A great in-home caregiver is worth their weight in gold. They can help an older person with cognitive or physical challenges stay in the home they love, rather than moving to a nursing home or assisted living facility. They provide companionship for their client and peace of mind for family members. But the very personal nature of the caregiver-client relationship means that when problems arise—and they almost always do, as in any employer-employee relationship—it can be tricky to handle them.
Making expectations as clear as possible from day one is key, but when things start to go off-course, you can work them out. Here are a few common issues that come up with in-home caregivers and how to handle them.
Problem #1: They’re always showing up late.
We’ve all been stuck in traffic, slept through the alarm, or couldn’t find the keys as we were running out the door. So, a late start once in a while is forgivable. But if your caregiver is consistently showing up late—especially if you need them to arrive before you can leave for work—it’s time to consider whether they’re truly committed to the job.
You might consider including expectations about punctuality in a written contract with the caregiver. Put it in writing rather than just verbally telling them, so there are no misunderstandings.
Problem #2: They spend too much time on the phone.
Your boss wouldn’t be pleased if you were scrolling through Instagram during an important work meeting, so it’s perfectly reasonable to expect your home aide to put down the phone when they are caring for your loved one.
Of course you want them to have a phone for emergencies, and they may need to check in with their own children or parents during the day, but there should be clear guidelines.
You can say, “Dad really needs 100% of your attention, so please limit non-urgent phone calls to when he’s napping.” If you live in a different town or state, this can admittedly be difficult to monitor. Drop in unannounced when you can to see if the aide is complying with the rules.
Problem #3: The aide gets frustrated or angry with difficult behaviour.
If your loved one is suffering from dementia, there can be changes in behaviour that are a challenge to the home aide: An older person with dementia may become more aggressive, refuse to eat, resist bathing, or accuse the aide of stealing. This would be a good time to consult with a geriatric care manager to see if you need to step up to another level of care or hire a new aide with more experience in dementia care (and a more patient demeanour). If you want to continue with the same caregiver, meet with them one-on-one to discuss the challenges and see if they are willing to go through additional training.
Problem #4: They aren’t providing the stimulation you want.
You may have visions of your mum’s caregiver taking her for walks, playing Scrabble with her, and providing endless hours of stimulating conversation and care. In reality, they may be spending hours every day watching TV together. This may simply be a matter of unclear expectations.
The solution: Write up a plan of care, which outlines exactly which tasks you expect the aide to do each day. The plan might include: Go for a 20-minute walk three times a week; bring mum to a book talk at the library once a week; listen to music and go through photo albums every afternoon to stimulate memory.
The plan of care is a flexible document, which can be changed as needed, but it gives the caregiver a clear guideline of what’s expected.
Problem #5: They don’t communicate well.
Whether you live round the corner or across the country, you want to be kept updated on your loved one’s daily progress, including whether there are any changes in physical or mental status or any issues that need to be addressed. But at the end of the day, your caregiver may just be too exhausted to let you know. So make it easy for them.
For example, you can ask the caregiver to text you at the end of every shift, just a sentence or two about any problems that arose that day, or a list of what activities they did.
Regular communication should be included in your plan of care—and if you live too far away to check in regularly, consider hiring a geriatric care manager to keep on top of things and report back to you.