When keeping your day job requires outside help, who will you let in? Here are 8 questions to ask before hiring any caregiver.
By: Stefania Shaffer
My mother’s decline seemed to happen almost overnight—but on a calendar, it was more like four years and one month of strange occurrences that would only be recognized in hindsight as onset dementia. Still, the slide down this slippery slope happened quickly, all things being relative.
In December she was still enjoying her hearty appetite until January came when she began pushing her food around on the plate. Maybe I hadn’t realized how long it had been that she had stopped requesting second helpings on any of her favorites—or when the last time was that she enjoyed anything on her plate. Nothing excited her anymore.
Life held very little interest for her. The only thing she longed for was sleep. Tucked into her quilts and pillows, she was actively sleeping her way into the next world—at least this is how the hospice nurse who came upon the scene two months later would gently put it to me then.
Besides sleeping, she developed a gurgling in her chest that sounded as if she might choke on the fluids trapped in her lungs. Some nurses will say that pneumonia is an older person’s best friend, allowing them to pass away peacefully. It does not look peaceful when you are the adult child newly found in her caregiving role. That sound gave me horrendous dreams.
Soon, it became evident that even with my husband to share the caregiving role, we still needed to keep our day jobs and a caregiver would need to be hired.
I could not fathom letting go of my trust issues when it came to letting a stranger in our house. So I begged my nurses to refer to me someone they knew who would become my new mini-me, loving my mother as I did, with the utmost patience and kindness.
My mother was vulnerable and I did not wish to make her more vulnerable with a stranger who would be in a position to easily take advantage. We’ve all heard the stories.
It is strictly forbidden for hospice nurses to provide referrals due to complications arising if a match turns out not to be a good fit for the family. That said, someone took mercy on me and passed me a name. And then I asked everyone I knew for anyone they might know. I went to a local church where I had heard caregivers were among the many worshippers, and my desperate presence caught the attention of a few currently available.
So I interviewed several caregivers. Not all were a fit for me and my mother. One simply needed a job. I wanted someone who wanted to work with elderly people. One did not possess a warm and caring smile. One would lie to me—a discovery made after using her as a substitute for my regular caregiver.
But, one was just right. Elizabeth happened to be the same sort of compassionate person I was—and she was exceptionally well trained. Familiar with loss at an early age, she took on a caregiving role within her own family. She evolved as a professional caregiver and hospice found her to be reliable, warm-hearted and beloved by families where she stayed sometimes for many years. She was highly requested and I was so grateful for her referral.
Still, I had a few questions of my own. Regardless of your particular family dynamic, here are the bases you need to cover with the caregiver who will become an extension of you:
To clarify, there are two types of caregivers you can hire—agency or private.
An agency providing caregivers will handle taxes, insurance and vetting; but they rotate caregivers, which can be confusing for a memory-challenged patient.
A private caregiver means you are in charge of taxes, insurance and vetting. Private can be less expensive, or more, depending on the demand for their services. The caregiver will also provide her own substitute, usually having a tandem partner they work closely with when doing 24-hr shifts.
* What experience do you have caring for memory loss patients? (Ask about experience connected to your parent’s specific needs.)
* How did you come into caregiving? (Even better if they experienced their own parent’s decline and this prompted them to help others.)
* What is your work history? (Caregivers who are quickly places after their patient dies, especially by another relative within that family, are beloved.)
* What types of meals will you be preparing? (Look for creativity—soup purées are perfect for someone having trouble with solid foods.)
* What will you be doing when my parent is sleeping? (Reading at bedside, or light chores was my preference.)
* How do you go about changing linens for a bed-bound patient? (There is a half-roll nurses know. Caution against lifting patients out of bed.)
* How will you handle temperamental siblings? (Best answer: You are my boss and I will defer to your instructions, which was highly necessary for our fractured family situation.)
* How will you dispense meds? (Best answer: Only if you leave pills in cups with instructions for distribution. No syringes or needles.)
Hiring a caregiver was the best decision I ever made. Hiring which one boiled down to this: If indeed my mother were to pass away without me by her side, then I wanted the last face she’d look into to be that of an angel. To me, this was Elizabeth.
The bonus? Elizabeth eased my anxiety by recording journal entries every 15 minutes of my mother’s sleep patterns, bowel movements, food and water consumption, meds taken and general mood. We also had a urine bag, so she recorded color, smell, and consistency. If your parent is bed-bound like mine, then record diaper changes and consistency of stool. Hospice nurses will read this report daily.
Straddling Two Worlds will be the next blog posting here.
About the Author:
Stefania Shaffer, a teacher, speaker, and writer, is grateful her WWII parents raised her to do the right thing. Her second book, the Memoir 9 Realities of Caring for an Elderly Parent: A Love Story of a Different Kind has been called “imperative reading.” Funny and compassionate, this is the insider’s view of what to expect from your daunting role if you are the adult child coming home to care for your elderly parent until the very end.
The Companion Playbook is the accompanying workbook providing the busy caregiver with the checklists and task sheets to get started today.