There are advantages and disadvantages to hiring caregivers from an agency. 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–they may be more loyal 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.
When selecting an agency, do some checking on the agency itself. Who runs it? Do they have training and experience in geriatrics? Many agencies are run by people who have no experience. If they do not, who is backing them up? Find out what their screening policies are for their caregivers.
Agencies vary in size. Large ones may have more caregivers to choose from, but they may also have more levels of people you have to work through, and they may lose the personal touch that you would receive from a smaller agency.
When you are considering home help, make a list of the tasks you want done. These can include companionship, help with what are called the Instrumental Activities of Daily Living (IADL) such as shopping, cooking, cleaning, laundry, and other tasks. You may want help with personal care tasks, what are known as Activities of Daily Living( ADL); these include washing, bathing, grooming, toileting, walking, medication reminding or administering and dressing.
Also consider how many hours you need from a caregiver. Often an agency will charge a two hour minimum. At some point, it may be cheaper for you to hire a Live In Caregiver than someone whom you have to pay by the hour.
When dealing with an agency consider the following:
- 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.
An older person’s first response to the idea of a Caregiver may be “We don’t need any” or “ I don’t want someone coming in my house.” Often it is from fear and pride. There are ways to make it easier for them to accept the help.
- 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.
