At some point in the caregiving journey, most caregivers will arrive at a time when they feel they need help in providing care.
There are three reasons for hiring caregivers:
1.Help with what are called the ” Instrumental Activities of Daily Living (IADL).” These include shopping, housekeeping, laundry, and and meal preparation.
2. Help with “Activities of Daily Living (ADL).” These are personal care needs, such as dressing, bathing, toilet help, and mobility.
3.Companionship and monitoring.
Caregivers may be provided by the local health authority, after an eligibility assessment. Cost is determined through income testing. Hours of service determined by need.Caregivers can also be hired through an agency or privately. Some advantages to an agency are that caregivers are pre-trained and screened, their benefits are paid for, and there is back-up in case they don’t show up. One disadvantage is the caregiver receives only a portion of the money that you pay. A second is loyalty may be more to the agency than to you.
Caregivers in agencies have various levels of training. These can correspond to the complexity of tasks they will be required to do. For companionship or housekeeping, you will not need a trained care aide. When you get into personal care tasks, you will. If you require medical tasks you might need a Licensed Practical Nurse (LPN) or Registered Nurse (RN). Make sure the caregiver’s skills correspond to your needs.
Some points on which to be clear with an agency:
- What tasks you wish the caregiver to do.
- What kind of training will the caregiver have.
- What kind of supervision will the agency do.
- Ask for the same caregiver each week.
- The skills you want–proficiency in English, or some one who is talkative, or someone who is experienced with the condition.
- What you want to do if the caregiver days fall on a holiday, or if the caregiver has an emergency or can’t make it. Do you want a replacement?
- Do you want the caregiver to have a car?
- Interview the caregiver first. This will cost you money, but you will be able to determine if the fit is good or not. Do not be afraid to say no if you do not think the person is appropriate.
- Do not be afraid to interview caregivers from a couple of agencies. You do not owe loyalty to a company.
You should be monitoring what the caregiver is doing, or even if the caregiver is even showing up. They should sign in each time they come, and there should be some record of what they have done. You should go to the home while they are there and watch what they do and how they are doing it. Pay attention to the way they are interacting with your loved one/client More important, watch to see how they are reacting to the caregiver.
You should be able to notice some improvement or changes from having a caregiver, which will correspond to the goals or reason for which they were hired. Is your lovedone/client cleaner? Gaining weight? More animated? Medications going down at the rate they should be?
The first response to the idea of a Caregiver may be “We don’t need any.” Often it is from fear and pride.
- Start talking about concerns or difficulties, before introducing solutions.
- Ask what kind of help they might want.
- Ask what the barrier is–and talk about the feelings.
- Suggest that there be a trial period of four weeks, and then you can re-evaluate.
- Be there the first few times the Caregiver comes.
- Start with once a week, then build up.
- Make sure your loved one is consulted by the caregiver on what they are doing and how they are doing it.
- If they won’t agree to help, they may listen to the physician.
- In the end, if there is serious risk, insist. Sometimes people’s pride won’t let them say o.k. but when they have help, it is a relief.
Canada’s Live in Caregiver Programme
The Canadian Government has a special programme that allows people to obtain a visa and come to Canada as a live in caregiver. For information, see this webpage: http://www.esdc.gc.ca/eng/jobs/foreign_workers/caregiver/index.shtml
Help With Monitoring
You may not be able to monitor hired caregivers, either because you are out of town, have work commitments, or are overwhelmed by other conflicting demands. You may be a trustee, lawyer, or financial advisor whose role is limited. This is an when a Geriatric Care Manager from Diamond Geriatrics can help.
It is our job to monitor and assess care. We look at what caregivers are doing within the scope of a total needs assessment of the older person and their family. With many decades of experience in aging and geriatrics, we can assess the care that a client or loved one is receiving in their home, in an Assisted Living residence, or a nursing home.
Our relationship is with you, not with an agency or a government service. We can be your objective, professional eyes and ears that will help give you the peace of mind that is sometimes hard to find.