In November of 2017, Mom had a week-long stay at the local hospital due to scary low blood pressure. As a result of that visit, someone on the healthcare staff referred us to the local Department of Aging. Turns out, one of the programs we qualified for was respite care.
A friendly case manager stopped by to talk about the program and left a Resource Guide which was a directory of companies that provide all sorts of home care services. I was to go through it, interview some companies, select one and call the case manager back to get things rolling.
Before calling the companies, I turned to my friend Google to learn a little about hiring a professional caregiver. As usual, one could get overwhelmed with the amount of suggestions and recommendations by this friend! But, this hiring outside help for a loved one is a very important decision and I was a rookie at this game.
Basically, I just wanted someone for a few hours twice a week to come in and provide mobility support for each parent for bio breaks, and companionship for my mom (my dad typically sleeps most of the time). We weren’t looking for household chore help, driving to appointments, or preparing meals.
Questions To Ask
One thing that had some importance to me to consider was to hire a local company or a national chain. I like supporting local and small businesses when I can. In this case, I thought we might be able to get better service, since I figured a smaller company would want to do everything possible in order to compete with “the big guys”. On the flip side though, maybe the caregivers they hired were second tier, or those who didn’t “make the cut” with one of the larger, national organizations. This being my first time, I decided to call and interview both the small and the big agencies.
Other questions of importance that my friend Google put on my list were:
- How long has the company been in business?
- Has your company won any notable awards?
- Was the company and each caregiver bonded and insured?
- What is your employment pre-screening process?
- What training requirements and certifications do you require of your caregivers? CNA? CPR?
- Can you provide me an example of when you had to fire a caregiver?
- How do you respond to emergencies?
- What happens if a caregiver is late or a no-show?
- Will my parents have the same caregiver each time?
- What are our options if the caregiver assigned isn’t a “good fit” and we’d like someone else?
- Companionship is one priority, do you have any older caregivers who may have common interests with my Mom?
- Do you have any caregivers that are knowledgeable with Post Polio Syndrome, Alzheimer’s and Congestive Heart Failure?
- Could we see the resumes of the caregivers you have in mind?
- Would I be able to interview the actual caregivers before deciding to hire your company?
I didn’t have any questions about finances as the Department of Aging was covering that, but several articles I read offered many sound questions about that.
So, armed with my list, I called about 10 agencies and had preliminary conversations. From that, I narrowed it down to two companies to invite into our home for an interview and their assessment of the situation; one was a small local franchisee and one was a national chain.
We met with the owner of the local company, and the office manager of the national chain. Both were pleasant and knowledgeable and spoke confidently. They also each asked detailed questions about each of my parents, their needs, and what we were looking for. For the most part, they easily answered most of the questions we had.
The interesting part was how each responded to the final two questions of my list. The local owner had brought a binder that had details about each of her caregivers, plus a photograph. However, even though she had mentioned earlier in the conversation that she had this info to show us, she only flipped through the pages from her lap but held on to that binder as if her life depended on it . I was close enough to see, though, that there were older caregivers who were better likely to relate with Mom on her staff. The office manager from the national chain company didn’t have anything with her, but promised she could share that type of info with us “if it was important”. Point, local company.
When discussing the possibility of us directly meeting and interviewing caregivers, the local owner said it would depend on the timing, as many were already on assignment and what days/times of the week did I want help to know who might even be available. The office manager flat out said no, it wouldn’t be possible. Point, local company.
Afterwards, mom agreed that she felt the local company would be her choice. So, we proceeded to the next step. Once I determined what times of the week I would like help, I followed up with my case worker to finalize the respite award. (I selected Tuesday afternoons from 1-4, after lunch and before dinner, and Friday nights from 5:30-9, after dinner and before bedtime routine.)
Unfortunately, the experience with this company did not match the “sales pitch” the company owner promised us. The first caregiver sent was a gal in her late 20s. She was late 3 times within the first month and didn’t show up at all on one occasion! Each time I called the office to report the occurrence, and each time the owner apologized profusely. When she did arrive for her shift, she spent most of her time with her phone, including conversations in which she left the room for, than she did spending time being a companion to Mom. After her second no-show, the owner actually filled in, and we requested a different caregiver for the future.
The next caregiver was also female, and even younger than the first one. This girl was punctual and pleasant, and she at least made an effort to engage in conversation with my Mom. But her shifts were not without incident. On several occasions I found that she had adjusted the thermostat up, once to 80 degrees. The first time I saw this upon my return, I asked Mom if she had asked the girl to adjust it, to which she replied “no”. Did the girl ask permission to change it? Again, “no”. The second time it happened, it affected Mom so much that she began having breathing difficulties and chest pains (because of the breathing issue) and told the caregiver to turn down the thermostat. Upon the third incident, I took a picture with my phone and immediately emailed it, and our complaint, to the company owner, requesting she inform the caregiver she is not allowed to tamper with our thermostat, and that she should dress for her comfort level. (It was late November, and the thermostat was set for 71 degrees during the day.) The final straw was mom recognizing the caregiver was sick about 45 minutes in to the shift. When Mom asked her about how she was feeling, followed quickly with “then why are you here?”, the girl replied that she did not want to get written up by the owner again for being sick. Upon my return, I immediately called the owner, explained the incident, and fired her company on the spot! Yes, I faulted the girl for jeopardizing the weakened health of both my parents, but I was more angry with the owner for creating an irresponsible work environment that could endanger their clients!
The following business day, I contacted the caseworker from the Department of Aging and explained our situation. She was kind and expressed concern and empathy for what had happened. And she asked why I hadn’t reported our difficulties to her earlier? Apparently, as our advocate, she could have helped right the ship much sooner. Chalk that up to lesson learned #1.
In retrospect, I also wish that I would have followed up on my original request to directly interview the caregiver before we hired the company. I feel that would have definitely started us off on a better foot. If the first caregiver would have showed up for the interview, we would have immediately said “no, she’s not a good fit” and asked for another to interview. This may have also tipped us off that the owner wasn’t as good as her sales pitch had been.
Third, it got me wondering if going with the small local agency was actually the better choice? Maybe the big, bad national chain has higher standards when hiring caregivers?
Hiring respite care is necessary for the family caregiver’s health and sanity. Hiring the right company or individual is an important decision to be made. Granted, it is unlikely that the outside help will ever match the care that I provide to Mom and Dad, but the next time I look for respite care, I will rely a little more on my case manager through the entire process.
I’ll keep you posted, as the case manager contacted me just last week about a new respite program we are eligible for.