Discovered yesterday that the care plans I've been given for DH evidently aren't as detailed as what's provide to the company or agency providing services. Since 2006 a Company has been providing personal and housekeeping care for DH--first 6 hrs a week and then bumped to 9. The male helper and I have had an ongoing job of getting DH to have a shower and shampoo once a week--any way we can. Now we have Hospice (just getting started.) The first week they sent aides to do showers two days running per nurse's care plan (I was told these helpers would do housekeeping things), in addition to the one provided earlier in the week by the first service. That didn't fly last week very well at all. I worked to clue him in and he agreed to one of the Hospice shower/shampoos this week in addition to the early week one. Now, because the Company providing the early week shower and housekeeping has a shortage of male helpers and ours is out for surgery, they suggested Hospice might help until he's back--a coordination. In clearing this with the Area Agency, our case manager agreed to the change and has suspended 3 of his 9 hrs. until our regular worker is back. She claims she set up those hours to cover 3 showers a week. Now I'm left trying to be sure everything essential gets done with less hours and substitutes, and feeling as though I dropped the ball. Another thing on my plate as I talk to these "Case Managers" about 'their' care plans for DH. It's hard to be in compliance with goals you're not informed of.
I think it all boils down to that nobody cares the way we do. They are good at putting it all down on the computer - spending their time making plans that no one reads - but it isn't implemented. A case in point: last summer I asked the Nursing Care Facility to provide me with their Care Plan since it was obvious that my husband wasn't even getting basic nursing care. To my amazement , I read how they would help select his clothes in the morning and help him with grooming (nails, shave, comb hair). It's never been done, is not done now, and unless I do it, he would be in the same pair soiled shirt and underwear shorts for more than a week.
Thank you Carosi. I never would have thought about that. I will put this in the Caregiver Tip section - very very important:
When you hire an agency, get a signed copy of the care plan that you AGREED to, and go over it with the person who comes in to do the work. If there is any discrepancy between what they do or are willing to do, and what the plan says, call the agency.
The copy of the Care Plan from the Agency says help with ADLS. Not specific as to kinds of help or frequency. It appears, they write up a more detailed plan for the firm providing the workers, but even so, in our case, the worker has been working wit us for over 3 years. In that time he would have said something if he wasn't doing all the things in the Care Plan, because the firm would have been on him about it--everything done goes on the time sheets.
Another good tip. Hope I remember it "when the time comes." I'm thinking I should be making a notebook for myself in the computer of suggestions ya'll make.