Questions to ask of a Home Care provider?

TrumpetSwan

Hello - wondering if anyone can recommend good questions to ask of a potential Home Care provider? I have an introductory or "in take" meeting scheduled with a representative at a local Home Care company later this week at my parents' house. Parents are aged 85 and 88 and currently living independently at their home, and honestly, they need help.

Mom has moderate dementia so can no longer help dad with meals or household chores. Dad has COPD and struggles to regulate it. I live one hour away, so stop in to check on them and am mostly met by mom saying they need help and dad refusing to have anyone inside the house. I tried this previously and even made a list 'tasks' I thought a Home Care provider could help them with. They both agreed to the list, but when the day arrived for the meeting, dad called and cancelled. I am trying once again after speaking to my mom recently when she was crying about needing help. It is overwhelming to see mom cry, and dad just sit there. I am hoping this time, we can at least have the meeting.

I have researched Assisted Living communities nearby, but dad will not even entertain moving to an ALF. Without some help in home, I am sure they are headed for a disaster where potentially a third party may intervene and force an arrangement upon them.

Anyway, I appreciate any insights on questions to ask when screening, or things to look for that might help ensure this goes well.

Thank you.

Olly_Bake

"Hello - wondering if anyone can recommend good questions to ask of a potential Home Care provider?"

Since you have done this previously, I think you are ahead of the game. What I have found with home care providers and aides is that it will be constant trial and error. I've switched many companies since caring for mom before she passed and now with dad. I've gone through many aides so just be prepared.

A few questions that became important to me

How late can the aide in mind work?

How do they handle a no show aide? Can a replacement be sent right away (most cases no lol)?

Is the aide in mind - comfortable working with the elderly, comfortable working with said medical issue (my LO dementia & other serious medial issues). Dementia makes many uncomfortable right off (found the ones in my age bracket 50 most comfortable so far).

Are they able to take parents for outings or appointments? Some companies allow their aides to do so but most in our area do not.

"Mom saying they need help and dad refusing to have anyone inside the house."

Oh boy, this is going to be a challenge. Are you or another family/trusted family friend able to be there when the aide comes out for the first day or first week to see if dad, especially, will get comfortable enough letting someone else come to help?

Change is hard and from reading your post, especially with dad.

Good Luck!

TrumpetSwan

Thank you, Olly Bake. Honestly, I am expecting the worst. I even think questions I ask will be given structured answers that I want to hear just so the agency can get the cash flow installed. I really do not think I will trust any answer they give, but will have to ask anyway so I know I did my diligence or I can rule out any obvious red flags.

I wish this was easier. I believe whatever comes of this will be what I own, my responsibility, and my "job" to resolve and my anchor to pull along through the deep water.

Thanks.

SDianeL

I have a caregiver recommended by the VA. The agency usually asks all the questions to determine the patient's needs and selects someone skilled to handle them. Your questions should be more about what hours, days and what care they do and do not give. Show them your list. Make sure they understand that your Mom has dementia. They need someone who is calm and understands memory loss. The caregivers usually provide care like bathing, medications and light housekeeping & food prep for the patient which would be your Mom I suppose? The agency came and asked me lots of questions about what things my DH could and could not do for himself and sent a wonderful caregiver who is calm and patient. He was totally against it but now calls him "my lady" Can you be there a couple of times while the caregiver is there to help with the transition?

ljanebarton

I highly recommend using a service. We have used Comfort Keepers for almost 9 years. More than likely they will have a nurse visit with you to find out what the needs are. Then they find the workers to fill that need. As with any one these days, finding people to work is challenging - but we have been very fortunate with more than several people staying with us for years. My husband requires 24/7 care from a semi-truck accident and this last year was diagnosed with Alzheimer's. Google home health care in the area and read the feedback. There are really good companies out there - and some, not so good. As around to see who anyone else has used. It's more expensive to go through a company, but well worth it.

Jo C.

Here are two links with input when hiring in-home assistance and questions to ask:

From the Alzheimer's Assn:

https://www.alz.org/media/kansascity/documents/hiring_a_caregiver.pdf

From the Family Caregiver Alliance - keep scrolling down:

https://www.caregiver.org/resource/hiring-home-help/

A good thing to be aware of, is that not all agency based aides are actually an employee of the agency; some agencies are like clearing houses; potential aides contact them to find work but are actually independent aides unto themselves - the agency gives out names of potential clients and they do get a cut of the aides fees.

It would be good to ask the agency about this - it makes a difference in oversight of the aides as well as being thorough on screenings and verification of work history, any licensing, insurance, etc. Do check your household insurance and see what it covers. I was surprised that ours did not cover hired care aides; I needed to take out a different policy at the cost of $120 for the year for good coverage for work related injury, etc.

When I was doing screening of aides for a large hospital entity that was putting health screening vans in some communities and wanted to hire a good number of aide assistants, I found some aide agencies I called upon did not check on all of their aides licensing/certification and accuracy of information. I double checked everything for each person. What a shock! Even with credible agencies. I even found an aide using someone elses license and credentials for their application using a false name. Many without current CPR training for sure. It was all over the board, so do be diligent when hiring and let nothing slide. Once accomplished, it is well worth having done the pre-work.

I also found a surprise problem hiring an aide to assist my LO when some agencies would not permit me to interview aides before hiring. I would not hire an aide sight unseen and uninterviewed if it was for an infant or toddler; no difference when hiring for a compromised person with dementia. Left me stunned that was a block. I also paid the aides for the time spent in interview.,

Also, each agency, even if part of a larger named corporation, can be different from the others in the same company; that was a surprise to me. It all depends on who is in charge in the agency office and how high their standards are; when it is difficult to find aides to work, standards can fall a bit so we still need to keep ourselves involved until we have it all in place for a bit of time.

I interviewed well and checked carefully, but a couple that did well on interview turned out to be absolute duds in reality in their work. Not just small stuff; larger persistent issues. That can sometimes happen; do not let that dissuade you from obtaining help. We found an angel on earth after a couple of lesser experiences. She was amazing, a blessing, and was with us for years. It will work out, but remember hiring a good person is one thing; keeping them is quite another, so do be a "good" boss and remember to let them know how much you appreciate them and do what you can to make things easier for them even in small ways.

J.

J.

Olly_Bake

TrumpetSwan, I hope you did not gather from my post to give up. It was made to let you know that you will face challenges. First one was what you stated in your post (getting parents on board) and the last was what Jo C spelled out play for play. Thank you Jo C!

I hope you will come back one day TrumpetSawn and let us know the outcome.

TrumpetSwan

Just stopping back to thank everyone who replied. I ended up meeting with the representative from the Agency and had a list of questions I went through. I was quite unimpressed. The representative spent less than one hour and did not say much of anything at all. After I shared the list of "action items" we had compiled I asked what else she would offer based on what she saw and she mostly shrugged and said they could do all that was on the list. I thought I would be getting a professional needs analysis and it seemed all I got was an order fulfillment.

I asked if we could interview the candidates or see their references, and she said no. I asked how we would know they did a diligent job of background checks and references, and she just said they have been doing it for years and are very thorough. So basically, they would send a stranger into the house of vulnerable elders expecting us to trust she did the needed checks. It seems they are trying to hide some gaps and I was uncomfortable with that reply.

Oddly, I also felt like my parents did a bit of show-timing while the Agency representative was there. I have not seen either of them be that talkative and energetic in years. The representative did not even see their daily reality.

Thanks.

harshedbuzz

@TrumpetSwan

You bet your butt your folks were showtiming.

I am sorry this experience wasn't what you'd hoped. I, personally, had the same impression of the agency HHA experience. When I needed home care aides to enable mom to get a break/get dad used to accepting care from others I had many of the same feelings you expressed.

A friend was using an agency with which she was happy. We called the agency but were turfed to a different franchise of the company nearer mom's house. Franchise protections meant I didn't have access to the D'town staff, only the L'town one.

I came to realize that part of my friend's situation was luck, but the other part was that friend was able to offer a very appealing schedule which allowed her to be a little choosier out of the gate. What happened with my parents who didn't want a FT person was that they initially were offered newbies or folks other families didn't mesh with for some reason. The first lady was rude and pushy-- she wanted to do light housekeeping not companion care. I suspect she stole a lot of mom's jewelry because she also left a handful of signed blank checks from another client in my kitchen. (Agency HHAs are not typically allowed to manage things like banking or paying bills-- at most they might shop with cash and return with a receipt) When I reported this to the agency, she blew me off. They sent a recent immigrant whose accent was so thick I could not understand her; she was lovely but she would be a good fit for my hard of hearing parents.

We went through a few more duds before landing on Chrissie who was "just right". She was about 30 and very pretty (like a younger version of mom) and both parents adored her. Her hobby was weed which might explain her very laid-back personality; we could only get her about 12 hours a week because she was very popular. Because she often provided MCF visits, she was a great resource when the time came to place dad. She even stopped by to see him a couple times if she was already at the facility.

I have another friend who used care.com to build a care team for her mom. This is more work on your end-- you need to check references and backgrounds as well as do payroll (she had her accountant handle it) and provide additional insurance but it was a win-win. She was able to hire higher quality folks for the same hourly wage (or a bit less) than the agency and the HHA didn't have to hand over half their hourly earnings to an agency.

HB

PS My friend who was lucky did have her luck run out. As a caveat, one of the challenges to finding these kinds of workers is that often they choose this kind of work because they can step in and out as needed. One friend had an aide who took off summers to be with her own kids. Another aide we knew of went back to her country of origin for 2 months each year. My friend needed a niche aide. As mom's dementia progressed, she reverted to speaking German much of the time. My friend found an aide who not only spoke German but who would cook and bake and do laundry with her mom-- when the friend got home a wonderful meal was prepped, the laundry was caught up and there was either a fresh bread or sweet treat for later. But best of all, mom felt accomplished.

The HHA's own mom had a stroke and needed care, so the HHA went back to Europe for several months. She came back, but mom had progressed a great deal so the HHA asked to be re-assigned to a more capable client because that was her preference.

TrumpetSwan

Harshedbuzz, thanks for sharing your experience. I am impressed your friend found someone who was such a great fit. Also nice your parents found someone too. I get the feeling finding someone who actually works well is more related to plain luck. Maybe if you keep trying a few, luck may strike eventually. I am really not sure I have the energy or motivation right now to keep chewing on this nugget. It has been a couple weeks and that person from the Agency never even followed back up with me.

With my parents show timing, not being enthused about accepting outside help, and the lack luster approach from this agency I just feel like this is going to be too much of my time and effort to get this off the ground and then to keep monitoring or adjusting as needed. Thanks.