Aging Parents And Issues With Home Care Workers

Given that most people want to age in place in their own homes, some will need to hire home care workers. Usually, the need to hire helpers arises when your aging loved one has trouble with basic tasks of daily life like walking or bathing. These so called “activities of daily living” or ADLs are walking, toileting, bathing, dressing, eating and getting from chair to bed and back. This kind of help is provided by unlicensed workers, as compared with skilled, state licensed nurses.

What’s The Problem?

Home Care Workers Can Be Hard To Find

So, why would this be an issue? Can’t you just get someone to come in and help out with those things for Mom or Dad?

The prospect of getting home care helpers may be more complicated than you realize. There is a nationwide labor shortage, particularly at the lower ends of the pay scale. Home care workers, paid by the hour, do not generally command high salaries. The agencies who place them with clients are having great difficulty filling the positions needed. Wanting to get help at home and actually getting it may take more time than you would think. Getting a competent person to do the job may also prove difficult. Agencies growing more desperate to fill open caregiver positions can hire folks who are less than ideal, and may be untrained and unqualified for this sometimes difficult line of work.

At AgingParents.com we see the full spectrum of caregiving as reported by the adult children, who have become frustrated with the workers for their elders. Here is a real-life example.

Darla is 86 and has dementia. She lives with her daughter, Isabel who is a retired professional with good organizational skills, enjoying a new career. They can afford the best. After hiring workers through a local agency, Isabel was astonished at the lack of skill the workers demonstrated. Folks with dementia can be difficult. Darla is confused, and sometimes gets aggressive. She takes medication but the real challenge of caregiving is to manage her behavior with the right words, the right approach and patience. One day when Isabel was in her home office working, the caregiver ran upstairs to her office, interrupting Isabel to say that she was having trouble getting Darla to take a shower. Figuring out how to manage resistance is indeed the caregiver’s job. Isabel was paying the caregiver agency to give that help. Isabel had to come down and get Isabel into her shower. After this happened repeatedly, the agency providing the caregivers was fired. They were replaced with a very expensive agency which held itself out as specializing in dementia care.

Did the special agency, charging $55 per hour for its workers, do any better? Inconsistently yes, and sometimes not at all. The agency has trouble getting and keeping workers whom it specifically trains in managing dementia-related behavior. A person showed up one morning for her shift, and when Isabel questioned her about her experience, the worker said it was her first day on the job and she had never actually taken care of a dementia client before. This is specialized care worth extraordinary prices? Isabel insisted that the agency replace the worker. They did, but it was not clear if they had enough workers to do the job. For the 12 hours of daytime care needed, there has been a parade of different workers of varying capabilities, all at the same price. Supposedly, this is the best home care available for dementia clients.

Using a memory care facility instead of home care does not necessarily solve the problem either. Isabel considered it. One new memory care place she checked out looks lovely and has many activities. Darla would not participate in all that stuff, Isabel was sure. She also found out that the company owning the facility pays its workers $18 per hour to start, a low salary for the area. How long do you think they will last as memory care workers when easier jobs are out there, probably for more money? Training for those workers was one week, likely full of the company’s policies rather than how to manage difficult dementia behaviors.

The Takeaways

1. It may be difficult to find a qualified non-medical home care agency to provide the consistent care an adult child wants for an aging parent or loved one. Keep at it, keep looking. Insist on accountability. Watch over what they do and whether they are accomplishing what they are hired to do.
2. Pay well. Workers in this field can easily find a better job that pays more in today’s labor shortage climate.
3. Do use an agency whenever possible. At least the workers are with a bonded and licensed entity that will do all it can to replace anyone who leaves the job. They likely have more connections to getting good workers than you do on your own.

For a full legal and healthcare perspective on how to get a home care worker and save aggravation and stress on you, read Hiring A Home Care Worker: What Could Possibly Go Wrong?, available at AgingParents.com or on Amazon.com.