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Nini, I looked for a caregiver who works for an Agency that was licensed, bonded, insured and had workman's comp for their employees. All the employees had been background checked, had their TB test, and flu shots. Some were very experienced and some were just learning. The experienced caregivers usually worked the day shift.

I used an Agency for my elderly Dad, who had 3 shifts of caregivers per day. One thing I liked was if a scheduled caregiver was unable to make his/her shift, the Agency found another person to fill in. I knew that my Dad was never alone. It was quite expensive but Dad had saved for that rainy day.   Dad had general age decline being in his 90's and he was a fall risk.

Oh, personalities was a big thing.  Dad was able to view quite a few caregivers to see who was a good fit.  He liked two very much, thus were scheduled on a regular basis.  They were with my Dad for over a year and up to the day he had passed.
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I made a checklist, then a work scope. If I was still interested after the first phone discussion, I asked for a copy of their contract to review. Usually that was the breaking point, as I found the contracts to be heavily weighted toward the agency's position, with frequent egregious terms binding the caregiver and family.

I saved them; someday I'm going to write an expose of them.

If I did get past that, and I did find one agency which agreed to negotiate (big concession!), I sent a work scope listing the activities which needed to be done.

The semi-medical issues were easy. The stumbling was the dysphagia assistance. One agency declined to provide any feeding assistance b/c of the liability of dysphagia. But it also refused to provide maintenance of the oxygen concentrator (i.e., just changing the cannula and filling the humidifier bottle).


This is really a hard task; if you're firm about what you want and the agency doesn't want to do it, you either compromise or move on.

What I really hated about caregiving agencies was the power, the absolute power they wield over families who need assistance.

Even if it cost more, I'd like to see regulation of them, as I think lack of that is one of the reasons they get away with what they do.
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I always interview the person coming to work for me . ( if the agency doesnt agree go to a diff) . I like to see how they interact with Mom. Do they talk to her , ignore her mostly . Are they friendly etc . I had one person come in barely notice her or talk to her that was wearing earbuds hanging around her neck ...Not for me ..Use your instincts but yes do a check on them
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Nina, The caregiver who comes into your home to look after your loved one brings their own personality, strengths and weaknesses into your home. The person being cared for will pick up very quickly on their personality. One family caregiver who had many agency caregivers coming into the home had a single trait on which he judged agency caregivers: Did they smile immediately on seeing the loved one? If so he took them, because that was what his wife liked. If they didn't immediately smile at her, she was not happy.

I now have caregivers coming in for a few hours every day of the week except the weekends and one day when my wife is at a day care centre. She sleeps a lot, which suits her and me and the agency caregivers. There is some evidence that sleep helps a person with Alzheimer's to cope with the negative impact of Amyloid plaques. Sleep does not remove the dementia, but it does seem to give the person with Alzheimer's greater ability to deal with the cognitive deficits of dementia, make them more alert..

You will need to adapt to the changing needs of the person for whom you are caring. That means that you, not the agency caregivers, know best. Listen to them, but only act when you think it is appropriate. This means you will need to change the times (and perhaps the persons who come into your home) in relation to the needs of your loved one. It is important to balance the amount of rest and activity of anyone with dementia, especially with advanced dementia. Live by the week, not the day. If there has been a lot of activity the previous day, make sure there is less activity the next one or two days.

Do recognize that you cannot care for a loved one on your own (and usually even with supportive help from other members of the family). You will become exhausted over the years, or even over the months. Therefore, get agency help BEFORE you become exhausted and desperate.

A small antidote to conclude: There was a situation here in England with three wives, none of whom could cope on their own, with their husbands with advanced dementia. They went to the local doctor crying. In two of those situations the doctor sent the person with advanced dementia immediately into a care home. Perhaps this was necessary; perhaps not, opinions would vary. In the third situation, the doctor said that both the wife and the husband of more than 25 years should go into a care home. She was livid, put her husband in respite care for two weeks, and now six months later he is still at home; and they are coping. The key point is that in all three of those situations the wives for many years had refused to have any help outside of the immediate family. Don't make that mistake. Look around to find the best possible agency and best possible carers. Don't go it alone. Take care.
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One thing to note, if you hire privately, thus not use a licensed Agency, you will need to contact your parents homeowner's insurance carrier. Your parents would need to purchase a "workman's comp" policy. This will help the caregiver should he/she get hurt on the job.

My sig other had injured his back trying to pick up my Dad when Dad fell out in the yard. And Dad wasn't a heavy person. It's like trying to pick up a 150 lb weight at the gym with only your hands.
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I think freqflyer just about covered the essential checklist for you Ninimoffatt in the first response. You want to make sure you have the cushion offered by a reputable agency for the service to include everything listed in the first paragraph of freqflyer's response. I will also add that using a licensed agency ensures uninterrupted service because there will always be a backup Caregiver in case of any emergency absence of your regular caregiver. Where I work, a non scheduled periodic supervisory visit keeps employees on their Ps and Qs, it also helped that benefits are kept competitive in other to retain good employees.
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I was glad that I was the caregiver. Before I could arrive to care from my mother who lived in another state from me by herself, we used for short term an LPN, who did a 12-hour night shift for us for a week. This lady operated a business, but when she asked me why I used a computer AND said "Don't you think your mom suffered a TIA?" My response="No, my mother had an ischemic stroke."
So do your research.
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Hi Nini, Freqflyer and Everyone...
Nini…. I looked into a caregiver and the rehab where my honey (we are not married) was even had a caregiver company contact me. I need a professional caregiver (as y'all said licensed, bonded, background checked and illness tested) for periodic assistance but found that Medicare would not pay for it. When I talked to the company that was referred to me their minimum was 20.00 per hour/ for 5 hours a day-5 days a week it would be 500.00 and the did not like to do minimal hours per day. Advised that this would not work for us and I would keep their information. Ugh!! I am working to start my art business and luckily my honey is mobile enough that he does not need my attention at all times.

Freqflyer...I agree. If they do not furnish work comp, then it needs to be looked into to. I would not hire a contract care giver for this reason. And you are correct....even if a person is not heavy if they fall it is like lifting double their weight to get them up. In my other posts, I said what it was like trying to get my honey out of bed, off the couch and off the toilet. I destroyed my back, which I have been recovering from since he went in the hospital. If he fell before then, I called the Fire Department as he was 236lbs plus and they came out and lifted him up. Since leaving the hospital and rehab he is now 71lbs lighter, but if he falls I will still not try to get him up. (I dropped 27 lbs while he was in the hospital, but am only 4'10 3/4 and have had strokes and other health issues). Luckily he has most of his mobility back as long as he uses his walker but according to rehab he is still a fall risk. Sorry, guess this was a long winded way to say why work comp is imperative. It is so easy for someone to get injured whether a professional or just someone caring for their loved one.

I won't comment on the contracts as since we can't afford a caregiver, this is something I am not familiar with other than the need for work comp coverage.

Y'all have a great night!
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If I were to hire someone as a caregiver myself, I would have the interview first to see how they interact with my LO, and if acceptable, then require the following: background check, licensed, bonded, cpr class or first aid class, TB test, flu vaccine. (If needed, I may consider paying for the class, test and vaccine, or reimburse with the first paycheck after they have worked.) And check on a work comp coverage...that is a good idea. And I probably would consider having second person do the same things and use both different days, so there would be a backup plan, and that each of them would be used to your LO and vice versa.
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And fyi... just because you use an agency, it does not necessarily mean that another aide is available if your aide calls off. They usually try to secure another aide, but that just isn't always the case.
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