Trouble with in-home care

CatsWithHandsAreTrouble

We've been having in-home caregivers from an agency coming to help out around the house and to tend to mom since late July/early August. One thing that I've noticed is that no one sticks around for much more than a month.

I know one got fired from the agency, at least one had health complications and can't work anymore, one got a new job, and others stop showing up with no explanations. I don't know if this is typical for a lot of places or if it's just the agency we're using, or that we just have bad luck. Maybe it's us??

I try to be open and understanding to everyone coming in. Not everyone has had experience with dementia and I try to give them information about it as well as run through what we'd like them to do while here. I reassure them that it's okay to ask questions and that we can raise concerns with each other, that we're comrades in arms, that if they have a better way of doing something, I'm open to it.

I don't think it's an issue with incompatibility with mom's dementia. She's not been a "problem" with them, very polite and tries to share her food with them and to give them a place to sit. Sometimes she's just tired all day and doesn't respond much to them, or cannot focus on anything. I'm here all day when they're here so I'm not missing anything that goes on (meaning I'm not assuming mom's perfect while in reality being a "terror" to the caregivers when I'm not around).

I keep thinking it's my fault that no one stays, that I'm doing something wrong. I keep thinking about our interactions over and over, wondering what I did wrong and am anxious whenever someone doesn't show up right on time. I get so worn out so quickly caring for mom day in and day out; I don't have much rest between caring for her, going to work, and doing miscellaneous things for my dad, my sisters, and our cat.

The new person didn't show up today and I'm already panicking that she won't be back. She was recently hired by the agency with no prior experience with caregiving for dementia. I tried to tell her that it's okay and gave her tips and explained a few key things with the intent to reassure her I wasn't going to be throwing her to the wolves.... We've had others come in for their first day and then inexplicably not show up ever again so I'm trying to remain hopeful that something beyond her expectations happened and caused her to only miss today.

So is this normal for agencies, not having people stay more than a month? Is it something I'm doing? Is it just bad luck?

Quilting brings calm

I think it is just normal. They can pick and choose their assignments because there is more demand than supply of home health workers. Plus I think the staff finds jobs that pay as well in other types of work.

The one time we tried to use nightly caregivers was enough to tell me that assisted living was the way to go for my parents. However their situation isn’t necessarily similar to yours

CatsWithHandsAreTrouble

Yes, thank you QBC. I do know of one girl who said she didn't want to work with us for various reasons and I think that's fine. She's also allergic to cats but was assigned to us anyway! Truly bizarre that the agency was okay with harming her health that way, or at least it seems. My younger sister and I are both of the opinion that mom would get better care if placed in a good facility, have been saying that for over a year. Dad wants to keep mom at home...

I'm just frustrated that any time I start to recover from being burned out with the help of someone else coming in, they disappear for one reason or another, or none, and I'm left hanging.

Good to know this is more or less how it goes. I've been working the same job for over ten years so I suppose it's hard for me to understand people changing assignments all the time.

M1

Getting home staffing --and facility staffing for that matter--remains a HUGE problem since the onset of the epidemic. It's not just you. I work for the Medicaid appeals board in my state and huge numbers of positions--including for adults and children at home on ventilators and life-sustaining equipment like G-tubes--are going unfilled. It's a problem everywhere.

*Ollie*

We had in home care for my mom and managing that was a job in and of itself! We started with a caregiving company and that did not work out for us. I was trying to manage that from another state and I have no idea how anyone can do that successfully!

When my mom moved in with us I used care.com to find care. It was hit or miss at first and we went through several people fairly quickly but we wound up finding someone great who was with us until my mom passed away several weeks ago. I feel like we had to be more flexible with the scheduling than I would have liked but when you find someone your LO likes, you'll do what you can to keep that person returning! My mom's caregiver brought lots of joy and laughter to my mom's world and dealing with her being late or changing the schedule here and there was def worth it.

Also, I think caring for someone who is fairly healthy physically but suffers from dementia can be difficult, maybe more difficult than someone who is bedridden and needs a different kind of caregiving. The first few people who initially were interested decided that the job wasn't for them. My mom needed interactive/companion care and not someone to do her laundry, clean her home, etc.

CatsWithHandsAreTrouble

Thank you for your input M1, always glad to hear from you. I understand the shortage in getting help, I'm more perplexed about keeping it.

Thank you too, Ollie, for your message. I think that's the problem we're running into. I do a little if the housework and all the laundry (our washer is a pain to use so I don't want the caregivers to touch it). Mom's early onset so she's still pretty physically abled and in relatively good health in general. Most of the care is focused on companionship and some IADLs (I think that's the word?).

I think I would be open to hour flexibility if anyone would discuss it with me? One woman used to work for five hours but then went and cut it down to three without explanation. I liked her so I didn't have a problem with it. She also inexplicably stopped coming and the MIA girl from this morning was her replacement.

Shan

When our LO was in assisted living, we used a couple agencies and experienced the same high turn over rate and no-show providers, especially during the day shifts. The last couple weeks before her move to MC we needed 24/7 care to make sure she didn’t wake up and take her dog outside in 20 below weather alone this winter, so we also had to find over night care, which was surprisingly easier to find and keep. When I asked the agency why that was, I was told the overnight shifts have a higher pay rate for doing less work. A lot of their new hires start out in the day shift but soon transfer to over nights for that reason. The difficulty finding and keeping providers is what ultimately led to our decision to place our LO in MC, which has been a blessing for me and my sister who were sharing the care duties and the consistent routine, activities and staff trained in dementia care is actually better for our LO too.

If you continue to struggle finding consistent care, don’t feel guilty if you need to find a better solution. I called the Alzheimer’s counselor line several times when I was struggling with this decision and received helpful advice. The counselor told me that if my mom had her full mental capacity and knew what we were going through for her care, she wouldn’t want us to be struggling so much and she would ask us to find her a good caring place.

CatsWithHandsAreTrouble

Thank you Shan for your insight! That makes sense! My sister used to work at a 24/7 convenance store and they too had an easier time keeping the nightshift staffed and it also paid a bit more.

Also bless you for mentioning the placement and reassurance about it. At this point in time dad wants mom to stay at home. Hopefully the right caregiver for mom is out there, I just have to keep at it.

mommyandme (m&m)

We used care.com and a few different services in two different states. For the most part we had people that stayed with us. The longest service we used here in CO had older caregivers that came. Maybe that helped as they were already semi-retired? That was great until I wanted someone to help change her adult brief (diaper) in bed as mom declined. The older women just couldn’t do it or didn’t want to so I was always coming back to get ‘er done. Yet, mom and I trusted them so I called it a win/win. Nothing’s perfect for sure and when mom passed I lost those “friends” too.

I wonder if a different service might be a better fit for you. Training new people all the time isn’t an efficient use of our time. when one of the caregivers were going to be out I was pretty adamant that I wanted someone who had experience with my mom or at least Alzheimer’s. Maybe you might discuss this turnover with the management and express your disappointment and expectations. You need the break!

CatsWithHandsAreTrouble

Thank you M&M for your insight. One of the caregivers we had was retired but she seemingly vanished. Hope she's all right.

I've thought about looking into a secondary or an altogether different agency but wasn't sure how that'll work out. Mom's on a assistance program that pays for her care. My older sister got it all set up so it's a bit out of my element currently. Also I'm not sure how I'd handle having two different agencies at once, I can barely handle taking care of myself on top of mom...