Quality of caregivers is abysmal.

I worked elder care for the 2 biggest companies in the nation. They are franchised out, so you get a very different 'training' and attitude from each one.

I was what you'd consider very overqualified for the job--but I needed flexible hours and had another job I was working around.

I was NEVER 'trained'. NEVER. Not even how to put a bandaid on.

I was paid $9 an hour and never received a raise. I worked holidays, weekends, whatever. I was lucky in that one of my families found out how little I was making and went to the company and worked out a 'private' raise for me so I was making closer to $15 an hour.

Many of the CG's don't have cars. Or licenses. Or clean records. Or don't speak the same language of their clients.

The turnover for any one client in the space of a year was 100%. Or super close to it. My client's family treated me like pure gold---b/c mom was a challenge and exhausting for the family. I loved her--but I got to go home at the end of the day.

Why is it so hard to get good workers? I would have to say that I never felt appreciated by my company, I was paid an abysmal amount of money and I was expected to be available 24/7.

I'm sure unimpressed with the CNA's that take care of my MIL. They've missed a lot of stuff and seem to be pretty poorly trained. Not my monkey, so I don't say anything.

Everyone complains about the money that is charged for in home care, but of that $39 an hour? Your CG is only getting about $12 of that.

I have contacted many agencies recommended to me by the hospital, rehab and hospice. None of them have certified aids. They are home health aids (HHA) rather than certified nursing assistants (CNA). Where I live the HHAs cost up to $39/hour! I can’t even imagine what a CNA would cost.

I have a couple of friends who are HHAs. Both of them are middle aged women who have raised families. I think they are both good at their jobs, but it is because they cared for children, handled emergencies, handled illnesses, made decisions, etc. Their training is life experience. I don’t think it would be out of line to request a mature, experienced woman from the agency. Good luck.

I was an in-home caregiver for 25 years and I now operate my own homecare business.

Here's how you get quality caregivers. Hire privately and offer quality pay. Not te insult wages that are usually offered.

Or if you're going to use a homecare agency, the first question you should ask is how much of what the agency collects for a caregiver actually gets paid to the caregiver. The answer to that should be at least 50%. If it's not then go with a different agency.

Homecare is mind-numbing, back-breaking drudgery work. The work is lousy and so is the pay. That's why the turnover rate is so high in caregiving. The people who usually do this line of work are either students who are going to move onto greener pastures, or it's people who couldn't get a better job.
You want quality, competent caregivers? It's going cost you. I did private care for a long time and named my price. Either the clients met my price and I worked for them or they did not and I moved on.

Please do not buy into the complete nonsense of it being "rewarding" and making a "difference" in people's lives.
That's the BS agencies tell their homecare workers because they won't do right by them.

Personally, I treat my people right because I know how it is and I'm not greedy. The same cannot be said for other agencies.

So if you want good help, pay for it. That's how you get it.

My parents had wonderful caregivers when they were still living at home. One actually visits my parents in the NH once or twice a mont on her own time.

I grew close to her during the year she worked for my parents. Her birthday was last week and I'm taking her out for lunch tomorrow and will give her a little gift.

I have met so many kind, compassionate people these last few years who were involved with my parents' care. The world is a better place because of people like these.

Care.com is like hiring off the digital street. Like facebook or next door hires, a lot of these people are under the table pay wise or otherwise.

Where I live HHAs are certified thru the State and like CNAs and are trained. They tend to do mostly cleaning cooking and laundry but overlap with CNAs and can do bathing and such. CNAs tend to do more hands on but overlap HHA in they do cleaning, cooking and laundry. Agencies are a business and there to make a profit. They pay the aides, the receptionist, the boss and overhead.

As an employer for many years since 1983 (in the graphic arts / advertising / branding industry) I can tell you that once we entered the 2000s we never found the quality of people like we did in the earlier years. They were dismal problem solvers and seemed to have 0 common sense or initiative. So, we got used to training up and investing in (and taking risks with) the mediocre ones we did hire and the same will need to be true of in-home aids. If you find a reasonable one you should consider teaching them certain things yourself, if possible.

I went through at least 3 agency aids to eventually find 1 that was with us for 6 years until she retired. She was awesome and worth the work to find her and we made sure to give her enough hours to incentivize her to keep requesting us. After that, it was a parade of clueless people who looked at their phone every other second and had no sense that we were a paying client with expectations. There is still a labor shortage combined with a mass of Boomers needing more services, plus the govt is being stoopid about letting people into this country legally to work and have better lives.

For anyone who needs to hire agency aids, you must request people who are experienced in working with people with dementia, and any other specifics your LO needs tending to. But good luck with that. I would now go so far as to have them watch Teepa Snow videos so that they can have some understanding of what they're doing.

As for how much they're paid... like teachers, if you raise their rate it just gets passed on to us consumers since healthcare is not a charity. If the government subsidized it, we'd just pay more in taxes (and my property taxes, of which 50% goes to our schools, just went up by $1,000 for 2024). There's no miracle solution here since the govt can't just print more money.

What exactly are you expecting them to do that they are not?

Honestly, I think agency caregivers are worse than private ones. The best thing to do is ask as many people you can for personal recommendations. If your community has a Facebook page or a NextDoor page, that's always a great way to find them.

I too was a little taken back when I learned that the title of “caregiver” did not translate to any actual professional training or licensing. Various home health agencies were all too eager to send over a “caregiver” for $40 to $50 an hour with a 4 hour minimum… only these “caregivers” were not CNAs or certified Home Health Aides… just rando kids that applied & were willing to show up. I found the same level of training (lack there of) occurring in the local Board & Care Homes. Before placing a loved one, ask the support staff some basic medical questions like “what do the numbers on a blood pressure reading mean, what are the signs of stroke?” etc I did that… my dad is still in his condo as a result.

Now I appreciate that there is a major labor shortage… inverted productivity due to more dependents in the population than producers… I am totally aware that our elders cannot comprehend the economic hopelessness & brutality anyone under age 50 is currently experiencing. So if a fast food restaurant is offering $18-$20 an hour to start, why would anyone of sound mind work for $15 to wipe the butts of angry old people.

The solution to my particular situation was hiring private pay caregivers. I’ve said this before - I am literally operating a small business specifically for my fathers in home care. Even with a background in business management/operations it’s complicated & exhausting. I really wish I could have utilized an agency, but the quality of care was in fact abysmal. This is not an attack on caregivers in a personal capacity, but rather the applicable care that is or is not provided.

I interviewed over a dozen applicants that I found mostly through local churches & work connections. I settled on 3 part time caregivers & scheduled them in ways that all can have 2 or 3 other clients. Only one was an actual CNA. For the others I purchased a used intro to nursing textbook that I keep in my dad’s place. Because I had 6 years of hands on wound & cancer care, etc from my previous forced family caregiver experiences ( plus I’m a licensed Holistic Health Practitioner & licensed Cosmetologist among other stuff) I did serious hands on training for my hired caregivers. By training them myself I was able to get the sort of care my father truly needs.

I looked into CNA licensing & here in California there are multiple programs available that will fully pay for someone to attend classes & become a CNA. The entire process can take as little as a month. When I think about the tens of thousands of dollars & years of education it took me to obtain my professional licensing & certifications… Now the government will pay for you to go to school for a few weeks & you can come out debt free earning more than Hairstylist with 20 years in the industry.

I do offer compensation that is far above any potential competition. My girls are paid every single week at $25 a hour to start, all food & beverages are covered during their shifts, paid Birthday Day off, are allowed to bring their pets with them to work & a holiday bonus. They have all holidays off & get plenty of little extras to show they are valued because it’s damn hard work. But they do not get healthcare benefits or paid time off. Now my one caregiver that’s a CNA frequently asks for pay raises but I’ve told her no & she free to find better pay - she’s still around… words gotten out in my dad’s condo community & I have people approaching me to ask to work for us. Turns out sometimes when you treat people fairly & respectfully, they will respond in kind. Not always, but the ones you actually want around will.

I truly believe the western world is currently in a crisis of caregiving that has only begun to emerge. The costs are simply too high & the only real solution any one can provide is financial destitution that is ultimately designed to obliterate the existence of a middle class for the direct benefit & profit of the investment class.