Hop on hop off bus of caregivers...

Hi there,
As a private caregiver, I have to agree with the posts thus far. After watching what my current patient went through with only one agency, I decided to take on her care full-time, got my business license and the liability insurance necessary, and more so that her mom and sisters specifically, could have peace of mind in who is caring for their family member. They live quite far away, so this is a huge stressor for them. My client is extremely challenging to deal with, and in turn, she couldn't keep the best aides nor any that the agency sent. There were two aides who said they literally only returned bc they enjoy working with me. But, she pushed them away too eventually, regardless - we all have our limits so I understand.
I think the wisest route is a smaller, private agency who has very set policies and procedures. For example, I run a background check (fingerprints required) and a drug screening- no exceptions. I check all references & if those don't pan out, I'm not hiring the individual. I verify their work history, ethic, licensures, certifications, etc - if anything is out of line, I ask what we can do to correct & if so, assist in getting an up to date cpr cert or find Cont Ed classes to either help them complete a certification, ensure skills are up to date, and so on, for example.
I train each person individually and supervise them for 2 weeks before sending them alone to a client's home.
I have very high expectations of myself and the individuals who I select to work with my patients. I offer what I would personally want if it were me or someone I dearly loved being cared for & try to offer services and integrity that I've not seen present in agencies thus far... unfortunately.
I've had more things stolen by home health aides (two specifically) within her former agency than she has. I've noticed obvious drug habits (one aide would go to my restroom immediately upon entering the house, stay in there for 20-30 min, then casually walk out like nothing was wrong)...I found drug paraphernalia in my restroom garbage - needle & all. Wow.
Needless to say, I wouldn't trust an agency, but what to do in these times...
Personally, I'd place "nanny" cams but be upfront in letting the agency know you have cameras monitoring your loved one. It's not just a matter of security...these cams also provide opportunities for you to check in via a live feed and even have a conversation with your loved one.
They're brilliant!

I'll post some info below regarding my favorite cam(s) & company to use.

I wish you all good luck! I'm currently looking to take on a new patient personally & that is challenging in its own unique way, as many of you know I'm sure.
Hoping all works out xx

Ref cam:
My favorite has to be the Wyze Cam - AFFORDABLE yet outstanding quality and features!! There are various models available based on needs of patient, so I just pasted an overall favorite of the most popular one below for reference:

I ordered mine through Amazon for $35 with a coupon offered at the time.

Item by Wyze Labs:
Wyze Cam Pan 1080p Pan/Tilt/Zoom Wi-Fi Indoor Smart Home Camera with Night Vision, 2-Way Audio, Works with Alexa & the Google Assistant, White - WYZECP1

We had better luck with private caretakers than using an agency. The agency we used would send a different person each time and we'd spend part of the 1st hour they were there going over what they needed to watch for with my mom. One woman wouldn't shut up about her issues and for $20/hour, I certainly didn't give a poo about her issues!! I fired her that night and then she argued with me and wouldn't leave until I called the agency and told them what was happening and they told her to leave. I was too tired and stressed out to put up with that crap.
However, sometimes finding private caretakers is difficult. It's like a secret underground network you have to infiltrate, but once you do, I think you can get better help. Plus they end up making more than the private agency pays their caretakers but it costs you less. In the long run, it's expensive to keep someone at home. We eventually placed my mother in a facility and saved a lot of money.

Research a couple of more agencies. Check them out with the Better Business Bureau and any online ratings. Also, ask to speak to others already using the agency's services. That may cut out some disreputable companies. A good agency will send in a person - an RN would be best - to see what tasks the aides will need to complete and any issues that aides may have to deal with (language, pets, mobility issues, providing transportation). The agency should have a policy where they will always cover absence of their employees.

Once you have an agency and are trying out aides. Stay with the prospective aide for a few shifts - to answer questions and see how he/she gets along with your loved one. When things seem ok, make unannounced visits to make sure that aide is keeping to the tasks they are getting paid for. Any problems should be first directed to the aide and then to their agency.

My mom-in-law had round the clock aides after a hospitalization since no family lives near her (her choice). Now she has goes to an adult day program and has 1 fulltime caregiver for afterhours. Both situations worked well for her and the family. So, I know it is possible for this to work.

I feel your pain. We'r went through 3.5 years, 14 caregivers, 4 different agencies and a few private pay. They left my confused mom alone sometimes for hours while they went out, shopping for themselves etc. Several stole from us, some things irreplaceable, some expensive. One came in and within three first 10 minutes, no joke, rearranged all of the furniture in the caregiver's room. Another, the weekend one, rearranged my entire kitchen. Each one was disrespectful, did not listen, did what they want. One wanted a baby, got pregnant with man she'd had 2 dates with and told him not to worry because our house was a great place to raise a baby. I used to post on her to get support but then people started saying I was making this stuff up. I was not. I stopped posting for several years now I think but I saw your post and really do feel your pain. By the way mom is still with us, she has companions during the day, we'r take care of her food, needs, diapering and cpap help. I'm blessed to have a wonderful husband. Good luck and God Bless.

My 94 year old parents now have 24 hour aides through an agency that was recommended from the hospital stay in rehab. That was our fist mistake. The hospital rehab was horrible-left my dad splayed out on the bed-he could not move he could not reach the call button, no one ordered food for him-i brought my mother every day for 3-4 hours. We waited 45 minutes for call to reply for assistance to get to the bathroom-which is why dad left rehab a week early. Home care seemed to be the best choice-parents refuse to go to retirement community. Mom is fairly able physically but very demanding-expecting home care to do her bidding. Dad kind of wants to just be left alone-first care giver seemed to have the right attitude until we learned she was being verbally abusive to dad as he could not produce a BM on her time line-housekeeper heard the lady yelling at dad threatening him with enema if he did not do his business-meds were also missing during her shift. She blamed housekeeper (known for 10 years) for missing pills. Due to dad dementia he thought the helpers were all doing just fine. Care givers have turned up very ill coughing and sneezing everywhere. Mom gave one aide the charge to go to the store and get groceries-against my advice and manger instructions to not do that. Aid bought 5 pounds of tomatoes, 10 containers of juice, 2 boxes of 24 count waffles, you get the idea-there was no room in the fridge for all this stuff. Some aids are no shows, nearly all twiddle on their phone endlessly or sleep while they should be working. I think the agency had to "let go" an average of 1-2 people per month.
I have seen horrible treatment for my sister in a Alzheimer facility-injuries, loosing weight, unclean etc. I have also witnessed horrible hospital care where meds were not given in spite of me being there 12 hours a day for 30 days when mom was "recovering" (not really) from a difficult throat surgery, so all this equals bad care at home, rehab, hospital, and retirement-aka memory care medicaid beds has been a 4 month long quest for good care that is not really available in my area only 15 out of 150 facilities made the cut-none have beds or are willing to give one to us due to sister behaviors.
My mom wants to private pay one of the better agency ladies-but I am concerned due to the lady presumably has her on off duty life, she will have her own stuff going on with family, illness, car wont start etc.-plus you have no back up at all when favorite lady does a no show. My parents are willing to do something that does not make long term sense. Even the favorite lady could turn to the dark side when she knows that there is no official supervision from the agency provide some kind of oversight/backup. Same reason I would not look into private pay person....involves way to much trust of a stranger to always do the right thing-which I have not personally ever seen happen.
I have considered the idea of moving my sister home and backing off from helping my parents-i would not be able to leave my sister unattended to do mom's bidding. I would be on duty 24/7. I went out yesterday to buy baby gates and other stuff my sister will need to live here-I woke up today feeling I want my sister to have good care-via community care, day care, or something besides just me-I know would be very hard/maybe impossible if behaviors get unmanageable. I want to try to take care of sis but not really really sure I can. We been refused by several care facilities due to my sister's unpredictable behavior already. My immediate family get very stressed when having any discussion about sister being here 24/7.

As someone who has gone through several caregivers for my in laws I would never go privately, I would ONLY go through an agency. What we "learned" after several caregivers is that we have to be honest and upfront ABOUT EVERYTHING. In our case my in laws were running off the caregivers. Literally. Vetting is critical. I cannot say it more emphatically. Caregivers have to know exactly what is expected and what behaviors they will see. Agencies, if they're good, will tell you if they have what you need. It's their forte. Make a detailed list of what is expected ; the type of person you are looking for ( someone your mom can understand - no language barrier, can articulate well) ; talk with your mom about what she wants and the type of person she would feel comfortable with. Interview caregivers, both you and your mom. To be honest...2 years after we began our journey we found that a Male caregiver was the best fit for our in laws.

Try
Care.com
Sitter city.com
Or what ever site is in your state.
They work for themselves and are more reliable. Seniors hate the revolving door of faces

I have had much better luck hiring caregivers privately. Word of mouth got me two wonderful women. I asked on facebook through friends in my community and found them. Much less expensive this route. These women had worked in hospitals and were fully skilled.

I would try for a different agency before hiring privately. As you have experienced, there are real downsides to private hiring. I think having substitutes 2 times in 4 months isn't unreasonable, but what is unreasonable is that the agency knew about the caregiver's being unavailable well in advance and didn't let you know about it. We parted ways with our first agency because of major lack of communication, both with us and with the caregivers. We had our caregiver come one morning when it was snowing very heavily and people were being advised not to drive--we had tried to call the agency to let them know we were fine and she didn't need to come, and she had tried calling to see what they wanted her to do. No answer on their end, not even an answering service or ability to leave voice mail. Caregiver ended up leaving that agency, and we did as well at that point. Our current agency is very good about trying to find a good "fit" for client and caregiver.

Being a professional caregiver is an awful job with horrible pay. You can often make more at Walmart or McDonalds. A very high turnover rate is to be expected.

Getting good caregivers is extremely difficult. I had the same problem. I think the caregiving agencies are part of the problem. I do not think that they screen their applicants as they should. Most of them only do record checks in the beginning. I believe it should be done at least every couple of years. They should also ask more indepth questions. For example, I had a caregiver sent to me to take care of a male Altzheimers patient who had been raped. The patient made a couple of semi sexual remarks and she lost it. A caregiver that had been raped probably should not be dealing with a male patient like this or any male patient if they cannot take these type remarks. It happens especially with Alzheimers. Also, the agency gets more than double what the caregiver receives. That also seems unfair even though I know the agency has liabilities.

I scheduled the days I needed a caregiver. Even though I did, there were days they had not scheduled anyone for me nor notified me that they had not. It is very frustrating to think you have someone coming that should be dependable only to find out no one was scheduled or they show up from 30 to 90 minutes late. That was my experience with agencies.

I had another CNA come in to help with baths. He would not come for less than 2 hours whether or not he actually gave a bath as the patient wasn't cooperative. He also showed up late or not at all. I explained to him that I knew things might come up but that a phone call would be expected if times changed. He didn't show me that courtesy and after awhile I told him I was looking for someone else.

There are devoted caregivers out there I believe as well as some who are not. I did finally find two who I could depend on and I so appreciated them. They were very reasonable in what they charged and were able to do the job. It takes experience and commitment to do this type of work as it can be very difficult.

As a caregiver for my own loved one, It is very difficult. I honestly don't have an answer to this problem but truly am sympathetic to anyone in this situation. As it was suggested, perhaps some financial planning is helpful but the care at home is better if you can manage for an extended time. I would agree the system is broken with more and more people who need this type of help, I believe communities even church ministries need to step in and provide some type of program to fill those needs. Not everyone is eligible for government help but need assistance also.

This is a national crisis that no politician is addressing. . If we think things are bad now, wait another ten years when the baby boomers are in need of care for themselves. This populous group will hit the national care needs like a freight train.
I have found finding qualified caregivers who "really care', and are professional like finding a needle in a haystack. Plus here in California, we have new caregiver laws with complex shift, sleep times, breaks and hour conditions. I also thought about moving to another country. I believe states like Florida,Texas, Arizona , New Mexico have much more lax laws and conditions that are also a lot more affordable. The care in facilities are also more affordable from my research. Maybe someone out there could verify this.
There is no easy answer to acquiring good caregivers or facilities, that I have found. I hope to find some answers from your post!

What state are you in and what agency did you use that sent East European males for caregiving/? This is a great answer to providing caregivers.

I understand that this is a difficult situation. My Mom just passed away after 10 years of living with me. I set the boundary early that as her POA that I would match the level of care to her needs. I could not help her if she was bedridden or had dementia issues. I had Doctor orders that she needed help with ADL issues. She accepted what the Dr said not anything that I said. He was male and a trusted person and I was her daughter-namely her child. It worked for 5 years and then her health started to fall apart. Two trips to ER and Rehab and home again was manageable because I had an agency provide care 3 hours a day from 9:30 to 12:30. They made breakfast and gave her a shower and make lunch and put it in a lunch box. They were her companions while I worked. I came home from work at 3. She slept in the afternoon. I observed that nursing homes meant her having a roommate, a 30 minute wait after asking for help and food that was not warm or tasty.

I got an eldercare attorney and transferred most of her money to me but left some in case we needed to go to a nursing home and would need medicaid after she ran out of money. There is a five year look back period. I used her pension and medicare and SS benefits but I had to plan for her to live to 100.
THis really worked out. I spent $120,000 in agency care over 6years but had funds for spend down for nursing home. She had home cooked meals, shower three times a week at a reasonable time and care with ADL tasks and her own room. Her dignity was intact.
My goal was to keep her comfortable but with the knowledge that it would cost $15,000 a month if she needed a nursing home. I did burnout due to 24 hour care and should have had respite care. I am an only child and it did come at a cost to my health.
My point of view was that she could stay home if this care matched her level

of care. Eldercare Atty left some money in her name in the event she needed long term care to get admitted to nursing home and protected funds from medicaid so that her funds could go to her heirs. It was a balance. When she passed away in a nursing home she was covered by medicare due to three nights in a hospital for a broken hip and wrist and transferred to rehab and was there for 7 days and passed away with help from Hospice. I did not want her to die at home because it was more than I could deal with alone.
With careful planning, and some luck, you can make it through the system. I had to fight and educate myself. If she had needed long term care because at the end she was a two person transfer, she had funds to gain entrance to nursing home and 6 months of money for long term care.

She was 95 years old and died on her birthday with comfort from hospice and nursing home. She had paid taxes since she was 17 years old and I believe that she deserved care. I was willing to pay for home health care and I was unpaid caregiver. I feel strongly that the system is broken and based on the idea that there is someone in the family who will provide care. Many are in a different situation. Why is it the people who paid into this system do not get the care they need? I am at peace with the decisions I made. I could have placed her in a nursing home and all of her money would be gone and she would have been on Medicaid. I chose to spend money on her care but not willing to have her go bankrupt and leave her grandchildren with nothing.
I wish all families with this situation to meet the level of care but get an eldercare atty and protect the funds.
My thoughts are with you all.

Mom has no memory issues and only needs help bathing and minor assistance. We only have an aide 3 days a week for 6 hours per day. I could not get anyone for less than 4 hours a day just to bathe her and it does allow me to get out of the house some days. I had a small list of household tasks to fill in the day and once a week laundry, I wasn't expecting a maid, just occasional vacuuming and wiping up the bathroom. We are fortunate that other than moving very very slowly, she is not really in need of assisted living. We have a home nurse in every other week because she has an indwelling catheter. They come and take vitals one trip and the next trip they change her catheter. She is pleasant to all her caregivers so I don't understand why we are having so much trouble keeping one.

You don't say what Mom's needs are or what her mental capacity for good judgement is. However, I can relate some of my experiences.

Father in law was very ill with congestive heart failure, and had trouble making it to the toilet, was not mentally sharp any more, very weak overall. He had fallen at home a number of times and finally decided to move to an AL unit where he had friends. He was there for a little less than a year when he passed away.

After a number of falls and medical emergencies, he was deemed too ill to rely on AL services only. Choice: nursing home or we hire caregivers into his unit 24/7. He opted for the hired caregivers. Hired them through an agency that was recommended by the AL management (no financial ties between them.)

We were sent young males from Easter Europe. They had to help him to the toilet, change diapers, sheets, help with some meals. They had a private bedroom. Eventually, they started leaving town for weekends without notice, using his credit card fraudulently, not showing up...which required that my spouse, only in his 30's and trying to build a career, to have to leave work often to attend to the situation.

Caregiving for the elderly can be difficult, boring, physically and psychologically demanding. I think these people just could not take it anymore. So there was a constant churn of caregivers. Your situation will continue for these reasons.

It sounds like your mother needs at least an Assisted Living arrangement, and if she has dementia or cognitive issues, may already need Memory Care. If physically frail and in need of continual nursing care, she may need a nursing home. Some places arrange for a continuum of care through those phases.

I'd give her the straight talk about her needs and the fact that Assisted Living, good ones, have the same staff present for extended periods of time. The care will be more constant and the staff will know your mother's likes and dislikes. To try to arrange caregiving at home and ensure quality and consistency, you'd have to make yourself her geriatric case manager. That's really a full time job in many cases