Monday, March 16, 2009

live-in care

I was asked to write a post about hiring live-in caregivers.
There are a number of considerations:
  • Do you want to hire someone? -As an employer you will need to understand labour laws in your country. Canada offers a Foreign Worker Caregiver Program.
  • Should you go through a non-profit agency, i.e., American Red Cross, Canadian Red Cross, or the Canadian Victorian Order of Nurses?
  • Should you use a private agency? Agencies, such as Qualicare, can provide you with a Nurse Manager who will take the burden of supervising a worker. Google and you will find millions of them from which to choose with no guarantee of excellence.
Job requirements:
  • Homemaker services (light housekeeping/meals), Activities of Daily Living (personal care, transfers) or IADLs, here is a list of possible duties.
  • Do they require a driving licence?
If you enter into a personal agreement write a contract, and get references. It is a risky business. Read "T" is For Trespass to find out what can go wrong with meds, finances, theft. Elder Abuse is a serious issue due to physical, psychological, neglect, social and emotional abuse. Ask for references from previous employers. If you hire someone with purported accreditation, check with, for example, the College of Nurses, to ensure that they are in good standing and have no complaints against them. A recent CBC news item speaks of theft from a senior. This option is not available to home care workers, such as PSWs, who remain unregulated and unaccountable for their actions. They may move from employer to employer seeking to remain under the radar and escaping tracking.

They type of caregiver is determined by the support you need. If there is lifting, you will need someone trained in this (i.e., PSW). Home Care Worker Conditions can be difficult. You want the best services you can buy. Many agencies use formal agreements, with bonded caregivers who are trained and supervised.
  • A homemaker can help maintain a home: house cleaning, errands, meal prep, purchasing food, transportation.
  • A PSW is the best choice if there is physiotherapy, assistance with feeding, bathing, but cannot administer medications, or, for example, clip toenails. They do not do house cleaning or housekeeping. They can remind clients to take medicines. There are many volunteer Hospices that will assist with palliative care.
  • An RN is best for serious medical issues involved, e.g., administration of medications.
There are many things you cannot expect any of the above to do:
  • heavy lifting, carpet cleaning, pet care, gardening, snow removal.
You may need to get in assistive devices, such as lifts, or commodes. Ensure that your home is as safe as can be, and easy to manoeuvre walkers and wheelchairs.

What is uppermost in my mind is that you get what you pay for. There are many YouTube videos in which family members demonstrate abuse of loved ones by employees. Qualifications of your workers: homemaker, Personal Support Worker (PSW), or Registered Nurse (RN). You are trusting a veritable stranger to provide intimate care in a private setting. You must be vigilant and ensure that your privacy is protected. Protect yourself by securing personal items. This Woman Catches Caregiver Abusing Elderly Father. It is rather shocking.

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