Saturday, January 16, 2010

Selecting In-Home Caregivers

Marion is in her 90’s. She lives alone, but is across the street from her son and his wife. Her children have hired many caregivers for Marion. However, Marion is never invited to interview or choose her caregivers. So, the result has been that Marion often goes without care because she frequently dislikes who has been selected to care for her and usually fires the person or drives them away with menial tasks unrelated to caregiving (i.e. pulling weeds). This has left Marion in an unsafe situation - without regular care.

Once when Marion was chosen a caregiver she got along well with, the benefits of good communication were obvious. Because Marion was instructing the caregiver in what she wanted and needed done, Marion was happier and more responsive during visits. The caregiver made sure she got up and dressed every day (as opposed to sleeping in bed all day in pajamas). She helped Marion to look presentable, even helping her to dye her hair red. Marion was eating regular meals, looking healthier and feeling better. She boasted how good it felt to have her back scrubbed during her bath. She stopped falling trying to use the restroom during the night (perhaps because she did not sleep all day, she had more opportunities to go during the day.) This caregiver contentedly worked with Marion for over a year until Marion’s son cut her hours back and she was forced to move on.

The lack of communication between Marion and her children has been a losing situation for Marion’s health and wellbeing. Marion does not communicate her wishes to her children because she feels they do not care (likely because she is never included in the decision making). Marion does communicate her concerns to her grandchildren, but they have no control over the finances, Medicaid, or care giving decisions.

As in-home care is highly personalized, communication is key. If a senior is of mental clarity and can communicate for herself, this is ideal. This gives the senior a voice and a decision in the administering of her own care. However, when family members step in and make decisions without the senior’s input or consideration, as Marion’s family did, this is highly destructive to the senior’s sense of independence, as well as the quality of care she receives.

A properly placed caregiver, sensitive to the client’s personal needs, would ensure better care and a greater longevity of caregivers. Simply working in firms that had high turnover rates, one gets a glimpse of the stress that training new people or adjusting to changes in staff creates. I cannot begin to imagine how just how stressful it would be to add a turnover in caregivers to dealing with one’s own personal disabilities or unattended needs. It cannot be healthy for seniors to deal with such turnover, which makes the initial proper placement such a vital step in the care giving process.

Benefits of In-Home Care
• Significant financial savings to seniors and Medicaid
• Staying in one’s own home is generally preferable to entering a retirement community.
• People tend not feel sick if they are cared for at home.
• People are able to maintain some forms of independence, as they address some of their own needs themselves or by delegating difficult tasks to an in-home caregiver.
• Seniors do not have to lose the community they have grown comfortable with.


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