Karen McPhail, RN, MSN
Help, I need to Hire a Caregiver!

One of the biggest challenges for most families is in finding consistent, high quality, private duty care for their family member! I constantly hear from clients:
"She is just not the right fit"
"He seems distant and like an outsider"
"She makes me feel uncomfortable"
"He seems irritated to be here"
"She acts like she is doing me a favor"
"She just sits on her phone all day"
"She hardly talks to me; she just sits there"
Over the years, I have found that there are two major factors that effect successful caregiver placement. First, taking the time to find the right fit for the client. Often times clients and families rush to get help or wait until they are truly desperate. This leads to quick turnover, a poor fit, mistakes, safety issues, dissatisfaction, resistance to future help, and occasionally injury. It is important to meet with several home care agencies before moving forward. If your family member needs daily assistance, ensure that you use 2-3 agencies for accessing care as you want to have a back up for emergencies and call offs. You want to of course have consistent caregivers, but also options if needed. If possible consult a Geriatric Care Manager (GMC) or Care Advisor for help. A GCM can recommend agencies, coordinate evaluations, and even interview and train potential caregivers. I always recommend for my clients that a Care Schedule or Customized Daily Routine is developed and kept in a central place within the home. I do this for each of my clients who are at home. This is something that will guide caregivers, specify care preferences, and can be given to agencies as a reference ongoing. Caregivers can then be trained on specifics of care prior to starting work. A customized activity / programming schedule is also something that I recommend and draft for those with cognitive impairments. Structure and routine is critical for these clients. I have found these interventions to be very successful for all involved! Feel free to contact me if you need assistance in navigating this.
The second issue that effects caregiver placement and retention is expectations and clients acceptance of help and care. Many people are resistant to having help, as they are set in their ways, like their privacy and feel that accepting care is the first step in showing weakness or decline. In addition, expectations for care providers are often not realistic. Sometimes it is just not possible to find someone who can meet all your expectations, take the time to think about what is really important and needed. No one is perfect and everyone needs a chance to settle in and learn the job. Show compassion, give your care giver constructive criticism and a chance to respond to your feedback. Most people want to do a good job if given the chance. This process involves some flexibility on everyone's part. You have to be realistic when hiring caregivers and understanding about their limitations. Focus on the care that is being provided and the caring and kindness that is being shown. Try not to pick at silly things. Many people hope for one thing and truly reinforce another during this process. Be upfront and honest and do not let dysfunctional patterns begin! Be clear about what your expectations are and with good planning and communication things will move forward for all in a positive way!
Feel free to contact me with any questions regarding this process! I am happy to help! I provide care management for any budget, never decline a client in need, and always take into consideration financial constraints.