Frail seniors with physical and/or cognitive limitations do best with consistent providers of care. Constantly changing faces cause confusion, frustration and significant risk of complications. Although this seems self-evident, there is in fact considerable scientific evidence supporting the importance of consistency in health care providers. It certainly is no different in home care.
Imagine a vulnerable elderly recipient of home care services opening the door in the morning to find an unfamiliar caregiver. One of the first tasks of the day will be the morning shower. How comfortable is that senior likely to be? And how tiring will it be for her to explain where everything is, make sure the caregiver knows her daily routine, communicate her meal preferences, etc. etc.? And how much more problematic would this all be if the elderly client had cognitive impairment and a family member could not be present?
Of course, getting started with home care entails meeting and getting to know a new caregiver at first. Comfort and familiarity take a little time to develop. However, in an ideal world, a senior with functional impairments who receives home care assistance should be able to count on one primary caregiver, relieved only occasionally with carefully prepared substitutes.
The real world, however, is far from the ideal. It is not unusual for home care companies to “cover” their scheduling obligations by assigning different caregivers to the same client over the course of each week. In some cases, home care workers are given a different weekly schedule every Monday.
As if this wasn’t bad enough, the U.S. Department of Labor has made matters even worse by eliminating the so-called “companionship exemption,” whereby home care providers had not been required to pay overtime wages. The new federal overtime regulations, which became effective in October, 2015, require that home care workers receive pay of at least one and one-half times their regular rate of pay for all hours worked in excess of 40 per week.
In response, home care companies have generally chosen to limit their employees to 40 hours or less. Employees who need more work to make ends meet are out of luck. A client requiring assistance for 12 hours each day would therefore have in the best of circumstances at least two, perhaps three difference caregivers every week. Add in emergencies and other reasons for absenteeism and the number could be higher.
At Ready Hands, we have always striven to match each client with a single primary Home Care Aide (or two, when 24-hour care is provided). They are generally relieved on alternating weekends. The arrangement works well for both our clients, who need the predictability and consistency, and our employees, who need the income. Faced with the new overtime rules, we have changed our compensation and staffing policies to comply with the law while also paying our employees competitively and maintaining continuity for those who depend on our services—all without passing on the additional costs to our clients.
Senior care recipients need consistency. We have always understood that, and our delivery model has always prioritized that goal.