol whatsoever.

If the hired person was feeling ill, even if it was a cold, had a temperature, GI disturbances; any hint of illness at all, they were to call and notify us asap and they were not to come to work due to risk for our LO.  This of course left us with having to find someone to cover that shift for a day or more, but did not want our LO to be exposed to illness that could be communicable and be dangerous.

I asked, not demanded, that if the aide needed a day or other time off for whatever reason and knew in advance, to please let us know asap so we could make arrangements to cover her hours to continue care.

Since influenza and RSV have become huge problem issues for our LOs along with the COVID issues; are you wanting the aide to wear an adequate mask when in the house?  If so; then what are the rules for changing the mask day to day AND are you going to provide N95 or KN95 masks, (these are the effective masks for the present viruses), if you want a mask to be worn?  I provided gloves to use in the bathroom assistance issues and when cleaning the bathroom.  

What I did do, was to type an easy to understand point by point of my LOs condition and routine; any conditions such as high blood pressure, heart disease, etc. was listed along with any cautions re the condition; I listed allergies to meds and foods;  any special issues were addressed, the likes and dislikes of my LO; times for meals and snacks, food issues like/dislike, getting adequate fluids during the day, rest times if my LO took daytime naps, favorite television programs, toileting habits, what upsets my LO and what soothes my LO.  Also included contact numbers for all family AND posted the street address and phone number for my LO on the refrigerator so that if there was an emergency, the aide would know the address and phone number.  911 can pick that up off the phone, but it is best to have it.

Had guidelines re handwashing (as in, please wash your hands before preparing food, after helping the LO in the bathroom, etc.); this sounds juvenile but you would be surprised.  RSV is definitely a virus that one gets off surfaces; even touching a serving spoon someone else has touched, one can get the virus off of a table, or any other surface that the person with or coming down with the virus touches can spread it, so once again being in public, at gatherings, and at buffets are sadly again iffy this winter. RSV can make the compromised elder severely ill; even in need of hospitalization, so the hand washing is important.

Very important in our situation due to my LOs behaviors:  The aide as NOT to accept any gifts whatsoever from our LO whether it was money, or giving of belongings, etc.  Anything like that HAD to be mandatorily cleared with me first. (My LO gave a "friend" a $300 tip for helping with something quite minor that took just a few minutes. She also gave away kitchen items that were high quality and needed as well as some of her good clothing; those  items were given to agency staff who took them and I did not find out until later. 

If prescription meds are to be given by the aide, that needs addressing with the family member loading a med dispenser or whatever; everything should be put in writing and it should be clear with written names of the meds and time to dispense the med, and all meds must be put up away where the LO cannot access it. (FOR ANY AIDE, BE CERTAIN THE AIDE CAN READ - really.  We had one who was a nice person, but I did not know she could not read. This led to medication being given dangerously which I discovered pretty much right away.  Had to find someone new.    If Tylenol or Advil is going to be permitted for any complaint of discomfort, then written guideline for how many and how far apart is necessary.  NOTE:   If the aide has her own prescriptions meds or any OTCs  in her handbag brought with her, she is to put the hand bag far up away out of the LOs reach.

I also was careful to welcome the person warmly as part of the care "team."  Hiring an aide is one thing; keeping them is quite another.  I wanted them to feel welcome and a key part of our team and comfortable with us.   I asked if there were any questions, was there anything special that they needed or wished to address.   I also checked to see how they would address an emergency, etc. If important, ask if they can cook and what types of foods they can cook for pertinent meals such as breakfast and supper. I let the person know I was available at all hours and welcomed communication and would readily address problem issues and necessities.

There were other items that I placed on a list, but I am forgetting that now; wish I had kept a copy.   Perhaps this person will actually work out; let us know how it goes, we will be thinking of you and hope it goes well.

J.

Jo C.

Just noticed your new Post and that you live in your mother's home; I am assuming you will be at work or other such place during the day.  I understand your feelings,  but any new aide is an unknown risk; this one being known by your sister may be of lesser risk than strangers.   Tincture of time will tell. 

It may be that after you get to know this person and if she is doing well with your mother that it will be an asset; sure do hope this turns out to be that way for you.  Fingers crossed.

Take good care and hang in there,

J.

May flowers

You can get a background check of this potential caregiver, which might give you peace of mind. But even then, there are things that we did when my LO was with caregivers we had never met (when we went for a week of respite).

We put all valuables, cash, checkbooks, credit cards, etc, and anything with account or ss# numbers or numbers in a heavy duty locked filing cabinet. We also locked away all prescription medication other than what my FIL was taking as well as alcohol. I felt better about doing this rather than tell a caregiver to stay out of certain rooms. 

Also, I was home during the day, but it was very important to me that the caregivers followed a routine with my FIL who was stage 7 at the time. I don’t know what stage your mom is at, but this was important at stage 6 and 7 for him.

 I wrote out a pretty detailed care plan so they knew exactly what was expected in terms of bathing, feeding, activities, and such. I also included a page tips that would make his care easier - like keep him warm during baths/changing, don’t have too many things going on at the same time (sensory overload), etc. anything that I knew would trigger him went on the tips page.

I also had an activity basket for them to use. It had a notebook with his background and family for them to use as conversation items, some big picture books, and fidget toys. I had a music player with his favorite music. I preferred the TV stay off, but if he were in earlier stages I would list what shows he liked. I mentioned other things he liked, like sitting on the porch.

Hope that is helpful!

We had some aides who followed the plan pretty well, and those ended up being the ones who had the easiest time here with him (and stayed the longest)

Kay82

Thank you Jo, your list covered many points I did not think of. This individual will be here at my mother's house.  She will be here 2 days a week for 4 hours each day from 10am to 2pm. I will have lunch prepared so she will only have to heat up soup or a casserole. I do plan to stay with the aide for the first day or two to see how my mother responds.

Kay82

Thank you May Flowers. I am unsure exactly what stage my mother is at. I will make a list of items the aide use to engage with my mother such as her many scrapbooks she made.

 My mother is still quite independent just very forgetful, does not do her morning routine in the same order every morning, has stopped in the middle of making her bed to go brush her teeth. I make her breakfast, toast & coffee, sit down with her and read the Bible while she is eating. Then I go back to my room to get dressed and when I come out she greets me like it is the first time she is seeing me in the morning.