How to Make Home Care Work

From the WebMD Archives

You've hired an in-home caregiver, and it feels like you finally have some room to breathe! Your loved one is getting the attention they need, you have more time to yourself, stress levels are lower all around -- it's a win for everyone.

But you're not done. "It's tricky to have that relationship of 'I'm monitoring this, and this is my job to advocate for my loved one, and your job is to take care of them -- and we're on the same team,'" says Amy Goyer, AARP's family and caregiving expert.

Forming that relationship is a little like managing a tiny staff. It takes clear direction and teamwork as well as regular supervision to keep things going smoothly.

Set Expectations

You can't hire a caregiver and take a long vacation. You should be actively involved, particularly in the first few days. "If you're living at a distance, make a trip to do this," Goyer says.

Your goals: Making sure your caregiver knows the ropes, that things are clicking with your loved one, and that there are no obvious shortfalls.

Write everything down. A job description can go a long way toward letting someone know what's expected of them. A checklist is equally valuable.

"So many times you make this loosey-goosey thing, and I think that's not helpful for someone who's trying to do a job," Goyer says. You may not know exactly what to tell them to do, but you know the quality of life you want your loved to have, so start with that.

She suggests creating a care agreement that gets specific about things like job duties, a trial period (if there is one), and what actions could lead to getting fired.

Don't Sweat the Small Stuff

"As long as someone is trustworthy, caring, and capable, and is getting the job done, ignore the imperfections," says Virginia Morris, author of How to Care for Aging Parents. "No one is going to do this job exactly as you would do it, which means you have to let go of some things."

That was true for Terri Corcoran of Falls Church, VA. She hired help for her husband, who had a disabling genetic brain condition. "I found that lowering expectations of the aide was more realistic, and that I had to really set priorities and overlook other things," she says.

And it worked. "The aide I had for 9 years was not very motivated in the beginning," she says. "After many years with us, he became very attached to my husband and really cared about him."


Follow Up Often

You'll have to do a lot of talking: one-on-one conversations with the caregiver, chats with your loved one, and discussions with the three of you together.

"The home care provider will tell you things about your loved one that they may or may not want to say when your loved one is part of the conversation," says John Schall, chief executive officer of the Caregiver Action Network (CAN). "You really want to have those different lines of communication."

One way to check that things are going well is to drop by when you aren't expected. You'll be able to see whether your caregiver is just as attentive when no one is watching.

Resolve Problems

Talk to the caregiver first, if it's something simple or easily fixable. Maybe you want them to spend less time on their phone or to dress more professionally when they're working. "Once they know, the chances are they're going to want to be able to change in a way that helps," Schall says. "It's what they do for a living."

For a more serious problem, let the agency know. "My mom had several falls because [the agency] sent someone who was just not trained and she didn't know how to transfer, and I didn't realize that," Goyer says. "You have to be really honest in terms of evaluating the people that they send."

It's OK to ask for someone else. You may need a caregiver with different skills or just a different personality. When the chemistry doesn't work, don't be shy about requesting a replacement. "That's not only totally appropriate, it's really better for everybody when you do that," Schall says.

And do it quickly. Keeping a caregiver who is causing a problem isn't helpful. "You're paying for it, and ultimately you're talking about the care of your loved one," he says. "You shouldn't let problems fester."

Bottom line: Trust your instincts. "You don't have to love this person," Morris says. "But you have to feel, in your heart of hearts, that this person is trustworthy and is going to do the best he or she can for your loved one."

WebMD Feature Reviewed by Melinda Ratini, DO, MS on August 05, 2016



AARP: "Hiring a Home Care Worker."

Amy Goyer, family and caregiving expert, AARP.

Family Caregiver Alliance: "Hiring In-Home Help," "Caregiver : Working Successfully with Home Care Services."

John Schall, CEO, Caregiver Action Network (CAN).

Virginia Morris, author, How to Care for Aging Parents, Workman Publishing Company, 2014.

Terri Corcoran, Falls Church, VA.

© 2016 WebMD, LLC. All rights reserved.


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