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TextOmbudsman Program Newsletter Article
Tips on Dealing with Home Health Care Providers
- "My aide frequently shows up late without calling to warn me."
- "The number of hours that my aide works for me varies from day to day."
- "My client is expecting me to work past the number of hours that we agreed to."
- "We are using my car to take my client to the grocery store and hairdresser, but I am not getting reimbursed for gas."
Home care consumers and the independent home care providers that serve
them have made comments like these to the Long-Term Care Ombudsman.
The problems expressed often stem from a simple yet critical oversight:
the provider and consumer did not put their employment agreement in
writing.
Among other things, it addresses the care to be given; days and hours of
work; terms of wage payment and benefits; designation of a backup worker;
advanced notice of termination of service; and who to contact in an
emergency. Perhaps most importantly, the form provides space for
the consumer and provider to designate a future date to meet and review
their agreement. Addressing the conditions of their agreement
should not be a one-time event because, if nothing else, the consumer's
care needs will likely change over time. The agreement should be
signed after each review and both parties should retain a copy.
When both parties take the time in the beginning to sit down, explore,
and record their expectations, needs, and preferences, many simple
misunderstandings can be avoided. This is because they cared enough
to openly communicate and formalize their agreement, and the result
is that they feel mutual respect. Both have a clear understanding
about the expectations of this home care service, which gives rise to a
greater level of comfort.
During the hiring process, consumers are advised to inquire about and
verify a home care provider's training, credentials, and prior
experience. Consumers should ask for references and call them with
forthright questions. A preliminary face-to-face interview with the
provider is a must!
The Revolving
Door
One home care consumer who needed home care services nightly, called us
out of frustration because the home care agency was sending a different
(and often new) aide to work there almost every night. This meant that
each night she had to orient or reorient the aide, and the two had to
become accustomed to each other. This was disruptive, time-consuming,
annoying, and anxiety-producing. Her home had a revolving door. The
resolution? The home care organization decided to create a pool of 4
to 5 aides who would rotate and serve as back-up to one another in caring
for this consumer.
Too Many Cooks Spoil the
Broth
The Long-Term Care Ombudsman received a call from the son of a gentleman
who was receiving home care. The home health agency aides caring for
his dad weren't doing what they were supposed to, he said. After the
Ombudsman interviewed all of the parties involved, the source of the
problem became clear: there were too many "bosses" in this
situation. The home health aides were receiving directions from the son
(who did not live there), the man's wife, the housekeeper, other adult
children of the recipient, the agency Nursing Supervisor, AND the care
recipient himself! The agency policy (appropriately enough), was to
follow the wishes of the recipient, but in this case those around the
recipient had other ideas and created difficulties.
The moral: When a home care service is engaged, make very clear to
everyone who, if not the home care recipient, is to give
directions.
Lead Us Not Into
Temptation
Consumers, please do not give your home care workers your credit cards
in order to make purchases!! If you need your aide to perform shopping,
create a petty cash box containing a set sum of money. Sit down with the
worker and explain how all receipts for purchases must be placed there,
and that the total of cash and receipts must equal the amount you started
out with at all times. Then monitor the box!
Drop By to Say
"Hi"
If your relative lives alone and is receiving home care, it is advisable
to stop in occasionally when the worker is scheduled to be there to see
how things are going. Pop over when the worker is NOT scheduled to
be working as well. Frequent phone call check-ins with your
relative are certainly helpful, but not a substitute for in-person
observations. This is a good idea whether the services are being provided
by an independent individual or by an agency which says that it
supervises its workers.
There's a Method to my
"Madness"
One consumer complained that his home care aides were not taking his
disabilities into consideration as they cleaned his home. They did not
appreciate the importance of making the bed in such a way that the
consumer could get into it by himself at the end of the day. They would
see the telephone receiver placed backwards on the phone and
instinctively, impulsively turn it around. The consumer used a
wheelchair and did not have use of his left arm, so he purposely placed
the receiver that way out of necessity.
The solution: explain your methods to the worker the first time he or
she comes to serve you. Or write some of these things down and have the
new aide read and refer to it. If the aides still do not comply
after reminders, bring it to the attention of their supervisor.
For further information on the hiring process and registries
of home health care providers maintained by county agencies in
Northern Virginia, please call the Long-Term Care Ombudsman at
703-324-5861.
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