What Should a Caregiver be Doing?

May 20, 2020 | Caregiving

The decision to hire a caregiver for a loved one might come after long, slow deliberation, or it may need to happen quickly if a loved one experiences an unexpected hospitalization. Either way, families must consider a number of issues to make the best, most informed decisions for their loved ones.

Decide what caregiving looks like for your situation

Caregiving is a huge umbrella term that means different things to different people. Elisabeth Knight, clinical manager at Caring Excellence At Home, says, “What we normally recommend is asking what caregiving looks like, due to the fact that there is such a wide range of services and needs that can be provided.” For some people, caregiving is mostly companionship, while for others, caregiving means helping manage a health issue such as diabetes or stoma care. It is important for families to have an idea of what needs they think their loved one has prior to contacting a company or home health care agency. 

Expect an assessment and a care plan

Most reputable home health companies will perform an assessment of the patient to determine what needs he or she has and then provide a care plan that details what caregiving will specifically look like. “Having some sort of a written contract is a good idea,” Elisabeth says. “It eliminates possible confusion. When a caregiver is supported and knows what their expectations are, they provide the best level of care.” A care plan not only protects the client, ensuring that caregiving requirements are spelled out, it also protects the caregiver from being tasked with services that are beyond his or her scope.

Care plans can change

Elisabeth says it is common for care plans to change. Sometimes this happens because a loved one isn’t keen on bringing a caregiver into the home so the family opts for care to be minimal at first. It often happens that once a caregiver develops a relationship with the client and provides care, the loved one realizes how beneficial it is, which means the care plan is expanded to include other duties. “I think you can almost guarantee that if somebody has had a trip to the hospital, they’re going to need an updated care plan when they get home,” she says. 

Ask what is not allowed

Families that are considering hiring a caregiver should ask what the caregivers cannot do or are not allowed to do. “We explain to our caregivers that we do not want them to do anything that is out of their skills of practice,” Elisabeth says. A caregiver who doesn’t feel comfortable transferring a patient from bed to wheelchair, for example, shouldn’t do it, both for their own safety and the client’s. When it comes to money and medicine, some companies have specific rules. “We don’t allow our caregivers to assist with writing checks or finances. Our caregivers are not allowed to fill medication planners,” Elisabeth says. 

Whether to hire an individual or a company

Some families may opt to hire a company that provides caregiving, while other families may use an individual who is not affiliated with an agency. While hiring an individual might be less expensive than hiring a company, working with a caregiving company means the caregiver will be overseen by someone besides the family, which could be reassuring and worth the extra cost. 

Families that hire individuals need to ask questions about liability protection and insurance to ensure their assets are protected should an accident occur. No matter what type of caregiver a family hires, Elisabeth urges them to get references. 

Caregiving character versus experience

“Oftentimes, people look at somebody who has five years, 10 years of experience as a caregiver and think that automatically means they are a good fit for their family member. In our opinion, hiring for character and somebody who enjoys helping others is something that is much more important,” Elisabeth says. Just because a caregiver only has a year of professional experience may not mean much in terms of the quality of care they provide. Sometimes the best caregivers are the ones who have provided care to their own family members. “I can train somebody how to do the work, but I can’t train somebody to have a heart to do this work,” she says. 

Questions to Ask If You are Hiring a Caregiver Not Affiliated With a Company

Debbie Tuggle, a retired clinical nurse specialist who has been a caregiver for various family members, offers some questions she recommends that families ask if they opt to hire a caregiver privately. 

  1. Are you willing and able to transport my loved one? (Make sure to verify that they have a valid driver’s license and insurance and check for any DUIs.)
  2. Are you willing and able to do personal care? (Some caregivers may be comfortable with bathing and dressing but cannot handle toileting.)
  3. Are you willing to provide nutrition? (Is the caregiver going to cook for and feed your loved one?)
  4. Are you willing and able to provide exercise safely? (A bedbound loved one still needs range-of-motion exercises.)
  5. If there are pets, are you willing to care for them? 

Debbie says it is important to ask specific questions about a caregiver’s training, such as where he or she received training and asking to see the certificates themselves. However, she also advises families to be fully aware and appreciative of the professional skills of the person they hire. “If you’ve requested a nurse, don’t expect them to do laundry and dishes,” she says. Finally, Debbie says families should be “firm but kind” and avoid becoming chummy with a caregiver. The relationship between the employer and the employee should always remain professional to protect everyone.

P.S. Three tips for first-time caregivers

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