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Dad (99) has been taking care of Mom (97), and still thinks he can carry on. Mom is incontinent with dementia. He has been talking more, and getting forgetful. Forgets to take his medication, and give Mom hers. I live at a distance, and try to get down to help when I can. The Medicare nurse that comes in 3 times a week recommended a home health agency, and a consultant will be coming in tomorrow to talk about getting help. I am Medical POA, but was told Dad is of sound mind so I can't go over his head. Dad has fired caretakers, because he believes he is doing great, and blames Mom for getting rid of caretakers due to her yelling at them, but it's him. He is in denial of his frankness, and thinks asking for help is a sign of weakness for this WW2 vet. Anyway, the nurse recommended that if we hire a caretaker, we get cameras installed. Now, I am concerned because Mom and Dad are so vulnerable, and I am sick thinking someone could abuse them. Do background checks show enough about the caretaker? I have sent out pleas to friends in the neighborhood about anyone they know who does caretaking to no avail. Any suggestions on good caretaking agencies?

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IMO, its much like hiring a babysitter. No matter what you do, there's going to be some risk. I would definitely install cameras so you can check in from time to time. Make sure you do it securely so that the rest of the world doesn't watch your parents while snacking on popcorn. People do that.

I would try to make sure you get the same person all the time. Some agencies will send out whoever is available. So your parents might get a different person everytime. I think it's best if they have the same caregiver so they can build a relationship.
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Are there jobs that your dad is having trouble with? If so tell him you are going to hire someone to work with him on those areas. Then when the person has been there for a bit he may accept more help with mom, because they are there to “work” with him. Sometimes the way we word the idea can change the attitude.
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Saveme1 Feb 2019
Thank you. Good idea! I will try this.
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Oh wow you’re at the very beginning. I started in 2013 and ended in 2018 coming in as a newbie going out as a pro ( if someone you fire gives you a key chain it says you’re the number one boss and you’re still on friendly terms I think that qualifies.) I considered myself the house manager and a caregiver. I’m not the only one who’s going to give you advice here, so I’ll focus on hiring caregivers and Agencies.

Caregiver agencies. There are none that can guarantee their workers integrity no matter what they say. The 20/80 rule is here too. Only 20% are good enough, I’d say 5% are actually what you expect, 80% are not worth your time. I never hired anybody that I didn’t have an opportunity to meet and work with first. The agency I worked with was willing to pay for one hour for training at my house, and I added paying one hour of training too. That was so I could determine whether or not I wanted to hire them at all. In any case ———-

Nanny cams are a must. Remove all valuables from the house is a must. And tell them you have nanny cams. That will help weed out a bunch of undesirables right off the bat. Even still, I’ve had caregivers who interviewed well, then watched the cams & they actually turn the nanny cams away so that I couldn’t see them! Fired! I always used them in the beginning and I would let them know if I saw something I didn’t like. That way they knew I actually used the nanny cams. Later, i only spot checked or when I felt suspicious of something. They were very valuable, Cannot say enough good about nanny cams. Put one in every room that your family occupies on a regular basis and one in the kitchen. They do eat your food and may do things you don’t like that you will want to know. Leave them out in the open. Have them keep daily logs with name/time and read them. Be on site as much as possible. Randomly show up.

I prefer private caregivers, an agency as a backup. Less expensive. Hire someone who is hungry to work. They will be more reliable. I used craigslist. Gave the basics, vague about my location, no phone number at this point - you have too many to weed out, that I had nanny cams, that I had high standards, and my deal breakers for Immediate dismissal. good people want a good employer and trustworthy coworkers too. I would give a starting pay and mentioned there were fast increases for the right person. I asked for resumes at the interview, ahead of time was better,and i would not contact anyone who could not form a decent reply back to me. first I email, then call, then an initial face to face away from the home at a nearby fast food restaurant. I wrote notes during the interview. Paid $10 an hour for the 1st four hours. considered orientation training, a get to know you and me time. $13 an hour for two weeks $14 an hour for one month $15 an hour after that. Rates may have changed at this point but that’s not too bad to begin with. I did the training. Agencies would pay one hour and I would pay one hour for two hours of training with any of their staff. I also offered holiday pay for the five major holidays during the year. Including Thanksgiving eve and Christmas Eve. If you don’t you will never have any time off for them. You really have to treat it like a business. I bought them gifts for their birthdays, their anniversaries, snacks on Fridays, I spent a half hour at every shift change talking to them about their personal lives. As unreliable as some caregivers can be, they are also one of the least appreciated and don’t have much fun in their jobs. I remember jobs where we always had office parties and had special occasions to get together, etc. Caregivers don’t. They work their butts off and have to be polite to their clients and employers can forget that there are people too and they want to feel like they are a valuable employee. This is not a job because it’s all about the money. Anyway that’s my two cents and the longest post I’ve ever made on this website. And ALWAYS ALWAYS TRUST YOUR GUT!
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Lizhappens Feb 2019
Lol. One more thing. Both private and agency caregivers callout a lot but less being private I think and also it’s easier to work with them to cover each other or to come in for additional shifts. With an agency that caregiver can call out on a regular basis because they know they will not be fired because they are one of the good ones. Then they wind up sending somebody as a replacement that you don’t know Or call you and tell you they don’t have anyone to cover at the last minute then what do you do? I don’t like that personally. Again it could happen with private too but you just have more to work with.
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These friends in the neighbourhood... how close are they to your parents?

The HHA consultant should, if she's worth her salt, be able to answer even searching questions and set your mind at rest. Would it be possible for you to take part in the consultation through a telephone conference call or anything like that?

The reason I ask about the friends is that there isn't really any substitute for boots on the ground; and if possible it would be good to have someone keeping a close eye on this important new relationship just until it's bedded in. It would be quite a lot to ask, and the friend would need to have plenty of common sense and of course be welcome in the home, but you never know.

Your poor poppa. The thing is, it's not so much a sign of weakness as being forced to accept that change is on its way; which unfortunately, inevitably, it must be sooner or later. Keep stressing to him that the help and support are his best way of continuing care for your mother at home.

You must sometimes wonder what happens if God forbid anything happens to him, too.

Have you had a chance to look around at what alternative options there are in your parents' area?
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gdaughter Feb 2019
Yes, that could be a good approach, a plan b, just in case something happens to you dad, then we need to have someone in our pocket to take care of mom...
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If there is a Bayada Home Health Agency near you, contact them. We have found them to be reliable, caring and extremely knowledgeable. It is a good company...the CEO ... the son of the founder ... gave a huge sum of money to employees as bonuses this year. Have had no problems with them in AZ.
Good luck....but as countrymouse said, they are not a substitute for boots on the ground family and friends.
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Before you do anything, remove anything that is "valuable" so it can't be stolen. Also make sure l00% of the papers, etc. are in perfect order. This includes a Will, durable health care power of attorney, and a general power of attorney so that you are fully in charge of EVERYTHING. Prepare a list of rules - do's/don'ts and make sure you and the caretaker sign it in agreement. Do background checks. Consult an eldercare specialist for advice. Be very, very careful. I took care of an elderly person for 28 years while working full time. I hired two people in the beginning to take care of her and it turned into a time of hell until I fired them after catching them doing some horrible things. Eventually she had to go into a nursing home where fortunately she was very happy. As to the father who thinks he is fine, tell him he either makes YOU in charge or you walk and be prepared to do it - until he realizes he has no choice. How else can you protect him. Just DO it!
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Lizhappens Feb 2019
Oh God bless you for 28 years and working full-time. I felt like I had my hands full with what I was doing.
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Please do background checks for the caregivers. My late mother was cheated by some untrusting people until I found out about it and put a stop to it.
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Here is a link to Missouri's Family Care Registry and what they look for when someone enters the helping profession. Employees are screened either every 6 months or every year, I can't remember. I would imagine that most states have similar data bases.

https://health.mo.gov/safety/fcsr/backgrounds.php
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If a Caregiver is from an Agency, They have already been Screened. However, Puttin gin a nanny Cam for your Own at Home Contentment is Fine as well.
If Mom and Dad don't Mind paying out of Pocket for Help, It might be worth the Ride at this Point. However, With a caregiver from an Agency, Mom and Dad will Be daily Monitored and any of their own Reports about their Physical and Mentality will be Reported as they see fit.
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Understand your plight. Whether or not he has been labeled of sound mind, you have to look at the safety of the issue. DPOAs act for the person and can be revoked at any time. Your parents need to be safe. Find a geriatrician and go with them for a checkup. Speak to the Dr before the visit about your concerns. They should understand and know how to handle concerns of this generation. Have them go for each other if they won’t go for themselves. Caregivers often die before the loved one due to stress. It takes a village to care for someone with dementia. Try and find a care manager to help them also. Good luck.
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