Episode 47 -
If you’ve ever cared for a loved one or have watched as a parent or grandparent slowly declined, then you know how important it is to make sure that they are being cared for with kindness, patience, and respect. These are difficult times for them and for the family. Maybe you’ve taken on the responsibility of their care, or you’ve started visiting with them every evening after work just to make sure that they’re taking their medications and eating dinner. The emotional and physical toll that comes with caring for a declining loved one can be heartbreaking and exhausting.
It’s hard watching as the person who use to be vibrant, strong, and active is now slowly becoming a shell of their former selves. It’s hard to fully prepare a family for what to expect when the time comes to care for their older loved ones.
If your family is like many facing this difficult situation, you’re probably still working, raising children, and in some cases, you may even have grandchildren. If that’s the case, you have officially entered the Sandwich Generation – and are struggling to maintain the balance between caring for your parents and your children.
The term Sandwich Generation was coined by social workers Dorothy Miller and Elaine Brody in 1981. It’s used to describe caregivers who became sandwiched between generations. Right now, 47% of adults in their 40s and 50s are supporting an aging parent in their 70s while also managing their kids. If you’re interested in learning more about the Sandwich Generation, head to the links in our show notes. There, you’ll find a link to an episode we did on the topic, as well as an article for further information.
Whether or not you’re struggling with this balance, you might find that you are unable to care for your loved one at all. Maybe you are still working and cannot afford to lose your job or to retire or maybe you live too far away. There are many factors that can prevent family from being able to provide the care and support that their loved one needs.
If you find yourself in this situation, it does not mean all hope is lost – you just might need to find outside help. But choosing a person or company to care for your loved one isn’t easy. How do you know that you are making the right choice? This is an important decision. After all, you don’t want to choose just anyone to care for your Mom or Dad – this is the person who will be with them when you can’t be. You have to find the right fit.
Many families struggle with this decision – but there are ways to make the planning a little bit easier. Begin by including your Mom or Dad in the conversation. This isn’t just an adjustment for the family, but for them too. They have most likely been independent their entire adult lives and now have to adjust to being cared for by a stranger.
Don’t be surprised if your parent is in denial about the help they need. There is a lot of pride and dignity with our older generations and sometimes they can have a hard time accepting help or acknowledging that they need any at all. Of course, sometimes a parent may surprise you and accepts their reality right away – you just might find that you don’t need to convince them at all. Still, if your parent is struggling to come to terms with what they are facing, there are plenty of ways to help them.
Sometimes families may find that there’s a sibling who may be better talking with their mom or dad about difficult subject matters. That sibling may be the best person to start the conversation. They can help to prepare the parent, and also remind them that outside help is the only solution for the time being.
Now you can consider whether you’d like to hire someone privately or hire a professional home care company. Remember, there are risks with hiring someone privately – like liability insurance, workers comp, running criminal background checks, and the risk that they may need to call in sick from time to time. Make sure that you discuss these risks with your family and loved one. If you decide to hire someone privately you will want to ensure that all possible protections are in place. If you choose to hire a professional company, these protections and many other benefits are taken care of. In that case, the family can use their energy focusing on their loved one.
Whether you’ve decided to hire a private individual or a professional company you’ll want to sit down with your family and your loved one and identify your loved one’s needs. It’s important that you include your parent in these tough conversations. By giving them a voice, you’re showing them that their input and opinion matters - and that they haven’t lost all of their independence.
I cannot stress enough how important it is that the family doesn’t exclude their loved one from these discussions and decisions. Too often, families start the process and make many of these decisions without including their loved one in the process. Recently, we met with a family who was ready to get outside care started for their mother, who was in her 90’s. They had already made a great deal of decisions – without consulting her. In fact, they didn’t even warn her of her new lifestyle until the day before her care began. When the mother met her new aide the next morning, she confided to her that she felt her family had gone behind her back. She was hurt that they excluded her from such an important event in her own life.
In the case of this particular woman, she had lived independently from the time she was 17 years old. Even now, in her late 90s, she was as independent as ever, with no cognitive or mental difficulties. Physically, though, she was beginning to falter. She was beginning to suffer falls on a semi-regular basis. Her family was understandably concerned that she may become seriously hurt or fall when there was no one there to help her.
This is a delicate situation for families and one that they undoubtedly make out of love. And, from time to time, there will be instances when it may be better or even necessary to make a decision without the involvement of the loved one. This could be for a number of reasons. Maybe they are dealing with cognitive issues like dementia and they cannot offer answers or input relating to their care. There are also times when a family’s loved one would really benefit from care, but they are determined not to get it, even after the family has sat down with them and were able to get them to agree – only to refuse the next day.
We have seen situations like this. A family recently met with one of our Case Managers and needed to have care for their mother. They had met with the Case Manager without their mother and informed them that their mother had experienced care previously for just two weeks. This usually means one or two things. First, the company sent someone inexperienced. Or, the client (in this case the mother) refused help.
In this situation it was because the mother did not want anyone helping her. The reason that we do an in-depth assessment and intake when initially meeting with families is so that we can learn as much about the person as possible. That way, we can ensure that they receive the best type of care for their needs – and connect them with a caregiver that would be a great fit. We never want to send “just anyone” to care for a person in need. The connection between the caregiver and the client they will be caring for is vital to the success of the care and the connection between them.
There is a lot that goes into ensuring there’s a good connection between the client and the caregiver. Afterall, this is one of the most important aspects of the care. This is the person they will be spending all of their time with – so they need to have shared interests and fit well together.
So, how do we find the right caregiver?
We begin by determining the type of care a person needs. This includes the amount of time that the help will be needed and the hands-on care that a client will need. If there are domestic needs around the home that are being neglected, we make sure that the caregiver is aware of them. Now, if you decide that a professional company is a better fit for your loved one, make sure to mention that to the case manager when you meet with them.
If the family decided to hire someone privately and will be posting the position publicly, they will want to make sure that they write a detailed description of the position. This is a good opportunity to share what your loved one needs - in terms of their care both personally and domestically. Since everyone’s needs are different, make sure to be as specific as possible. For example, if your loved one is diabetic, you will want to make sure you mention that, and make sure that the caregiver has experience working with diabetics. When creating the description, you will want to designate someone in the family to handle the interested candidates.
Make sure, for safety reasons, not to divulge any of your loved one’s personal information. This includes their name, phone number, or address. It’s ok to list the city so that anyone who is interested will know the area they live in. Next, decide where and how you will conduct the interviews. It is always a good idea to schedule the initial interview in a public place. With the current situation with COVID, you may need to make some adjustments.
Remember to take these interviews very seriously. This isn’t like working in retail or even in an office. These positions are very personal. There is a great deal of responsibility involved when another person relies on you. This could mean making sure that their medications are being taken on time and appropriately, attending their doctor appointments, helping with their daily nutrition, and so many other things that sometimes are just taken for granted when you do them naturally.
Take the time to get to know the person you are interviewing. If your loved one has a cat, make sure they aren’t allergic, and that they like cats. Are they social and talkative? If they are and your loved one loves to visit that could be a really nice connection between the two of them. What are their interests and hobbies? You know your loved one better than anyone, so you’ll be able to see how you think this person will connect with them.
When you think you have found the right caregiver, reach out and let them know that you think they would be a nice fit for your loved one. Then, ask them to provide you with 3-5 professional references. These should include people they have either cared for privately or companies that they have worked for. This will help you to know a little more about their character as well as their dependability. Remember, your loved one and family will be relying on this caregiver to be there for them.
If the caregiver agrees to move forward, you will need to create a work contract. You can create this at any time, even before you officially hire someone. We would recommend contacting your attorney or finding one to help create the contract for you so that you and your loved one are protected. They’ll provide the details that you will need and make sure that every detail is accounted for.
The contract will cover things like:
Pay rate and wages.
Hours they are being hired to work.
Social Security Number (for background and tax purposes)
The job description that they have agreed to fulfill.
Behaviors that are grounds for dismissal. This will include things like tardiness, calling off, smoking, drugs, abusive language or behavior, etc.)
Termination. This would include (how much notice is needed, reasons for termination without notice, etc.)
Then you or maybe another sibling helping with this portion of the process and the candidate would sign and date the contract.
When hiring someone privately, have your attorney advise you on what you will be responsible for, so you can make sure your family and loved one are protected in the event of an accident or injury. They can advise you on workers comp, taxes, liability insurance, and bonding of the caregiver.
The next step that you will need to do is the background, motor vehicle report, and drug screening. There is never a reason to skip this step or take the word of the candidate that they have a good driving record and clean background. Some candidates may even arrive with a recent background that they just completed. Always be sure to do your own.
After the background screenings, it’s time for the caregiver to meet with your loved one. This will be a great opportunity to give the caregiver a tour of your loved one’s home and show them where medications, cleaning supplies, and other day-to-day items are kept.
When the caregiver finally begins caring for your loved one, there will be an adjustment period for everyone – including the caregiver. They may have years of experience, but they don’t have any experience with your loved one.
If you’re able to be present on their first day, stop by for a little while to see how they are doing. Still, don’t stay too long because it can sometimes be easy for a loved one to think you can stay longer and come by more often and then they won’t need a caregiver. This typically happens with the loved one is already against having help. If everything goes well after the first week or so – and your loved one is happy and enjoying their new friend - it will hopefully bring you peace of mind.
The last step you may want to consider is to start thinking about a back-up plan for those unexpected and expected times your caregiver may not be able to work. There may be times they are sick, have a funeral, have car issues, or be on vacation. Finding someone that you either know or that replied to your job description will hopefully be a little easier than when you first went through it before. Eventually, you will want this person to shadow your regular caregiver once or twice. That way, when they do need to be there, they won’t be completely unfamiliar with your loved one and their routine.
We hope that you find the right caregiver for your loved one and that it helps them to continue living healthily, safely, and with dignity. Having the right caregiver makes all the difference.
We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone who could benefit from this episode, please share it with them.
Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Please Join us next time on All Home Care Matters where we will be discussing an issue that many seniors face and especially now during the pandemic the issue has become even worse and that’s Combating Isolation.
Sources:
https://www.nwpc.com/health-care-and-the-sandwich-generation-infographic/
https://www.tn-elderlaw.com/free-resources/resources/ten-tips-for-choosing-a-caregiver-for-an-elder
https://podcasts.apple.com/us/podcast/all-home-care-matters/id1513502341?i=1000486838856
https://www.allhomecarematters.com