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My Mom is 94 years old with Parkingson's Dementia lives with me and I have been her primary caregiver. I just hired a nighttime aide so I could get some rest. Instead I was up most of the night supervising the aide. Is it normal for the nighttime aide to shower in my Mother's bathroom? Also, she slept thru my Mom's nighttime medication and I had to wake her up. I was told the aide isn't supposed to sleep. This was only the first night. Should I let it go or is it time to try a different aide? Also, I would appreciate any best practices suggestions in navigating having aides in the home

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@MargaretMcKen

OMG! Please accept my apologies and totally disregard my post to you.
I misread it and I am so sorry. You know that I agree with your advice and assessments of most situations that people post here because you are a wise woman.
I misread the thread and I apologize sincerely if my comment was offensive to you.
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MargaretMcKen Oct 2022
No worries, Burnt. The only people I get a knife into are trolls, not you!
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@MargaretMcKen

First of all, you don't know what kind of caregiver I was because I never worked for you. That being said you may commence with the sand pounding now.
Second, I would not have consistently stayed employed in this field for 25 years if I wasn't good at it and mind you the last 15 of those years were private-duty care cases. Families in need of a caregiver look for me. That was by word of mouth and references.
You don't get those if you aren't good at a job.
The number one reason why a client or their family has a problem with the home caregiver is lack of honesty on the part of the people hiring a caregiver and/or with the agency they come from.
Lack of honesty about what the client needs are and what the family expects. Lack of honesty and communication from the agency to their aide about what the job actually is and how much care the client needs.
Granted the aide the OP hired for her mother should certainly have asked permission before using their shower. No one should just assume it's okay to shower at another person's house. That has nothing to do with someone being a homecare aide. That's just basic respect and manners.
You would also be much mistaken if you think people working overnight jobs can't get some sleep.
Paramedics do.
Fire fighters do.
Hospital doctors/nurses do.
Police do.
Pilots and flight attendants on long flights do.
These people are on call in the overnight. Since they are not alone on the job they do not have to stay up all night the way a lone security guard somewhere has to.
The OP is in the house when the aide comes in the overnight. There is also only one client who I'm assuming is human and sleeps at some point. So there's no need for the aide to stay up all night. Unless of course they are being paid to.
The difference in pay between a Sleep Duty aide and one that has to stay up all night is big. You want up all night? You pay for up all night.
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cwillie Oct 2022
Uhm, I'm not sure why you are going off on Margaret, as far as i can see she was defending you (I'm guessing the nasty comments you are reacting to should have been in quotes)
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How do so many assume this aide was merely a “sleep duty “ aide? This doesn’t make sense since if all that was required was to be there and sleep mostly then OP wouldn’t have hired an aide. The company needs to train better . As far as showering , I’d say onky with permission and even then mostly just for rare times or if she somehow became soiled from an incident of incontinence or vomiting or food…
also stop attacking other posters people!
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BurntCaregiver Oct 2022
Most people assume that she's a Sleep Duty aide because when a family hires an overnight person for an elder it's just to have someone nearby because the elder is asleep. No overnight homecare aide provides food and entertainment for a client. That's not how it works.
Their job is mainly diaper changing or toileting a couple of times in the overnight, making sure the client hasn't fallen, and repositioning a client in bed. If a med has to be given, sometimes they do that but not very often. That's what it is.
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She's not a live in caregiver I'm assuming but paid hourly. IMO showering & sleeping while working in your home is quite 'ballsy'. Hopefully she's been replaced.
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Get rid of her pronto. Showering and sleeping?? she isn't doing her job. tell the agency and get someone else. Personally, I would have thrown her out my house immediately. I would never stand for such behavior.
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People work night shift all the time without being fed, showered or given a bed. At most they get to snooze off in a chair, one ear up, listening.
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XenaJada Oct 2022
My aunt had a night worker staying with her husband who had late stage cancer. My aunt worked a 3-11 shift at a hospital. Said she came home one night and the aid was asleep on the couch in the living room and had her 2 teenagers there, whom my aunt had never met, asleep on the floor in the living room. All were out cold. My uncle was awake and needing to go to the bathroom and could not get up on his own.

From what I hear, this kind of crap is typical.
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It is inappropriate that the aide would take a shower in your house without your permission. The fact that she slept and missed your mother’s medication is inexcusable. Time to find someone else.
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BurntCaregiver Oct 2022
That aide should definitely have asked permission before taking a shower.
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Never. Not only is it improper. It is disrespectful to your mother, you, and the profession. The fact it was only one night only means they knew they were wrong and still did it. Time to find a new side.
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MargaretMcKen Oct 2022
Hi, and I won't say 'welcome to the site'. Your profile says that you ‘are caring for Christopher Lee, who is 50 years old, living at home with age-related decline, anxiety and urinary tract infection’. Oh really? I hope that you have asked a doctor to sort out the UTI.

You apparently have a reading disability, as you have missed the considerable comments about different types of ‘night care’ at very different rates of pay. You are also very rude, as per your other post “you were a lousy caregiver”, etc. Go away!
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I would let her go.I wouldn't go to sleep or shower
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There are several comments about giving meds.
If an aide has to hand the medication or physically help them take the medication that is one thing.
If the aide can take a pre dispensed medication that is in a cup and the client can pick up the medication and physically take it themselves that is different and in most areas that is permitted.
A private hire caregiver can dispense medications per the instructions of the employer/client.
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Burntcaregiver,
Excellent answer.
I in my 20s worked for group home with 6 residents, mentally and physically handicapped.
I worked 8-10 hours shift, sometimes till 9pm and awake overnight person did not show up often. Residents had complex needs and meds were required as was for all workers passing meds admin course.
So I stayed often overnight which was beneficial in terms of pay, but, it took me months to get back to normal sleep cycle. After few years I injured my back.
Years of backbreaking work provide me with understanding how hard it is to be caregiver.
I have total respect for all caregivers.
My husband has Parkinson and worse, the need for overnight care was limited to a week after 2 surgeries.
Perhaps you need to discuss with dr about meds adjustments, some CR work.
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BurntCaregiver Oct 2022
Amen to that, Evamar. You know how it is. You also know that for every two caregivers like us, there's probably a hundred lousy ones.
That's why client families should not be knit-picky to their caregivers. Be respectful and speak plainly about what is expected from us. Also being honest with the caregiver about what the job actually is and what we can expect never goes unappeciated.
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I originally started with three aides and a dialysis tech. As I’ve gotten better at things I’m down to a part-time aide and my dialysis tech. The two of them have a half bath they share. If there were an emergency I would allow a shower, but as a rule no showers at my house. It’s my home for me and my family only.
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I forgot in my response that CNAs/aides, by law, cannot distribute meds. They can remind maybe even hand the client the bottle or med-planner but they cannot take the med from the container and hand it to the client. They are not medically trained.
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BurntCaregiver Oct 2022
We can distribute meds in some states it we are medication certified.
I have my certification in my state. Technically my training is that I am an APCNA (Advanced Practice Certified Nurse's Assistant) This is basically like an LPN only it was a lot cheaper than nursing school. Some states have this. I can pass meds, do dressings, and a large scope of care though all of it must be under the supervision of an RN.
I can also do CNA training for certification.
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No aide is going to stay up all night long when the position is in homecare.
It would cost you a fortune if you want an aide that is going to stand at attention all night long. There are aides who are hired as 'Sleep Duty' aides. A Sleep Duty aide is exactly what the job title says. Pretty much they get up once or twice during a shift to change a diaper or put a client on the toilet. They don't give meds (unless you're hiring and paying privately). They don't fetch snacks. They don't entertain or provide nighttime companionship and they don't stay up all night baby-sitting for dementia clients who wander. An overnight Sleep Duty Aide is more on-call than anything else. Sort of like how fire departments and paramedics work. They don't stay up all night at attention waiting for calls but they are on-call. So when one comes in, they go. If an aide has to change a diaper or toilet somebody, they do. If an overnight security guard is what you need or a nurse, that is not a Sleep Duty Aide.
Did you not discuss what the job duties were going to be with the aide you hired? Or with her care-coordinating supervisor who came to your house to set up homecare services with the agency you're using? My guess is you didn't.
I was an in-home caregiver for almost 25 years and I have found in my experience that most client families are not entirely honest about what their LO's actual needs are and what they expect and don't expect from the caregiver. You need to speak plainly so your aide knows what you want. We're not mind-readers who can correctly guess what you want from us but fail to say. We do not anticipate your LO's every potential need and want. That's way above our pay grade. If this kind of servant is what you're after then I suggest you make it a requirement of employment that any potential aide you may hire come with a reference from Buckingham Palace or the White House.
If the aide taking a shower in the morning is a problem then tell her she can't. Once again, honesty and speak plainly.
I'm going to lay a truth on you here. If you're this knit-picky on Day 1 then you're going to have a mighty hard time finding and keeping in-home caregiving help.
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Thatslife1972 Oct 2022
You were a lousy caregiver. you take a night shift to work not sleep because it's late. Does any other night shift allow you to sleep on the job....No..... you are making excuses for you and other lazy caregivers who believe they deserve a check for showing up and doing the bare minimum
.
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It does sound a bit like the aide has a daytime job and nowhere to live. However that is not necessarily impossible to cope with, particularly if you are paying the lower rate for not staying awake all night. I wouldn’t worry about the shower, I don’t feel any exclusive attachment to mine.

I’d talk to the aide, find out what is going on, and see if it can be made workable. Yes, she needs an alarm for the medications. Mother probably needs a button to press that will wake the aide up, if mother needs help. I’d guess that you can find one, or someone on the site can recommend one. With both of those things, you may find a workable arrangement that won’t cost the earth and may meet the real needs.

Your problem of being 'up most of the night supervising the aide' should have been a one-off while the aide gets up to speed. If it isn't, you need a different aide!
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bethny58 Oct 2022
Thank you!
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You are paying the aid to do a job. A nighttime caregiver is NOT to sleep that is what they are getting paid for! Why do they need to shower where they work?
That is not acceptable, nor should you have to wake them up to do their job. I hope you fired that aid; I would have fired her after I woke her up. Where did you find this aid? Did you go to an agency?
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BurntCaregiver Oct 2022
You are much mistaken, cw. In fact, a Sleep Duty aide gets a lower pay rate than a first and second shift in-home CNA because they are not expected to stay up all night.
The family hiring them also pays less for this service than what a first or second shift CNA or homemaker/companion gets.
If you're for a Sleep Duty aide then expect a Sleep Duty aide.
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I’m not sure that the Aide is responsible for giving meds. They always say that they don’t do that. Only if it’s already prepared by you. If she came from another job & your mother already asleep & can’t escape bed, then a quick shower is up to you. If you prefer she shower when she goes back home, then tell her…also tell agency pay docked for shower time.
Hugs 🤗
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I would probably talk to the agency and find out what their expectations are with the aid. Is she supposed to be up all night? Is she allowed to shower? NOT allowed to sleep through mom's med time - total fail on that one. Maybe she didn't set her alarm but that's a one time mistake and it happens again, game over.

I have been very happy with the aides I have had in our home. I've been so lucky. One girl, my least favorite, gave her notice so will only be here 2 more shifts which I'm glad for. But the other 3 have been WONDERFUL.

Back to the shower - if mom is sleeping and her showering won't wake her, then I guess it could be OK as long as she is checking on mom.

Is there more for her to do overnight or just the one med? Is she "on-call" and has a monitor or something in case your mom needs her?
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bethny58 Oct 2022
Thank you! The daytime aide is working out nicely. I'm going to talk with the agency and ask for a different aide. The aide not knowing enough to set an alarm for the meds concerns me. I now know I have to make my expectations clearer.
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First, understand that a sleeping role pays lower than an awake role.
If she is going to be sleeping, she should set alarms to regularly check on your mom. Even if she's just going to doze off, she should not be missing medication times!
Showering in the middle of the night is just plain rude, nevermind inappropriate! Maybe her utilities got cut off and it's the first hot shower she's had a weeks, who knows...
Personally, I'd write up a list of tasks with times listed, etc, and see if she follows it next time. Once. Then she'd be gone. It only gets worse if they get away with too much.
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bethny58 Oct 2022
Thank you!
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I have nighttime sitters for my mother in memory care. It's through an agency and costs a whole lot of money. These are awake shifts, the aide is supposed to stay awake all night! Dump this aide and call an established agency who will send you someone with experience. If the agency aide is sick or doesn't show, the agency has enough people on their roster to supply another aide.
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BurntCaregiver Oct 2022
Yeah it costs a lot. But if you were paying for Sleep Duty aides then it would be a lot less and they do not stay up all night long.
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I hope you had a talk with the Aide before she even started as to what you expect.
Showering in your home no matter who's shower it is is unacceptable. (I might understand on a rare occasion if she cam from another job and was soiled doing that job. But she should ask permission)
Missing a medication is unacceptable.
If mom is sleeping and in no need of immediate care I can understand an aide dozing off BUT not to the extent that you have to wake her. If your mom tried to get up would she have heard her?
Before the aide starts the next time she is scheduled talk to her and ask her to explain herself and why she showered, why she missed a medication dose and why she is falling asleep.
Make it VERY clear that if it happens even 1 more time you will look for another caregiver.
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bethny58 Oct 2022
Thank you for your thoughtful answer!
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I had a low tolerance for aides messing up, especially ones supposedly vetted by an agency.

I let slide the one who was supposed to do light housekeeping when she turned out to have no idea how to load a dishwasher because she'd never seen one, but when she came back the next time with a cold, I was done. The one who let my dying dad get out of bed then fall, necessitating a call to the fire department to pick him up, was fired on the spot.

Personally, I have never taken a shower at work, so your aide shouldn't either. She's on the clock when she's at your mom's house, so if she's working days then pretending to work nights while sleeping then showering, then she'd be off my payroll immediately.
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BurntCaregiver Oct 2022
I am about the most competent caregiver that can be hired. I have a wealth of experience and specialty training. Both having been acquired over 25 years in this field.
I wouldn't have known how to load a dishwasher until quite recently in the last few years. I had one for years but never used it because I consider that wasteful. If we were entertaining for a holiday and there was a lot of dishes, my husband loaded it.
Your aide came to work with a cold because she doesn't get sick time. Agency-employed homecare aide is one of the crappiest, lowest paying jobs in the world. We all have bills to pay, including your sick aide. Jobs that don't offer sick time will have workers coming to work sick.
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The problem I have with this is that she didn't ask first. Makes me think she feels entitled to do whatever she wants, which is a red flag.
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Did you hire her yourself or thru agency?
Specific requirement are based on pay, for sleeping and helping 1-2 times could be little over $100, for awake all night $250-300.
I would not worry about shower, you could ask her if you prefer her not to take one, personally it would not bother me.
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tell the agency you want another aide as this one already violated their no sleeping policy.
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I would worry about her being homeless and living in her car and trying to live out of your house. My son hired a nanny who turned out to be homeless and was living in a car
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I went through like 5 aids before I landed on a good one for my Dad. The shower thing is a little weird...I wouldn't be 100% cool with that but could tolerate if the aid was fantastic otherwise. But sleeping so that she misses giving my parent their medicine? Unacceptable as far as I'm concerned. That's a primary requirement. Dispensing medicine appropriately and on-time is a primary requirement.

But so as not to be hasty....like others have mentioned give her a few more days and see how she does. Sometimes it takes a little time for the aid to get used to the new client and for your parent to click with the aid. See how it goes but don't let it go too long if you notice other things that are strange or get the sense this is more of a pattern rather than a one-off situation.
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The shower thing--I don't know, that wouldn't bother me, esp if the aide was coming from another job to your mom's. Also, if she's like me, I clean the shower while I'm IN there, saving water, time and energy.

As far as not sleeping--that's brutal to be up all night, again, if she is working double shifts. She can set an alarm to wake her to get mom her meds. I personally could not do a 'all night' shift for any amount of money. She should be able to catch a little catnap here and there (Kind of like when your kids are babies and sleeping 2 hrs at a stretch--it wears you out).

Yes, you do need to talk to the CG and explain her duties in very clear language.
I'm curious, what kind of meds does she need to be awakened in the night to receive? Most meds are before bed and then in the morning. Waking a sleeping person to give them medicine--kind of baffles me.
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bethny58 Oct 2022
My Mom has Parkinson's. She needs a dose during the night or the symptoms become so bad she can hardly get out of bed in the morning.
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I would be FAR ANGRIER about her sleeping on the job!

is she through an agency?
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bethny58 Oct 2022
Yes. She should have set a timer since she probably knew she would fall asleep.
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I would first find out if this is a second job. Does she leave this job to go to the next...if so I may be a little lenient on the shower. Also, sleeping but...she needs to be told that she is there for you to get a good nights sleep. Its her responsibility to see Mom gets her night time meds. If that means setting up an alarm, so be it. She is there to care for Mom.

Give it a week. If she still is not doing the job she was hired for, replace her.
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