Assess them first on how they react to emergencies
By Mike Takieddine
If I were to walk into a homecare office and spend a little time by the receptionist’s desk, I could probably be able to form an opinion as to whether I would want that agency to handle Mom’s care. I would look for tell-tale signs that, after so many years in elder care, I learned to trust.
An agency that shows character and self-pride
The majority of incoming calls at an agency are from its caregivers, some checking in from clients’ homes, others waiting for assignments. I would listen carefully to the receptionist’s tone in dealing with those who may at times sound desperate for lack of work. This would give me insight as to the agency’s prevailing culture: are all the calls handled courteously and with friendliness, or does the receptionist slip at times into impatience and condescension? For Mom, I would want an agency that promotes self-esteem and respect, particularly towards caregivers seeking work.
You may not have the opportunity to sit by a receptionist’s desk, but if you have a friend who employs a home care agency, ask their caregiver what she thinks of her agency. That should give you plenty to think about.
A moderately busy agency would be just fine
An agency that is not busy finds it difficult to retain the best crop of caregivers. Those would rotate to other agencies that could give them work. By the same token, an agency that is too busy would have their best caregivers already on assignment, and I wouldn’t want them to scrape from the bottom of the barrel to fill my need. A moderately busy agency with a substantial roster of caregivers is the recipe for me.
Avoid a high turnover in caregivers
Agencies draw from the same pool of caregivers, and caregivers are frequently listed with more than one agency. Caregivers usually strive for three factors: they want a care recipient to be close to where they live, they want the assignment to have a schedule that matches their own and, finally they want a nice patient, someone appreciative.
For Mom, I would want a caregiver who meets the first two requirements: she must live within 10-15 miles, and her preferred schedule and Mom’s must coincide. I wouldn’t want my Mom’s caregiver to abandon ship if some other agency offered her a more appealing assignment.
A proper screening for Mom’s caregiver
There are State regulations governing the screening of caregivers. For example, criminal background checks must be conducted and updated periodically, certifications verified, and references obtained. It is this latter requirement that has a lot of flexibility in it. At some agencies, the Admin Assistant makes the calls to obtain the references, at others the Care Manager (or Care Coordinator).
For Mom, I would want caregiver references vetted by the Care Manager. I may also want to check with that person to see if they remembered anything else beyond the notes they made from their talk with the caregiver’s prior employees.
Find out how an agency reacts to emergencies
To me this is the key factor, for it reflects on every agency’s Achilles heel. Let us say Mom has Alzheimer’s and cannot be left unattended. She has continuous shift personnel, 24-hours a day. It is the agency’s responsibility to have Mom covered at all times, and when someone doesn’t show up, well, that’s an emergency.
An agency has recourse to other caregivers who serviced Mom in the past, and a bunch of yet more caregivers who are on standby. But there are times when all that breaks down, and that’s when I want the agency to tell me what they would do next.
For my Mom, I would want to hear that they would send some responsible staff person from the office until a more appropriate caregiver could be dispatched.
Judging a home care agency is not so difficult
You must first feel comfortable with the person you’re dealing with. When it comes to their rates, agencies usually retain roughly 40% of what you pay. However, they perform vital tasks on your behalf:
They recruit and screen new caregivers all day long, almost every day, so as to be in a position to send Mom their best
They are responsible for filling-in for sickness, weekends and holidays and have non-stop coverage of Mom’s daily and weekly schedule
They have continuous oversight over the caregiver at your home and over Mom’s overall wellbeing
They must troubleshoot all problems that arise, and problems do arise when for example you have an 85 year-old care recipient functioning in cramped space with her caregiver for all those hours and days
And they handle all payments to the caregiver, including taxes, as well as providing other benefits and continued education programs
In essence, you outsource all that to the agency. At the end of the day though, you would be way ahead if an agency finds you an ideal companion for Mom, and that’s really all what you want.