A friend’s (I’ll call her Maddie) mother’s health had deteriorated to the point where she can no longer live by herself. Because the mother lives about a six-hour drive away, Maddie hired an agency to provide live-in assistance. Every other weekend, Maddie makes the trip to visit her mom and oversee the care she is receiving. Because of the round-the clock schedule, each time she goes she meets a different caregiver. One she adores; one she tolerates; another scares her.

She immediately expressed her concerns to the director of the agency, who assured Maddie that their caregivers are thoroughly screened and there had been no problems with any of these three, whom she referred to as “the cream of the crop.”

Which led Maddie to comment, “Maybe they should try crop diversification.”

I asked Maddie what “scared” her about the one caregiver.

“Just something about her –  she seemed inpatient, her voice was gruff and she was sort of sloppy; it was just a gut feeling.”

Her mother, in the mid-stages of Alzheimer’s, had no complaints about any of the caregivers, but Maddie wasn’t sure if her mother would be able to recognize or report mistreatment.

I have worked with many caregivers and have seen the best and a few that actually scared me. You cannot always judge caregivers by their appearance (although factors of appearance such as dirty uniform and neglect of personal hygiene can be indicators of the quality of care that will be provided). However, I am a believer in “trusting your gut.”

I asked Maddie what she would do if, instead of the caregiver taking care of her mother, she had been hired to take care of her three-year old daughter? If she had any misgivings – even though she had no definite proof of wrongdoing – would she leave her daughter in this woman’s care?

“Of course not!” she exclaimed.

So how is this different? We discussed the two situations and came to the conclusion that neither her daughter nor her mother should be left in the care of someone she didn’t trust.

Maddie made two important decisions. First, she requested that the “scary” caregiver be relieved of her duties (concerning her mother) and Maddie was given the opportunity to interview possible replacements. She met several assistants she considered to be much better matches for her mother.

Her second decision was to have surveillance monitors – granny-cams, if you will – installed in her mother’s home.

She did a lot of research before taking this dramatic step, including seeking advice from her lawyer. She realized that some caregivers would balk at this, but felt that gave her an extra measure of security: bad caregivers would not want to be videoed.

The caregiver Maddie “adored” was not at all upset; she even commented that it made her feel more secure to know that her good actions were being recorded.

Maddie knows her situation is not ideal. She wishes that her mother were closer, and is considering taking steps to make that happen. In the meantime, she feels much better knowing that she does have a way of keeping an eye on her mom, even though she’s hundreds of miles away.

Note: Most caregiving situations are not fraught with neglect or abuse; unfortunately these do happen. When it becomes necessary to hire someone you do not personally know to provide care for a loved one, be vigilant. Use only a reputable agency or delve deep into the background of a non-agency caregiver. Visit frequently, on different days and at different times. If you have proof that abuse has occurred, report it to the proper authorities immediately.