Arranging home care assistance for an aging or chronically disabled loved one can be a challenge for many reasons. One of the biggest hurdles is finding a high caliber home care aide who fits in well and forms a stable, long-term relationship with the care recipient. High turnover due to an unsatisfactory “match” is a big problem in home care. In this article, I will describe how we try to achieve good matches at Ready Hands Home Care. You can also view our video on this topic here. Whether you are using an agency like Ready Hands or hiring directly, I think you will find this information useful.
One note: I am going to assume that readers already know to obtain written or verbal employment references and do background checks. Also, this article will not cover legal and tax related aspects of hiring.
Verify Training and Experience
You will want to ascertain whether the prospective aide possesses the appropriate technical skills and experience needed. Proper training in personal care tasks like bathing, toileting assistance and transferring assistance are basic to many home care assignments where the care recipient has significant functional limitations. Training or experience with any specialized procedures may also be important in some cases. Examples would include the use of mobility assistive devices such as lifts, glucose monitoring, management of urinary catheters, feeding tubes etc.
In Virginia, licensed home care companies like Ready hands Home Care that employ hands-on caregivers must confirm proper training, usually by verifying completion of a state-approved Certified Nurse Aide (C.N.A.) training program. Examining a training certificate or a state issued license is the right way to do this. A C.N.A. is a good choice when personal care tasks are going to be involved, but not terribly important if mainly companionship, household tasks and safety supervision are the main needs. Besides hands-on care skills, don’t ignore more commonplace factors like cooking ability and driving skills.
Don’t Ignore Non-Technical Qualities
Just as important as technical skills and training are things like personality, work style and communication. More often than not, it is these kinds of factors that make or break a home care arrangement. The question is not whether the aide possesses some particular qualities, but whether the aide’s qualities would be a good fit for a particular care recipient.
Suppose the care recipient is a quiet person who values privacy. Then an aide who is animated, mothering by nature and has a bubbly personality might not work. However, the same aide might be perfect for another person with a different temperament. I recall one of the aides we employed years ago who was lauded by several clients as an angel of mercy. We once sent her to work with a gentleman who refused to have her return and called me personally to recommend that we fire her. But the problem was not with him or with the aide—it was with the “match,” which was a bad one!
Work style can make a difference as well. Some care recipients need a self-starter who works without direction well. Others prefer someone who stands by and awaits direction.
Make Sure the Assignment is as Good a Fit for the Aide as the Care Recipient
Sometimes we forget that to get the best out of an employee in a work setting, the circumstances of the job must meet the employee’s needs as fully as the employer’s. At Ready Hands, we never forget this. We can only achieve a happy client if we have a happy aide too.
You should ensure that the work schedule and total weekly hours are right for the aide. Will the aide’s financial needs be met? Does the schedule conform to other day-to-day obligations that the aide may have? Is the commute distance reasonable? Does the aide have reliable transportation?
Don’t Take “Yes” for an Answer
Applicants seeking work naturally want to get hired and may not think to mention potential obstacles that may only become evident after they have started working. One example we occasionally encounter is upcoming travel plans or other things that will interrupt or conflict with the work schedule. You hire a great aide and then soon learn that he or she has had longstanding plans to go out of state for a week to a wedding next month. Or, perhaps he or she will be resuming nursing classes after the summer is over and won’t be able to continue after that.
Our rule of thumb to uncover such problems is to not “take yes for an answer,” without carefully probing for the unexpected. How about fear of pets or pet allergies? If you have a dog or a cat, that will be important. Forget to check the driving record? That could be a problem if the aide who is to drive your loved one to appointments turns out to have a history of moving violations or accidents. Didn’t think to ask about other concurrent employment? You may discover that your aide has other work that supersedes or conflicts with yours. (We are approached all the time for overnight work by aides who have a day job and would obviously be falling asleep if we hired them to attend to one of our clients at night.)
In over ten years experience providing home care services for Northern Virginia clients, I have found that keeping the foregoing considerations in mind will a achieve satisfactory result 90% of the time (presuming basic screening and background checks are also performed). The other 10% of the time, we replace the aide and get it right the second time!