Home care

JC5

DH diagnosed with vascular dementia 5 years ago is “progressing” in this horrible disease. He has difficulty walking due to major back issues short term memory deteriorating only leaves the house with me. I am looking into home care from some agencies nearby for companionship maybe 6 hrs a week and give me some time. What questions do I need to ask? Been putting this off but I need to act on this. Tks for your help

Russinator

Several months back one of our members posted these questions.

 

Administration

1. What is the staffing ratio and what is the longevity or the help?  Turnover?
2. How does the staff interact with the clients?
3. What nursing and other capabilities are available on site?
4. Do they allow outside services to come in?
5. Is it owner managed or hired out to a management company?
6. What's included? 
7. Cost?  What are typical annual increases?
8. How is payment handled?
9. What is the wait list like?
10. Is there a fee to be on the wait list? Is it refundable?
11. Population size of the facility?
12. How is the assessment handled (e.g., does a nurse come to your home)?

 

Accommodations

1. What is the access procedure for the memory care area?
2. What is the access like from the room to the common areas?
3. How are personal items secured?
4. What is in the room - anything or providing all furnishings?
5. Is a fridge (or can there be) in the room?
6. Access to snacks/drinks 24x7?  What types?
7. How are dietary preferences handled (refusal to eat fish, shellfish, tomatoes, etc.)?
8. Any underground parking?  Is there a way that I can park his motorcycles there and have him be able to visit them? What is the cost?
9. Access to outside areas to walk or sit? Secured?

 

Lifestyle and Care

1. Will someone go get the client to participate in meals and activities?  How are clients encouraged to attend?
2. What can the spouse or kids participate in - what would we have access to with the client?
3. Haircut facilities?
4. Is there a transition for levels of care or is memory care a one-stop?
5. Transition approach?  1 or 2 person transfer and/or lift?
6. How are concerns like incontinence handled?
7. What about someone who may refuse to shower?  Change clothes? Etc. - will someone notice, how will they encourage engagement?
8. How do they handle the transition from home to the new accommodation?

 

Overall environment

1. Cleanliness
2. Smell
3. Visual Environment
4. Impressions of the personnel

SDianeL

when the VA provided respite care I started with 4 hours one day a week. I would fix his breakfast and the caregiver would arrive about noon. She just basically sat and talked to him and helped him with the TV. I didn’t expect her to fix meals or do any cleaning. I preferred she focus on him and remain calm. So I would request someone with experience with dementia. Someone with a calm demeanor. If you want them to fix meals or light cleaning make sure that is in the contract. I would return around 4pm in time to fix his dinner. The first time she came I stayed home. The next week I left. The third week he asked if his lady was coming. Make a list of his behaviors so the caregiver knows what to expect.

LJCHR

Another thing I would ask is if in-home care, are they license insured and bonded. What is your hiring process for caregivers? Does it include background and drug testing? What is minimum hours required per shift? What is average tenure of your caregivers?

Marchbanks

When interviewing a potential caregiver, important questions to ask include: their experience in caregiving, specific training they have, their approach to health and safety, what services they offer, if they are comfortable with any special needs, their emergency response procedures, and whether they have any relevant certifications like CPR or first aid. General Caregiving Experience: 

• What is your overall experience in caregiving? 
• What types of clients have you cared for previously? 
• Can you describe a challenging situation you faced while caregiving and how you handled it? 

Training and Certifications: 

• Do you have any formal training in caregiving? 
• Are you certified in CPR and first aid? 
• Do you have any specialized training relevant to the needs of the person you will be caring for (e.g., dementia care, medication administration)? 

Specific Caregiving Tasks: 

• Are you comfortable with personal hygiene assistance (bathing, dressing)? 
• How would you manage meal preparation for someone with dietary restrictions? 
• Can you explain your approach to assisting with mobility issues? 

Health and Safety: 

• How would you respond in an emergency situation (e.g., fall, medical crisis)? 
• What procedures do you follow to ensure the safety of the person you are caring for? 
• How do you monitor and report any changes in the person's health condition? 

Availability and Scheduling: 

• What are your available hours and days of availability? 
• Are you flexible with scheduling changes? 
• Can you provide overnight care if needed? 

Personal Qualities and Communication: 

• How would you describe your communication style with clients and their families? 
• How do you handle challenging behaviors or difficult situations? 
• What are your personal qualities that make you a good caregiver? 

Important to Remember: 

• Ask questions specific to the individual's needs and medical conditions. 
• Check references and verify any certifications or licenses. 
• Discuss your expectations clearly and ensure the caregiver understands their responsibilities. 

Marchbanks

Just saw you are looking at hiring from an agency and the list above is more questions you should think about for an individual. I’m interviewing an individual on Friday. Fingers crossed it works out. Like you my DH is progressing and I have definitely reached the burnout stage and recognize I need help.

JC5

Thanks so much! I knew you all would know the right questions to ask! Helps a lot!

terei

https://alzconnected.org/discussion/comment/237749#Comment_237749

I think she was posting for questions re: care coming into her home

harshedbuzz

@JC5

You've already gotten some great advice.

A couple of caveats about the realities of our experience with agency caregivers-

The agencies where I live typically require a client commitment of 15 hours/week minimum. Ours had a 3-hour minimum shift as well. If you need fewer hours, you may need to find someone on care.com or via word-of-mouth.

IME, agencies will often send whoever they have free initially. These may be new hires who haven't established a client base or folks who other clients found didn't work out for them or aides who previous clients have died or gone into care. The longer you're with the agency and the more hours you schedule, the more say you'll have over who they send.

Be sure to lock up any valuables you have. One of dad's aides swiped some of my mom's jewelry which was a real kick in the teeth. This same individual left the checkbook (which she wasn't supposed to have) of another client at mom's house.

We introduced aides as being there to help mom after TKR. Dad would never have accepted a caregiver who was there to care for him. It took months before he warmed to one of them. That rare creature was a pretty young woman who looked a bit like mom as a young woman which I think helped. She was great if you could look past all the weed talk on her Facebook page. This wasn't a dealbreaker for me but YMMV.

HB