Our regular aide is on vacation for 10 days and we have a substitute who's been here before and done an adequate job. DH has undergone some changes lately-unable to process commands or even process information, restless at night, getting up 2x and looking for shoes (we hide them afraid he will try to get out) or just aggitated and not sleeping. Well the substitue is angry he cannot sleep thru the night and that DH won't respond to him to go to sleep; is frustrated that DH "does not listen to him". I advised him that these are tyoical behaviors for a person with dementia and since he claims he has experience with working with and caring for dementia clients he should have strategies on how to deal with these behaviors successfully. He replied that he won't be coming back next tme we need a substitute. Actually I am glad in some ways because it's always difficult to get him to do the job he's being paid for, but both DH and the dog are familiar with him. When I suggested that he take DH for a walk to get some of the enery out which might help him sleep better, he refused saying it was too cold and windy
We have DH on meds to calm his restless behaviors and have lunesta if needed but frequently they don't keep him asleep for the whole night. I guess I am just venting because I am disappointed that this aide doesn't feel it's his responsibility to do what needs doing.
Any suggestions? I don't want to change to someone I don't know while our regular aide is away-they could be far worse.
????????????????????????????? Doesn't sound like he was dementia trained to me. Or if he was, he is ignoring the training. Is he from an agency? If so, I would tell the agency you don't want him again and why. I would tell them to send someone who understands dementia behavior. If he's not from an agency, when your regular aide returns, I would aske him/her to recommend a substitute.
On my home page - www.thealzheimerspouse.com - on the left side, scroll down to the box that says "Elder Care Locator - Find Elder care services in your area." Click on that box and follow the instructions for finding someone well trained in dementia in your area.
LFL first off you are paying his salary not the agency. thru the agency of course. therefore if it were me, i'd have a plan i think DH would be ok with and let him know this is what we will be doing today. i wouldnt leave it to them to decide how to care for them. its in your DH best interest as you know him best not the aides. things he will enjoy or be interested in the aide should be able to participate in that with him to keep him busy. at night if you are paying them by the Hour, they are paid to stay awake, not sleep just doze as needed and always be up with your spouse is up. i wouldnt settle for an aide who backtalked period. but thats me.:) they are there as a paid caregiver to specifically meet YOUR needs not their own. make it clear there will be an agenda to follow and find things for your spouse to do day or night if hes up. we all know that the sleep schedule is haywire with our spouses and its not up for discussion that a paid worker is disgruntled over non ability to sleep. have a frank discussion with them what you expect. hope you work it out. new ones are always hard to train, but sometimes it has to happen divvi
I've had care aides like that and talked to the agency about the problems, but the problems with that aide continued. Got another one. Still not good. If one agency consistently sends poor aides, try another agency. I don't know if you have "The Nurse Next Door" in the States, but I highly recommend them. They match the aide to the patient until they've got a good fit. As for training a new aide in your home, it's a nuisance all right, but less bother than having to deal with the inadequate ones. One aide that was with Eric until he died was a middle-aged doctor from Russia who wasn't licenced in Canada. He took care of him; she took care of me; she took care of the doctors and nurses, she took care of the hairy ex-wife and children. I was/am so grateful.
It's a term made up by SCS when we were writing a soap opera on this site in Oct./11. It makes me laugh every time I think of it.
But I need to talk to you! I promise you as I promised Bama...no funny stuff. I need to tell you about my wife. But then Harold groaned....Martha looked nervously from Harold to D. Many thoughts running through her tired, stressed brain. Harolds first wife, his horrible children, (all hairy by the way) and now D...what was a woman to do?
LFL--I think you are stuck muddling through the 10 days with the sub. In my experience, the main attribute an aide can have (even over training and experience with dementia) is a positive attitude and a willingness to do anything that will make the patient and caregiver's lives easier. By this time and with the knowledge you have of your husband, you can train a willing person to care for him properly. You can't do much about a bad attitude! I would tell the agency what happened and why you don't want the sub ever again. Most of the aides I had were very good, but one had burnout and a few wanted to do as little as possible. I didn't want those back, even for one day.
Mary...I remember that now....I had forgotten about the Soap Opera we wrote. It was funny then and still is. The visual of a "hairy ex-wife" is worth a laugh time and time again.
Thanks to all of you for your responses and suggestions. Yes, I pay his wages to the agency, but the agency has reminded me that he is their employee, not mine. And if he has any issues, he needs to speak with them first, not me. I am willing (w/i limits) to tolerate some of this behavior for the next 5 days but will make sure that he takes DH out for walks-he needs the physical stimulation. divi, I have recently been advised that if you hire a 24/7 aide, they are NOT expected to be up with the client during the 8 hours they are supposed to sleep; if the client doesn't sleep then you need to hire another aide to be awake during the night to help the client. It's all bs by the agencies-they want to make as much money as they can during a bad economy where many families are no longer hiring agencies. Also, I have some physical limitaions and the agencies have advised me that if the aide helps me at all-meaning puts one item of clothing in a wash with DH's clothes, then they will charge me half the daily fee ($100) for the aides additional services. I feel so ripped off and trapped.
A daily agenda is a good idea. I'll try it tomorrow.
then to get around that, i would hire 2 different shifts one for a 12hr day say 9-9 and another for 12hr night. they are paid per shift regardless of hrs worked. i confirm you are being seriously ripped off. Any of the aides i have had and they are numerous, will do wash and kitchen dishes or anything you ask while the 'client' is napping or otherwise non engaged by himself. i agree if you hire one aide maybe 24hrs they get entitled some hrs sleep but try avoiding that hiring 2 or more shifts different aides. even hiring several shifts the hrs should still add up to the same hrly charges. that is total BS. if you have any recourse find another agency, as that one has its agenda bigtime. makes me sick to hear such stuff. unfortunately if you live in rural areas there arent several to chose from to guarantee they have to work for your business. stinks!
I think that I am the mean-queen of home health agencies. I have been thru all the local ones. I demand that they provide the service I am paying for. The agency is suppose to screen the aide and make sure that they have the necessary credentials for the service that you are requesting. They must make the matches. However, they sometimes have lazy people who are just looking for a check. It is your right to demand that the lazy slackard be removed and replaced with someone who can provide the service. taking your DH for a walk and being able to interact with him on a compassionate basis during the night are not too much to ask for, they are in the regular scope of his duties. The aide is working for you, you are not working for the aide. Demand a replacement. you might be surprized that your DH is more responsive to a new, more compassionate and competent aide than you might even imagine. One week I went thru 4 different aides, until the staffer send in her "trouble shooter", a very compentent nurse from the Virgin Islands, who they(the agency) had to pay extra money to come to my house. I continued to pay the rate in my contract. These agencies have to report to local government entities and do not want any bad marks on their evalualtions. I have been told that staffers cringe when they hear that I am on the phone. I want my relationship with them to remain just like this. As long as they are afraid of my wrath, I feel that they will bend over backwards to take care of my DH.
when i have had issues i have had really good luck with regards to the owners. most agencys have franchised and have someone who is the main investor even if they arent the ones running the place. i contacted the owner and told her as a business person myself i would want someone to report any misgivings to me if i didnt get resolutions thru the managers or persons in charge. she agreed at once and i had a direct contact with her if anything was amiss. they know the clients are the lifelines to successful business income, so if you get nowhere with the person 'in charge;' try to report it to the owners. since this happened, i get regular calls from the managers asking how they can make their services better.. grin.:) divvi
Update-I called the agency to clarify that I was NOT to pay the aide for the food he brought with him. I was advised that I was not to pay him and that he was to make a list of foods that he needed and I was to buy them for him. Then the agency manager asked if I had any other issues with the aide (which I thought was unusual). I told her yes but I would discuss them after his assignement was ended since I needed him for the next few days. She said she really needed to know what other issues I had, so I told her. Although she was discreet, it was apparent that they've had several complaints about him and his work ethic. She said that they will never assign him to DH again and will work with me to find a suitable replacement who is willing to do the job.
Just a note regarding hiring 2 aides with 12 hour shifts-in our area, the hourly rate for aides (hired thru an agency) who work shifts (not live-ins) are paid $22/hr which is significantly more expensive than the daily rate for a live-in. 2.5 times more expensive-about $600/day.
Thank goodness you let them know. A tiger does not usually change his stripes!!!!!! If you ever have to have another replacement, it would be a good idea to call as soon as you suspect a problem. They should just fire this clown and not send him to some other poor suspecting soul!! Unfortunately, Home Health Care is a business not a caring compassionate organization. Hope all works out for you and DH until your regular aide returns. Keeping you in prayer.
LFL--glad that you got things worked out. I think the agency should give you a partial monetary credit for the time the sub worked. He is supposed to lessen your responsibilities, not increase them! Since there were complaints from other clients, that proves it wasn't your doing.
Thanks all again for responding...I have a meeting with the agency manager on Thursday and will discuss with her possible credits and how to alleviate this in the future. Although there's a plan of care in place, I don't think the agency discusses the requirements of the care plan with the substitute. So I've devised a daily agenda that the aide is expected to perform as well as menu choices for breakfast, lunch and dinner and will review with the manager so we can negotiate in advance what the substitute's responsibilities are and what he must carry out whether he likes it or not.
Glad to have regular aide back. I believe the agency will continue to use the sub because in our area it is almost impossible to get a male aide. His work record keeps him from having a ft position but I know the agency will continue to use him as a sub because they cannot get male aides.