First day with home health. Any suggestions?

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First day with home health. Any suggestions?

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My parents have moved in with us and although they can't live alone, they need only a little assistance right now. My dad is a fall risk, having had two back surgeries in the past two years. My mom has early dementia, with short-term memory problems. I want to establish a relationship with a care agency so that I can call on them as needs develop, and have arranged for a four-hour visit once a week for now. However, I'm not sure how to keep the helper busy right now. Any suggestions for our first day?

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Assisting with bathing/showers? Prep and serve a meal?

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I did light housekeeping, read to my clients, did meal prep, shoot, I even washed windows somedays I was so bored! Laundry, running errands, with or w/o my client. Helping them with PT. Cleaning out closets. Cleaning out files ( if allowed)...You are there to be an extra set of hands, look for things to do and check first to see that it's OK then plunge in. A 6 hr shift with only 3 hours worth of work will seem endless!

Your first day will be a walk through of the home and getting to know the CG. Sometimes, even in a short period of time, you'll immediately know if your parents get along with the CG.

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My Moms needs are higher level - and when I did have an agency helping once a week in the beginning - I felt just like you and had no idea what they could help with to pass the time when mom just still slept a lot after the stroke. It all depends on the person who comes as well as what your parents will allow.
Days will differ.
Sometimes moms helper does her nails and toenails - some days she just has enough time to help wash her up and switch my laundry - some days they pack a picnic lunch and go for a ride to a park or by the ocean - reads to her - does crosswords - plays games and does craft projects. Takes her outdoors for a stroll through the neighborhood - helps my mom find new books on tape or makes a calendar of birthdays (to help her remember special dates) and helps her choose gifts online and then they tell me what they chose for someone so I can order it.
Moms helper is a family member but even so i wanted her to know more about Mom so that I wasn’t constantly in the middle of them getting to know each other - so I made a folder with all sorts of ideas and lists of “all things Mom” anything like she has 3 grandchildren and their names - things she liked to do before and after her stroke - almost like a little bio so they could ask her about them and they were things I knew mom loved or meant a lot to her and it helped her open up to someone else - and allows them to get to know each other so I didn’t feel like I was always having to be in there giving ideas - games and tv shows and movies she likes - some of her therapy worksheets and then even things like ask or remind her brush hair or set up her toothbrush.
With an agency I was always getting someone new and having to repeat the same stuff - so just sitting down and making a list of a little info on your parents and their likes and then a list on things that you feel they could help you with it will allow them in any downtime to say “hey you have laundry I can help with”? Or ask your parents anyone up for a card game. Do anyone need anything at the store. Any prescriptions needing pick up. Do you have any birthdays and want to write cards out - It allows the helper to ask you and your parents things - that maybe even you forgot about in a busy day. 😊

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When a caregiver comes, they want to know what to do. Make a list of things you would like them to do. For instance, give parents a snack, do an activity with them, sweep the floor, do the laundry etc.

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Before i hired the agency i currently have, one of their managers came for an interview. She asked me what activities my hubby needed help with; i.e., dressing, bathing, meds, toileting, etc. She then asked what household chores needed to be done. I gave her a list of things that the caregiver could do, but emphasized the caregiver's primary job was to be companion to my husband.
After 3 unsuccessful aides, a wonderful woman came. After 2 hours, I called the agency and asked for Lorraine full time. She has been with us for a year and a half.
We have a list of things to do, mop, vacuum, laundry, etc, split up over the week's time. She pretty much does as she pleases, although I do try to get her to slow down on the housework. My house as never been neater, and my husband looks forward to her arrival every day.

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Maybe do a little snack prepping - either for your parents, or maybe for you? Cutting up veggies? Slicing fruit?

Maybe freezing some sandwiches?

Portioning out oatmeal? Anything else that can be easily made and frozen, that would take some pressure off of you?

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Is there any way you can get the four hours split into twice a week for two hours each time? That will be better for everyone if you're not expecting the home/health aide to do any housekeeping. Having her there for four hours at a time can also put a strain on the parents too because they might be uncomfortable if she has nothing to do but sit there for that long. Break up the time if you can.

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This is a great idea. I would have liked to do that sometimes. It would have worked out best for us at certain times but no one would agree to come help for only two hour shifts. I think it was because some workers drove quite a distance. They don’t want to pay for extra gas. I had one caregiver ask me for gas money. I gave it to her because she said that she needed gas to make it home.

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Meal prep and light housekeeping is always needed.

Best wishes to you and your family.

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Have her change bedding, dust, vacuum and clean bedroom/bathroom area your parents use. If they have different diet, food prep could be done to cover several days so all you have to do is pull out of freezer/frig and pop in the microwave. A couple loads of clothing/towels/etc generated from their bedroom can be done.

Avoid doing things in the areas your parents use so that help is primarily taking care of tasks you did not have before parents moved in. Laundry, deep cleaning of areas, meals would be the biggies that I can think of

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HHA due not do deep cleaning ever. That's for a house cleaner to do.

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Jeepers, four hours? That's a lot of care all in one go. Did the agency do an assessment of your parents' needs?

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I agree with you on this. We have had our own experiences with four hour shifts and depending on what is needed, or not, they can be very inefficient, with the person sitting around for most of the shift.

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Agencies usually do four hours at least

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Is four hours their minimum? If not, it might be better to have shorter visits spread out over the week, esp in the beginning. It might be too taxing on them or too boring for everyone. I started my mother with 1 hour every other weekday, to get her used to having them. She didn't really need help at that point (although it wouldn't hurt!) I moved it up to every day, but still only 1 hour. Mostly it was a sanity check (she lived 1.5 hrs away from me, so I couldn't check on her every day) and to have them check her med dispenser (timed/locked) - if she missed them, they could point it out to her. The plan was to increase time and duties as needed, but sadly this didn't last 2 months. She refused to let them in, insisting she was fine, independent and could cook.

IF the agency allows less time/day, shoot for 2 hr twice/week or 1 hr more days/week. As they get used to having the aides around and a routine can be established, you can increase the time as needed.

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Independant people. I have been a care giver for over 10 years .
Many times I have made 1 or 2 hour visits . We also do not get paid 12.00 (Agency charges 26.00)
Agencies also can not guarantee the same person each visit. This causes immense confusion with dementia and Alzheimer's individuals.
Gold luck

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Can you talk to your parents about what they would want a care giver to help them with? Will the agency let the care givers do some light cleaning or make a meal for them, take them outside or for a walk? Does your father need help getting into the shower? Think about times when they actually would need help, and also where they would help you. If you have "strangers" coming into the house, be sure to lock up valuables and financial papers.

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Consider 2 2hr appointments a week. The caregiver can help with meal or dressing and fall risk for toileting or play a game with them etc. Whatever hours you choose, You can also ask her to wash your parent's dishes or laundry or change and wash bedding. Perhaps she can ask your mom to help with folding and putting away clothes to engage her.
As a caregiver; I'm concerned when i go into homes that I'm nor confused with a housekeeper, so please realize keeping us busy can include time socializing with your loved ones with cards, tv, games, helping them do their exercises or look at photos. Splitting the shift would probably work best for a happy medium of chores versus companionship imo. Hope that helps.

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When I had an agency help with my dad it was in their job description to do light housekeeping. I had them wash the bedding and change it, do some vacuuming, mop floors, clean the bathroom and fold laundry. My dad was suspicious of anyone who would hover around him so this way he thought I was just getting help with housework. I needed to be able to leave the house for shopping and some alone time each week so that worked out well for me. All I could afford was 4 hours a week. The caregiver gave him his lunch which I had pre-prepared too.

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WE had a plan that was NOT followed and that generated stress to the point our short term of having service was ended a couple weeks ahead of schedule and it was a RELIEF. Light housekeeping was in the plan, but yet when a note was left to do such tasks so that I got SOME relief, the caregiver (through an agency) obviously was not happy at all and preferred to sit on her a** doing a crossword or similar puzzle. So it depends on whether you have done a care plan with an agency or if you self-hired and need to generate your own plan. Do they need help with personal care or someone to stand by while they tend to their own needs? Light cleaning? (make sure your valuables/breakables are in a safe space, preferably a room with a lock). Regardless of whose paying, focus on your parents needs as well as your own to give yourself a break. Something the aide does is something you will NOT have to do in your "free" time. Or she can do something that assists your parents. Or if nothing else companionship or send her to go shopping with a list. We use gift cards for the preferred store so no funds have to exchange hands...not perfect but better than a credit card or other being handed over.

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I faced this very issue when my parents were living at home, especially since they did not think they needed help. I did two things that helped a lot:
1. I put together a caregiver notebook with information about my parents and instructions. For example, fairly early into her Alzheimer's, my mother became very random in her snacking. I starting buying fruit and nuts, and the caregiver was instructed to fill a snack bowl I put in a place my mother would likely go to first. My father wouldn't admit he was a fall risk in the shower, but he started allowing them to stay nearby when he discovered the joy of someone else drying his back. I shared how much my mother loves to be outside, pick flowers, and arrange them. So walks around the block with instructions to the caregiver of where to find vases went into the instructions.
2. I put together a "memory box", filled with small objects from trips, cards from friends, and postcards of favorite art. Sitting with the caregiver discussing what was in the box was something both parents and the caregiver greatly enjoyed.

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In my own home, I would not want a caregiver either doing housework or meal prep, because I like things done my own way. That's personal preference. You may want help with that - especially someone to do some cleaning in your parents' room.
My grandmother liked having "a girl to give me a bath" once a week. She would have been embarrassed to have help from a family member. If your dad is a fall risk, he should have someone to help him.
Caregivers are also trained to help the people they care for with social and intellectual stimulation. They can find activities to do with your parents - crafts, walks, puzzles... That can be a great blessing to you and your parents.

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My mother is livid that caregivers started at her house this week. She has forgotten about the assessment, discussions, et cetera. Minimum shift is 4 hours, so they’re covering her morning and noon pills, walking outdoors with her (she has fallen a few times), light housekeeping, laundry and lunch prep followed by dish washing. I do the grocery shopping weekly and post the menu on her fridge.

I wrote an introductory document about her family members, career, interests, favourite places to visit, significant life events and such, for the agency.

My mother likes plants and rooted cuttings over the winter. I’m going to set up potting soil and planting cups on a patio table so they can work standing or sitting. Perhaps growing pots of herbs or flowers would help engage them. Making art together? Like some folded heavy card to draw on with art markers as greeting cards. My mother still writes letters to a few friends.

I have had to remind her repeatedly that she needs to speak up if they suggest doing something she doesn’t like, instead of coming to my house after they leave to blast me. (I live next door)

We’re off to a rough start and I’ve explained over and over that it’s all happening to keep her safe in her own home. I prefer her safety to my own popularity. Hopefully the waters will soon smooth.

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Kudos on taking this initial step to establish a relationship with an agency and giving your folks the opp to adjust to someone coming in to help out. Before all of this I did not realize the difference b/t services provided/allowed by home health care & home care support. Medical care can be provided by HHC, but some agencies limit typed of activities they can do (i.e. no light cleaning, shopping, etc). HC agencies send professional caregivers to provide non-medical related activities such as companionship, light housekeeping, med reminders, and assist with limited ADL care. The HC support agency we hired had a min. hour requirement (4 - 6 hours/day w a 12 hour min./week). I prepared a spreadsheet of things to do, suggested activities, and such to help the CG out. This was okay the first couple of weeks, but then the CG got used to the "schedule" and more efficient. Ultimately, s/he was able to complete activities w/in 1 - 2 hours and had 2-4 hours of "empty time"/day. I tried to have my LO and the CG do socialization activities (i.e. play cards, read, go to library, watch tv, engage in conversation). However, my LO got "annoyed" b/c she thought the CG was not doing anything and should leave after her "chores" were done. After trying different approaches, I had to switch the CG, but the scenario would repeat.
I share all of that as a way to show that I learned it is best to prepare your LO(s) for receiving assistance from "paid professionals" and engage them in the process as they are able. Check their (& your) expectations and revisit every two weeks, like an evaluation of sorts. This helped my LO feel like she was the "supervisor" and had some control over the situation. Ultimately, my LO moved to a senior campus, but thankfully we had these experiences and can share with you and the others here.
Good luck and keep up the good work with this chapter of life.

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I sat down with my mom to establish a simple "to do" list for the helper to refer to. We posted the list on the refrigerator and showed it to the person from the agency. The list started with housekeeping so that mom could warm up to the idea of outside help. Simple vacuuming, washing of floors, changing of sheets, laundry, and light food prep. I did offer to be there for the first and second time the helper came to the house, again to facilitate mom's adjustment. It really worked well. Last suggestion is that sometimes, you might get another person to cover for the main one. We kept a little notebook that the caregiver would document the things they did so that two different helpers didn't do the same task twice and not do other tasks at all. It also worked as a way for them to communicate with me so that if they noticed that something needed purchase or repair or mom exhibited an illness or what have you, I would know. It also allowed the other helpers know what was done and what still needed doing. Four hours is a long time, so maybe you could add a social activity. What I mean is that the caregiver and one parent or the other engage in conversation or even play a game or whatever your parent might enjoy. They can get to know each other that way. If your mom doesn't eat enough (that was my mom), they could sit and visit while nibbling on a snack. Eating is less of a task when one is socializing. Last, if a caregiver from an agency doesn't work well with your parents, don't be afraid to ask for someone else.

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This is a good plan! If we could have ever got my dad to leave for a little respite, it would have been a great plan for my mom!

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Imho, plan a to do list as needed going forward.

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Let her play games with them, go for a walk, look at pictures, just sit and talk and ask each other questions.

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You all have been so kind and encouraging. Thank you for all your suggestions!

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My wife gets 7 - 10 hour shifts of help. The aides who want to stay busy are always finding things to do, The one's who aren't as industrious sit a lot.

I have a daily list of "must do" items and suggested items to be done.

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First day with home health. Any suggestions?

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