I’m new to the Medicaid aide service through MLTC. New aide started Monday for six hours a day. She is nice but hard to read. I’m not seeing her really trying to engage with my mom. She gives her dinner and helps shower her. The rest of the time is spent watching tv. She does the bare minimum of the list I made for her. Basically I asked she clean up kitchen counters and bathroom after use and quick vac the floors. She has not taken the trash out. When watching tv, she sits on another couch that’s about 12 feet away from mom. I have cameras in plain sight at my moms home so I can see there is very little interaction. This makes me sad. I don’t want to jump the gun and complain or offend the aide as this is just her first week. My mom has dementia and when I ask her what she thinks of her she just says “she's ok” or “I don’t know”. ( It’s important to note that with her previous aide right from the start Mom said “I like her, she’s good! That aide had to leave after only 2 weeks). But I don’t get that happy response from Mom with this current aide which troubles me. How do I get the aide to be more interactive with Mom and take a more active role with light housekeeping without being confrontational or offensive? Is it too early in the game to seek someone else who will be a better fit? On the other hand, I don’t want her to think this level of care is fine. I really need help with this ASAP.
The second one spent all her time on the phone. Sitting on a bar stool in the kitchen and only did anything when directly asked. The 3rd one kept having personal family issues so she had to leave early all the time.
The wonderful lady who has been with us for 1 1/2 years was actually a substitute for #3 who couldn't make it one day because of a " fender bender". Lorraine has been a God send. She treats my husband with kindness and respect, can get him to shower and take his meds when he's being hateful, is right there when he's trying to stand up to help, but won't insult him if he tries to do it himself.
She makes him all different kinds of things to eat, she doesn't care if he wants to eat pie for breakfast, she just fixes it and gives him a protein drink along with it.
If she had her way my house would be vacuumed and mopped every day, we compromised with mopping his bathroom everyday and the rest of the house as needed.
I did inform the agency of the deficiencies of the other workers. I felt they needed to know how some of their employees acted.
So, it's okay to request another caregiver until you find the right one. Its better for your LO, and you will be happier too. And thats
Important!!
you know... trust in your instincts and your mom's..... not sure? talk with the aide and point blank ask her why she is not engaging so much..; maybe she is tired or her heart wasn't in this to start with.
When you're working in a person's home and establishing a relationship, you can't just go at it like a bull at a gate. Some clients do like the bright'n'breezy approach, true, but others are far more reserved; so it's a mistake on a caregiver's part to make assumptions.
I've been doing a double-up round this week, attending calls with a co-worker to clients who need two people to support them. My co-worker is great, very experienced and conscientious, but ohmygod she NEVER shuts up! - but it didn't seem to bother anyone apart from me :) I expect they'd describe her as chatty and friendly. I was mentally calling her other things by the end of the round...
NYCmama, if the tasks and routines that have been specified are being done to a reasonable standard, I should give the interpersonal stuff more time to develop. You say this lady is nice? - so maybe she's just not quite as extrovert as the short-term aide your mother liked.
The more active role with light housekeeping: again, a caregiver can't make assumptions, and this part you have to take VERY seriously. I might think "I'll just take the recycling out and wipe down the counters," and you might think that harmless enough, BUT!!! - if it isn't on the support plan, it serves me right if I get my ears ripped off by my line manager because the client's family has complained that I interfered. You cross boundaries at your peril.
Sitting on the other couch - also correct - "hands, face, space."
Many times people don't really know what a hired caregiver's job is and will often attach other duties onto it that are not part of the job. Agency caregivers who earn next to nothing, have their job duties laid out from them by their bosses about what they are supposed to do and what they're not supposed to do. The only real concern of whatever agency they work for is that they put their time in. The time and hours are really the only think the agency itself has to answer to the state for. Anything else is on the aide personally. People sometimes don't understand that we are not entertainers. You've probably seen the tv commercials for homecare agencies that show some senior and their aide cooking together, playing cards, doing puzzles, and having a great time. It's NEVER like that. Think about an aide on a six hour shift (like yours). After the feeding, hygiene care, and light housekeeping is done there's probably four or five hours left on her shift. Maybe play a game of cards or do a puzzle for an hour like in the advertisements. Then what?
In addition to the totally gross and laborious chore of bathing, toileting, diapering, wiping a**, and feeding some elder the aide also has to make sure the home is adequately clean and safe. They have to make sure your LO doesn't get hurt or into trouble during their shift. This is the job.
The job is not become a one-person circus to make sure the senior that aide is getting minimum wage for, doesn't experience a moment of boredom.
If your aide is doing an adequate job, isn't ripping your mother off, and not being abusive then consider her a good aide. You will not get better unless you're hiring and paying privately.
As for her not meeting your chore list requirements. Offer to drop her a fifty extra in cash each week and watch how much she starts cleaning. I will tell you honestly speaking as an in-home caregiver for almost 25 years (private pay many of those years). If I was making minimum or just above on some job and some elder's adult child made me a chore list, I'd throw in their face and walk away.
I put it out there because I'm new to this process, and needed feedback - but I'm no pushover. With Covid-19 still so rampant, of course I'm reluctant to have aides coming and going; so I'm praying I can find the right "one" ASAP.
Your response was spot on - thank you!
Realize that caregivers, generally speaking, are not well educated and focus on cleaning/housekeeping and feeding, changing soiled garments. Some are there to 'sit' with a elder (and deal with hygiene needs) to insure they are safe.
* It is critically important to be very specific with a caregiver what your expectations are.
- Write out a list and go over it with her.
- Show her exactly what to do so there are no misunderstandings; ask her "do you understand?
* Why do you NOT want to confront caregiver? This is education and training, and is essential.
* If you allow a caregiver to sit and watch TV rather than do\ her job, you cannot expect anything different.
- What skills and qualities do you want in a caregiver?
- If a caregiver doesn't want to work, she'll do what she wants and test your boundaries.
* You must deal with your own fears of asserting yourself. What is in your way to communicating clearly what you need and want. This is a job; it is 'work' - people have to know what to do based on what you tell them you need them to do.
* Once you talk to her and go through a 'to do list,' ask her "Can you do this?
* Role play talking to your mom and see if she can do it. She may not have - both - the skills, maturity, or interest in actually interacting with your mother. She just wants to get paid for doing the bear minimum.
* Ask her if she wants the job and if she is willing and able to do what you ask her to do. If she doesn't do it, get someone else. Why would you even consider keeping her on?
It is like training a dog - the one who really gets trained is the dog's owner. The dog does what it wants until it is told what else to do, or how else to behave.
* SETTING BOUNDARIES and EXPECTATIONS are essential.
* Get assertiveness training for yourself. Don't be a door mat . . . for anyone. This may be a life long learning, indicate low self esteem, overwhelm and or a combination of a lot of factors. You need to step up to the plate or give someone else the responsibility of training and working with the caregiver.