A friend asked what she should do when her father’s caregivers acted inappropriately? One young girl seemed overly affectionate, kissing and hugging her dad – even the first time she met him. Another aide kept her cell phone close by and frequently took and made calls while she was “on duty.” A friend told me about stopping by to check on her mom early one morning and finding her dad awake and alone, while the night shift caregiver was in the shower, preparing for her daytime job. “Well, you didn’t tell me I couldn’t take a shower,” was the CNA’s response.

Hm…what are the rules for in-home caregivers, and who is responsible for making them?

Selecting someone to come into your loved one’s home and provide care – unsupervised – can be a challenge. How do you know you can trust them to abide by your rules and do what they are supposed to do?

There is an obvious advantage in utilizing the services of an agency that will thoroughly vet their staff (as well as handle paperwork and file taxes – other difficult issues). The downside is the cost, which can be almost twice as much as hiring a non-agency represented individual. When you hire independently, the family is responsible for doing a thorough interview and background check. Referrals from friends and family may help you find the ideal person.

Agencies also establish strict rules for their in-home staff, and anyone who chooses the individual route must do the same. It is better to determine guidelines from the start rather than to have to make them as you go along, when you discover the person taking a shower or snooping in the basement.

Will you allow caregivers free access to the entire house or do you prefer that they stay in a designated area? Many people are attached to their cell phones and insisting that calls be limited will be almost impossible to enforce. Is the caregiver allowed to raid the refrigerator or should she bring her own snacks? Can she read on the job? Watch television? Take occasional naps if working the overnight shift? Have visitors (spouse, friends, children) while on duty? This may seem like a no-brainer, but I have heard many complaints from family members who stopped by to a house-full of the caregiver’s relatives. How will you verify that guidelines are followed? Frequent unannounced visits, especially in the beginning, should be made. Some families, when suspicious of misdeeds, have gone so far as to set up a video camera. If you suspect problems, this is an alternative.

What about personal interaction? If you feel uncomfortable with a caregiver’s expressions of affection, chances are your loved one does also. Many caregivers – including myself – are naturally affectionate and greet their patients with a hug or kiss. Some patients appreciate these gestures; others do not. A professional caregiver should be able to discern reactions and act accordingly.

Remember, you are the “supervisor” and have the right to makes the rules for anyone who comes into your loved one’s home to provide care. A caregiver who cannot or will not abide by your rules should not be allowed to continue in the position.

Caring Quote: Just as in any profession, there are good and bad caregivers. You must be diligent in finding the very best and then treat them with the respect and kindness they deserve. rzwj