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Agree with others, to hire privately. Ask friends and family first.
Best wishes.
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TouchMatters May 2021
Again, while I am one of these people [ind contractor / have my own business offering care management, including direct service], know there are no background checks, no finger-print(ing), no insurance.

IF a person is going to hire an independent contractor, do the following:

1) ask for references (family of client and the person they worked with)
2) Ask them to get TB test (at their expense)
3) Ask them to get fingerprinted (at their expense)
4) Verify work references. (Don't just ask for them.)
5) Ask for personal / character references.

Anyone can offer to care for an elder. You must do your part / due diligence to insure the person you hire is, frankly not a criminal and is honest and has the integrity you are looking for. If you do not do your part, you will be responsible for the outcome.

* I've been working in the field for 'more officially' over 8 years, primarily at one retirement community where I contract with individual residents.
All care providers at this retirement home MUST be vetted through the retirement home:
1) show personal and work references / work history
2) Out of my $ pocket:
- yearly TB tests
- FBI finger print(ing)
Provide copy of car insurance

3) Weekly Covid test and proof

This SHOULD BE standard for any independent hire.
Hopefully, it is what an agency requires before they hire on caregivers.
Gena / Touch Matters
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The first time I hired private care for my mother, I caught them playing a game on their phone with their feet up on her coffee table. Why? Because I was at work and the first few days of it I decided I'd drop by unannounced. "You look comfortable," I said as I walked in. I called the company and told them the caregiver, and the company as a whole, were fired.

But not before I asked the person, and the company, why it was this way. "Well she was asleep and..." the person said. This was before I pointed to the sink full of dishes they could have put in the dishwasher. I asked for a refund of services, which I got, so that I could be paid to load the dishwasher.

I've found it takes several tries, and time we don't have, to find a caregiver that "clicks" and gets along with our elders. We eventually found one that actually went on to become a family friend, but not without moments of great anxiety and angst. She went on to get a different job otherwise I'd call upon her again. Some people love this kind of work. Some people need it to pay their bills. It takes time before you find the former, and go thru hell dealing with the latter.
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Oh dear! Some folks (particularly those with no medical background) equate the words "respite care" with palliative care for the patient - so they provide mostly companionship (although if they doing their homework, they are not even supplying companionship). Maybe removing the word "respite" from the job description might help a bit.
I was lucky to be able to hire a trained CNA for my Mom and she was wonderful!! Cooked for Mom, served lunch, took her for walks and rides... varnished my kitchen cabinets ( in spite of my protestations). As I said I was lucky and this woman had the work ethnic of a saint.

There are lots of reasons to go with agency personnel including the ease of payment, the coverage for liability and the fact that the agency will at least attempt to get a replacement if the caregiver has an unplanned emergency. However, as been pointed out they tend to hire at min wage (which isn't going to get you a lot these days when Amazon is paying 18 an hour) so the caregiver may only see $12 of the $20/hr you pay the agency. Sounds like the agencies you have dealt with are hiring students to be bad adult babysitters and that is not what you want.

If you have tried 4-5 agencies, perhaps it is time to try, as has been suggested, a private duty person from one of the care site on the internet. There is a person who posts here who works private duty and I am sure she can give you the names of some reputable sites.

I wish you and your family luck and peace on this journey.
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Maybe Mom would be better hiring someone privately. She may need to take out taxes and SS but she will have more control over who she hires. Sounds to me these agencies are hiring students. Are they Certified Nurses Aides? Hiring privately she makes the rules. She interviews telling them exactly what she wants.
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Fir starters, if you want good help that will work and knows what to take care of without being told, hire private help. Use a care finder website, interview a few people and check their references. Then negotiate the pay.
I've been an in-home senior caregiver for almost 25 years. I stopped working for agencies and went private cases only a long time ago.
You're not going to get experienced caregivers who know how to handle this kind of work from some agency paying minimum wage. Also, agencies lie to their caregivers. I know this from experience. Pretty much every case a homecare aide gets sent to is described as living in an immaculately clean house for some sweet, little old lady and all you have to do is have tea with her. Or some cool old-timer who just wants someone to watch a ballgame with. That's what agency help gets told. That's never what it actually is. Homecare agencies will pretty much hire anyone too. What they collect in payment is not what the worker gets. The caregiver usually gets minimum with no benefits. Clients aren't going to get much from that worker. Hire privately. If you're paying out-of-pocket for agency help, pay that to a private caregiver and you'll get good results.
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I am so sorry you are going through all that. We were lucky when we needed to hire a caregiver for my stepdad because it was too much for mom. We found a jewel in a woman who cleaned and took care of my stepdad. My stepdad died in 2017 and my mom came to live with us. Fast forward to 2020 and we were lucky that this same woman was available for work and we hired her and pay her as an employee. She cleans and takes care of my mom while I work. We also have a very responsible young adult who is a CNA come out as well since the other one can’t work on certain days. All in all with doing in as private pay we come out ahead of what the agencies charge. Plus our employee gets paid better hourly rate than the agencies give them. But I know that’s not always the case. We have used Senior Helpers in the past and Homestead Assistance. They were both good agencies but I don’t know if they are nationwide. I know this is hard but there are some good caregivers out there.
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dogparkmomma May 2021
I hope you are covering them with the same benefits they would get at work, including worker's compensation coverage if they get injured. If you are paying them, you are also obliged to pay payroll taxes just as any employer would. Otherwise, they are not better off with the higher salary you are paying them.
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We have been using an agency recently - for several reasons. The first was that we needed 24/7 care while the entire family was out of town for my nephew's wedding. That went well. They had no choice but to see to FIL's every need 24/7 because there was no one else to do it. Of course they only did what he asked for or we explicitly asked for(we left a notebook full of daily instructions) and there were some gaps from what SIL usually does when she is home - but they don't live there and couldn't anticipate everything but we couldn't complain.
What we didn't realize at the time because they had just started with the 3x a week as the bath aides at the same time - was that FIL was not allowing them to come into the bathroom with him. WTH? They weren't going in with him because he said he didn't need them. They aren't really 'allowed' to do more than the client or the client's proxy directly ask/tell them they need done? (apparently, we had no idea) So we fixed that really quick. FIL injured himself getting into the bath and we put our foot (feet? LOL) down immediately and said that they would be in the bathroom with him at all times and gave them a list of things that HE needed their assistance with before, during and after the bath. Ever since then, those things have been occurring. He didn't want them in the bathroom, he was embarrassed, but what was the point of having bath aides that weren't assisting him to bathe?
I don't know about other agencies, but at least with this particular group, as long as we tell them exactly what tasks we need done, they are doing it. If we don't give them specific tasks, they will sit and keep him company or wait on instructions.
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AndreaE May 2021
In my contract as a paid caregiver it also said to assist with bathing and toileting needs but the final say came from the client. So if the client says do not go into the bathroom with them, we are to respect their wishes. Its a difficult grey area for sure. Luckily my client was my mom (who just recently passed away) so I went in anyways but I can see how this could be a problem. I'm following this question because I will be trying out a new client when I'm ready to go back to work and want to make sure I'm doing it right.
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Well. There is a major communication problem.

Your mother is communicating her wants to the agency. The agency is communicating those in the form of tasks within the support plan to its workers. The workers... are not hearing, not complying, not agreeing..?

Your mother reports the failure to the agency. The agency hears the report and promises to act on it. And then..?

But I am also interested in "picture the scene." Worker arrives, briefed via the support plan which s/he should get in skeleton form with the day's rota, and then in more detail on the client's premises. Yes so far?

So this particular Wednesday, mother greets the worker and says: "today Mr Client would like to shower and shave. He would like oatmeal for his breakfast. I will give his medications. Once he is dressed and settled in his riser recliner he will probably need a nap, so if you could then help me change the bedsheets that would be much appreciated."

And the worker responds by..?

What should happen is that the worker first Reads The Support Plan. I personally take a blank Daily Records sheet and bullet point the support plan directly onto it, but that's because I do love a checklist. Last Sunday morning this led to my marching into the client's bedroom and demanding (kindly, not fiercely) to know why the client's wife was stripping his bed without assistance - "It says here," I said, tapping the folder with my pen and looking at her over my glasses - but the rule is that if she's happy, you're happy and she'd pretty much finished the job.

Anyway. So, worker reads Support Plan. Has your mother read it? What does it say?

Let's assume it says something like: "if time allows, please support domestic tasks including laundry, garbage disposal and tidying client's living areas e.g. bedroom, bathroom, day room."

So the worker knows this, and your mother knows this, and your mother comes into the room after an hour or so and finds your Dad asleep in his chair and the worker engaged in online training on her laptop. And your mother says..?

Now. I am only guessing. But my guess is that your mother finds it much easier to do the tasks herself than to say "Oi Mush!" to a strapping lass with a sulky expression, and possibly also finds it preferable to put her own dishes away than to leave this job to said strapping lass with the ham-fisted approach to porcelain.

There is an awkward phase during which workers coming in to the home seem to cause more trouble than they save. The first time you visit a person's home, you don't even know where the light switch is, let alone how they like their coffee, how dark they like their toast, whether they tuck their t-shirt in or prefer it hanging out; whether they store their mugs on their rims or their bottoms. I got my head bitten off for picking up and folding a damp towel - "I WISH you wouldn't do that!" snapped the client. I froze and delicately attempted to put the towel back exactly as she'd left it on the bathroom floor, then realised it must look as if I was taking the mickey and blushed - there is no winning with some people.

Now. There is no reason on earth why your poor mother should be expected to be a trainer in household management, and at this most stressful time in her life also find the energy and patience to engage with workers in teaching them their job. But that, to a greater or lesser extent depending on the individual worker's attitude and life skills, is the trick of it.

So, now then, hand on heart, do you think your mother is communicating directly and openly with the people who are actually standing in her house?
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As others posted, it really does depend on who is sent out. I have had good caregivers for my mom and some that were completely useless.

It seems like complaining to management hasn’t helped you very much. That’s a shame.

I think it is useful to complain if the organization is managed well. A good manager wants to know of any issues that arise and resolves them. A poor manager simply won’t care and will do nothing to fix the issue.

By complaining with an organization that cares, not only will your problem be resolved but you will be doing others a service by preventing that agency to send a caregiver that isn’t following procedures to future clients.

For me, personally, I want to be fair and give people a chance to correct a problem. If someone squares any issues, I let it go. If issues continue, then there is a bigger problem and I would bid farewell to them.

It also depends on finances. Some people can afford to pay a private caregiver for their services and they write up a specific contract. This should be prepared legally. I would not ever pay someone under the table like some do. That isn’t good for a variety of reasons. Consider everything. With an agency, if one caregiver can’t show up, they will send out a replacement.

You could consider paying for a housekeeper and separate caregiver for specific needs if your budget allows for this.

I had a caregiver that wanted to help me when she was finished with helping mom. It was very sweet of her but I told her that I didn’t expect her to do extra. I happened to be mopping my kitchen at the time and she offered to do it. Her organization specifically told me that she was only required to tidy up my mom’s room and care for mom’s needs, bathing her, helping her dress, preparing a light meal or snack. I cook so I never asked her to cook but she did serve mom her meal. Mom enjoyed when her caregiver shared a meal, a cup of coffee and a snack with her. I always made extra food for the caregiver to have a meal too.

I do hope that you are able to find suitable help soon. Wishing you all the best for you and your parents.
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You are referring to the one's that come to the home for respite, lol, they are worthless.

About a month ago, I bought one of those Traeger Timberline grill/smokers. Had not even used it yet, put it through the initial heat cycle, thats it. Came home from work, Sat before tax season ended, exhausted and the worker was bbqing ribs and sides for her family started it at her 8 am shift and slow cooked it all day. I was so angry. Made dinner, on stove and she told me her client preferred to "be served at 6:30 pm." I was livid. The normal lady just steals Keurig, tp and paper towel. Thats only the last month.

The agencies lie and if you complain too much, they will say you are difficult and wont send staff. Pick your battles and get a housekeeper to help mom with chores.
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MonkeyMoo2 May 2021
That’s terrible! I don’t understand how people have the nerve to do things like that. Today’s CG set up a laptop and started working on homework. My Mom has finally had enough and told her she was being paid to help them and could she please not do personal work during her shift. About an hour and a half into a 4 hour shift, she knocked on my Mom’s door telling her she had done everything listed so could she take off??? Ugh

We’ve been going through this cycle for about a year and a half now, if you do manage to find a decent one…they quickly get another job doing something else.

We also have a housekeeper that comes weekly for cleaning. But with daily soiled bedding and clothing, this stuff piles up quickly. I just don’t understand how a caregiver expects to get paid to do their own personal schoolwork or whatever rather than the things they have been hired to do. If I did that at my job, I would promptly be fired!

At this point, I’m not seeing the point in evening hiring them. It still all falls on my Mom and now she’s stressed and irritated on top of it all!
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when we needed a CG for dad,( mom was in a local rehab) the first one was a middle aged guy,, he took dad to see Mom, and here at the house he watched TV with him, but other than that he was on the computer ( looking for another job it turns out.. LOL) When we needed another once Mom came home, to "keep dad busy" so Mom could get things done, we used the same agency,, and boy what a difference in this lady! We actually thought about hiring her away from the agency as our own personal "Alice from the Brady Bunch".. but it was cost prohibitive as to the agency penalty.. She help Dad busy,, walks and projects,, kept Mom company too,, always looking for things to do and wanted to cook ( mom still liked to do that,, so no go therr but she always brought treats she baked.. ) and she tidied up . So maybe we just got lucky,, or you are unlucky! The agency was great about keeping in touch.
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FWIW the facility where my sister works has staff that are supposed to work 1 on 1 with problematic residents and most of them do the same thing 🙄.
Unless there is a significantly lower rate for "respite care" I would ditch that and go with something more specific - for example bath care, or whatever it is your mom need help with.
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