Getting good help, how do you find reliable, trained home care providers?

I contacted both the Alzheimer's Assn. and the AAA (Area Agency on Aging) when I wanted to hire help.    AA e-mailed a list in about 1/2 hour or so; the AAA took a week, and by that time I had already done my research.

Before that, though, I researched online and found a company with Veterans on staff, in management positions,  and worked with them up to the point of hiring, when the nurse who did the actual interviewing said they wouldn't take care of anyone with dysphagia b/c of the liability.  Otherwise, we were ready to go.    It was by far the most well organized, professional, cooperative and flexible agency I had contacted.

Unfortunately, this kind of search is frustrating; the publicity and self perceptions of the agencies aren't always realistic.    That's something I found out, and how I weeded out the bad ones:   I asked for a copy of their contract to review.   Any that wouldn't address concerns just weren't candidates.  To me, that negativity reflected a potential lack of cooperation down the road.

I'm hiring through a national franchise. Each franchise's management can be very different. At the minimum they must do criminal background checks and their employees must be vetted and qualified/certified to do specific tasks (mobility assist, give meds, higher levels of medical tasks). Ask for someone with experience. Ask for specifics (like I must ask for someone with good command of English because of hearing and comprehension issues of my LO -- thick accents cause her problems). I go over expectations with the hired aid as sometimes admin doesn't communicate everything. Make sure the aid has an thorough understanding of dementia and how to engage with someone with it (if that's what the need is).

HI... I have been a caregiver for 25 plus years. I am 68 and still doing it, mostly through agencies all these years. You can go another route: other places like them that offer in home caregiving or go with agencies. There are advantages and disadvantages to both. I got a job taking care of a man and was witness to daughter who had hired me, abusing him so, of course, I told his home health RN. Less then 2 weeks after reporting the abuse, I was then notified that I had been reported; they would not name the person but it had to be the man's daughter. would not tell me what the woman said. I then found out that this daughter had also gotten another aide fired I found out that the daughter had lied to me about so many things but... could not prove it. would not listen to my side of the story but then... I can't blame them. I don't know what was said except what this other aide told me...... that the daughter was missing "something" from her house. So...not been able to work through them. But...they do not know me any more than they know that daughter.

Now... with agencies, if you want to go that route. Another problem I have with agencies are their nurses, including RN's. One agency hired an RN right out of school. She had no idea what she was doing. Most aides knew more than she did and she would instruct us on how to do our jobs and some of what she said were dangerous! A good question you might ask? The nurses you have, were they aides before becoming nurses? How long have they been in this field? Have they done any actual caregiving, one on one? And if so, for how long? Now, when it comes to the aides? First of all, aides are NOT housekeepers. They do what is called, "light housekeeping". That means---they clean up after themselves and the patient while giving care to the patient. They don't do whole house cleaning. So, the patient uses the bathroom, they clean the bathroom. They use the bedside commode? they are to clean the commode. They make meals for the patient only (some families try to get us to make meals for the whole family.. and do all the clean-up... dishes, etc.. for the whole family. Nope... nada) One exception... they usually make meals for the patient's spouse, also. Clean up kitchen. We can't be expected to clean the oven, fridge. We are to watch out for expired food in fridge. We sweep, mop kitchen. Take out trash. Watch out for the supplies the patient uses and tell whoever needs to be told so they can get some more. Gloves should be in EVERY home for taking care of the patient and for the clean up aides do. Do the patient's laundry.. NOT FOR THE WHOLE FAMILY. Keep patient's areas clean, organized and tidy. Go get prescriptions. May get groceries but NOT FOR THE WHOLE FAMILY. Patient may want fast food but not expected to pick up FOR THE WHOLE FAMILY. If little Jennifer, daughter or granddaughter of patient needs cupcakes for something at school, the aide is not required to make those. Yes... I had an MS patient tell her daughter that I was going to make cupcakes for her party at school and the daughter was to help me. But daughter stayed in bedroom... would not come out. I made those cupcakes because I had time... I just plain did not want to get it into with anyone at the time but today? I would not do it. Nope. Bratty daughter. I had one patient that expected me to take care of her, her husband who hated us caregivers and was abusive and had the police called several times on him and she told me I was to take care of their son who had mental issues. And she expected me to clean up the house... the whole house. Again... do NOT confuse us with housekeepers. We are there to give personal care: brush teeth, get on commode (no heavy lifting), shaving, making meals, feeding, bathing, put on lotion, deodorant, etc...changing clothes, laundry, visiting with them, doing things they like, (puzzles, listening to music, reading)

Also aides go with the patient to appointments. They can go with them places such as weddings, special events, etc. I had one aide, I was taking the urine container to the bathroom. The new aide followed me there. Walked into the bathroom and this aide asked me where I was going to empty the urine! uh hum.... in the toilet. When I went to rinse out this container, she did not know we needed to do that! uh hum... (again) The young ones and even the older ones have no idea how to vacuum...if they do vacuum, they don't empty the canister. So many times I come on and the canister if full and/or the hoses are plugged up. They don't know how to unplug the hoses to get it suctioning again. No one seems to know how to do that! Or they think they don't have to do that? Well... somebody gotta do it cause it is just patient and me!

Here is a problem I keep having. I come to new patient's house. I ask where the cleaning stuff is... for the light house keeping . Seriously... they look at me like I am from Mars. "I need some cleaning rags... gloves"... they expect me to clean but without cleaning stuff and gloves. Really? Many of these family members of the patient... usually their kids, have no idea where this stuff is! And I also find out that when they hired aides, they got rid of the housekeepers that have been coming for years! This happens all the time! And the families get really upset with me when I tell them that we don't do all this dusting, moving furniture, but we do what is called "light housekeeping"... where aides clean up after themselves... clean those things used while taking care of the patient and ONLY used by the patient. We don't clean all 3-4 bathrooms; we don't do all the family's laundry or make every family members beds, or take care of the kids' animals, make the meals for the whole family and then do all the kitchen clean up. And then they don't understand why the caregiver never returns.