In home help

Rosanne77

Tomorrow I will be talking with an agency that will provide in home help for my DH so I can do so many needed things that I have been putting on hold since his diagnosis in January. I have been utilizing family and friends to spend time with him when i have appts or do something socially, but some of his needs are more than I feel comfortable asking them to maybe have to deal with. He is okay having an aide help out but he is very worried they won't be able to take care of him like me. What are your suggestions for things I should be sure to ask the agency about? I feel like i would be so much more relaxed if a trained person was there with him when I'm gone. I'm hoping it will work out. It would be so wonderful to be able to be away from home and not worrying or trying to get what I need done as quickly as possible to get back home. Am I dreaming, or will this work??

sandwichone123

It works to have someone stay with your LO while you tend to other important aspects of life—yes. They should be able to provide care you wouldn't feel comfortable asking family or friends to provide, such as personal care. Training and skill vary widely, even with people from the same agency. I would prioritize personality over skills, because skills can easily be learned by someone that has the motivation to do so, and who gets along with your dh.

SDianeL

the agency should ask enough questions to find his needed care. I would make a list of YOUR expectations. Will they give medications? Will they prepare meals and do light housekeeping? Do they have experience with Alzheimer’s patients?

​fesk

I would let the agency know your exact requirements. You may even want to put those in writing. I would make sure the agency does background checks, etc. If the agency picks someone out to help you, I would ask specific questions about the aide - how many years experience, what certifications, does he/she have experience with Alzheimer's (if that is yes, ask for more specifics), how long has the aide been working with the agency (has that been on/off or steady), and ask them to explain the aide's past jobs and ask questions from there.

If the agency sends a nurse to fill in a care plan with the aide, be sure to give the responsibilities of the job then and preferably in writing so there can be no misunderstandings.

Aides work with many different agencies and switch between them depending on the job. You'll want to know if they have a track record with the aide or if the aide is new.

If you decide to try the aide out, I would spend one day going over everything with the aide and showing him/her how you do things so they can hopefully do the same with your husband.

It's hit or miss with the aides. I have been dealing with them for years through agencies and private and have seen all types. Listen to your gut and keep an eye on the aide initially. In my honest opinion, the agencies I have dealt with will say anything to get the aide in the door and earning them money. There are good ones out there, but it may take time. Who knows, you may be lucky and the first one works out, I hope that is the case for you.

Jeanne C.

The agency we use has a process during intake to go over all the ADLs (activities of daily living) to determine how much help is needed. The nurse then develops a plan of care for the home health aide to follow. My husband's aide bathes him, dresses him, helps him with toileting/adult briefs, prepares his meals, provides companionship, and does some light cleaning (dishes, vacuuming, etc.). Be frank about his needs. And yes, personality is important. I also suggest asking about how absences are managed. Our current agency has a policy to notify asap and provide a sub if at all possible. Our aide has never called out (knock wood) so I haven't had to test it. Our former agencies never provided subs and frequently didn't notify me (and the aides called out a lot).

Rosanne77

Thank you all for your ideas! Soany things i had never thought of. I'm hoping he would always have the same person. I hope that can be the case. I talked to the caseworker for about 45 minutes on the phone and described, as best I could, what my husband's needs would be, but its ever changing depending on the time of day. She will meet with both of us tomorrow and then a nurse will come out to do an assessment. I feel like i would have to almost be there for the first time someone comes to care for him. I'm worried about leaving him with someone he will have just met. I guess i will know more tomorrow. 🙏🤞Thanks again.

M1

Roseann I think you’re right, it would probably be good for you to be there for the first time or two until some trust is established…

Me&Sis

Hello Roseann,

We have had caregivers from an agency for the past four months. On the first day, I couldn't stay because I had to work and have had a lot of days out this year. But, I asked my son to come, and greet the caregiver and that worked out perfectly. He stayed long enough to get them settled and answer any questions, but when he left it felt natural like his visit was over and it was time for him to go. Mom believed she was continuing her "visit with her friend" and the day went great.

I would say that having a routine is really important for my mom, but also for the caregivers, and it is kept in a binder where they make notes about the day. The only moment of agitation Mom has had was about the note taking so it is now part of her care plan that they do that out of her sight (around the corner on the kitchen counter).

I left lots of things available for them to do while we are gone (a basket with very simple puzzles, conversation cards, colored pencils and coloring book, magazines to look at and a family photo album). This summer I am on break from school, but still have them coming three days a week and it is nice to notice they keep the routine going. Saying, "Dear, it's time for our breakfast, should make you a bagel?" even if I am here. And, "should we do our chores first or go for a walk?" Mom doesn't usually have a suggestion so they just cheerfully take her through the day.

I was worried too that someone wouldn't take care of her as well as I do. But, she is getting wonderful one-on-one attention and honestly it is more than I can do all day long. They are great because it's their job, so can keep it up and then go home to their families. I don't have the energy to give her that level of attention all day and do need to take care of my own things.

So, I agree with others. Personality counts for a lot. And, routine is important, but you can set that up when you create a care plan.

Wishing you well!

Rosanne77

I thought I would update. The meeting went well yesterday. DH sat through the whole process (2 hours). The intake person answered all my questions, thanks to all that gave me suggestions, and even some things I hadn't thought about. My husband thought the idea sounded great and even though the person said if we wanted to talk privately about it, we could call her in a couple days, he was like, i think we should get this in place! So next week the nurse will come for her assessment, and the first aide will arrive while she is there. I will stay for the whole time the nurse is here and then guage when I feel we are all comfortable to give the aide and my husband time on their own. I don't have any appts that day, so I plan to just go to see my daughter so I can be close by. I think keeping a log or notebook that myself and the aide could communicate from is a great idea @Me&Sis ❤️ I'll update but I'm so happy DH seemed agreeable to this. But as we know, this is ever changing. What's good today may be ridiculous to him next Tuesday. 🙏

​fesk

That's great news! Let us know how everything goes.

M1

Willingness to accept help is huge, huge. Do let us know.

Rosanne77

https://alzconnected.org/discussion/69740/in-home-help

Update: DH in home care went well this week. He did get a different aide for each day, (2 days) which I thought would be hard on him, but he actually was fine with it. I'm going to try 2 days a week going forward, maybe more if it continues to work out. Thank you to all that commented with ideas and suggestions

​fesk

Very glad it went well.

Rosanne77

Thought i would leave another update about having in home help. This past Thursday, I was to have an aide from 10 -2 pm. They couldn't get someone to cover until 11:30 so the nurse manager came until that time. Very nice person but that meant i wouldn't meet the person that came on at 11:30. Then I thought well I'll check in and see how its going. Back in January, when all this started, I had security put on all my doors and cameras in the house. Which I informed the agency about before i hired them. Anyway, around 12:30 I turned on one of the cameras where my DH usually sits and watches his favorite shows. No one was there. I checked back at 1 and there was the aide bringing him a cup of coffee. Then she got on the couch and curled right up and was asleep in under 5 minutes! A couple of times she rolled over mouth hanging open. My Husband even spoke to her and she never moved or acknowledged him. At this point i was 10 minutes from home. Walked in and she never even woke up when i came in the room! Finally she did and said she was so sorry, she was just so exhausted! I dismissed her immediately and called the agency. Left a voicemail. No one has yet to get back to me after 2 calls. I was just so livid and scared of what might have happened. I will be calling again Monday morning. Thoughts??

M1

unfortunately par for the course. These folks who work these jobs are usually working mutliple shifts just trying to make ends meet. Even at our MC, which I consider pretty well run, on Saturday afternoon two aides and the nurse were sitting in the kitchen talking to the cook—not a resident in sight. I had to wonder what everyone was up to and what trouble would result.