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We have had care givers thru agency that are paid for by insurance. My grandma has to be turned every two hours as a safety measure. The recent care giver said but she won’t be able to watch tv…. Told her if it was going to be an issue I’d talk to the agency. She quit and insulted me on the way out. She would feed my grandma but nothing else in the care of plan, later found out by my mom she was letting her stay in the incontinence underwear until my mom got home, no grooming barely gave her liquids late every day talk on the phone for hours on end. We have only had one care giver who was competent (she left bc her mom got sick we understood but she is missed) They also would tell us about past clients, I’d quickly change the subject but isn’t that information protected? It’s been horrible. It’s depressing. Insurance told us complaints are frequent. Yet somehow these women are certified? How? Any advice? I’m very drained.

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It's scary and depressing to read your post as I am just in the process of enlisting LTC insurance benefits for Home Health Care. I've noticed that insurance highly restricts benefits of that nature to "accredited" (with very specific types of accreditation) agencies, no solo caregivers who might otherwise be perfect could possibly afford to get. To me it seems like a mismatch of skills with credentials and because of past difficulties with the LTC insurer, the picture I get is that they're doing everything they can to control the entire process, and restrict benefits to discourage us from applying for benefits. Why do I need to have someone with credential to help with basic housekeeping, meal prep, etc...? Does making a bed require accreditation? It's absurd. It drives up costs and has discouraged me from dealing with this, even though I'm burned out. Certification, and agency accreditation don't provide any indication of attitude. Plus, I do not agree that an insurer knows what's best for my mom. Unfortunately, they get to call the shots - all of them.

We are facing this as a process, a journey, and know it will take time to get a good match for my mom. I hope things settle for you and someone stable, pleasant and helpful comes your way!
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The workers are underpaid and are expected to go above and beyond. Our work culture does nor respect caregivers and view them as low skill workers.
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Geaton777 Feb 2022
I agree that they are underpaid but as with teachers and childcare workers, it is an economic issue: the higher the wages the higher the cost to the consumer or government. Look at medical workers: doctors, nurses, etc. who get paid more for their essential services, but also look at how expensive medical care is because that cost gets passed along (and granted that wages are not the only variable that impact the cost but in almost every case wages is a company's biggest overhead expense by far).
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Agency care is horrible because for the most part because they will hire just about anyone. They offer no training and absolutely zero support to the aides they send on an assignment. Most of the time they don't even give the worker they're sending in any back round on the situation and no explanation of what to possibly expect.
Last but not least, agency-employed help gets paid practically nothing. Minimum wage or just above, and of course no benefits.
I've been in elder homecare almost 25 years. Many of those years were employed with an agency. Then I wised up and went private-duty only.
I was an adequate caregiver when I was low-wage with an agency. I certainly didn't knock myself out though. Client received what was in the care plan and the minimal at that and this was more than most agency caregivers will do. The agency expects us to go the extra mile, etc... Please. Not for what they're paying.
I go the extra mile for my private clients because I'm getting pay that I think is fair.
These are the reasons why agency-hired care is so bad. Their only concern is putting a worker in a house and collecting the money. They don't care of they worker is woefully incompetent or not doing right by the clients.
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ACaringDaughter Feb 2022
You criticize agencies suggesting they are trying to take financial advantage and then admit that you personally calibrate your care based on money.

Care providers who are motivated by their heart (not their wallet) may ultimately be the most successful.
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I would say it depends on agency management for the most part. You do know, I am certain, that the pay for some caregivers is quite poor. This means that this job doesn't attract quality folks determined to do a excellent job. There are many factors. I do, myself, at this point believe I would have in home cameras installed if I had an elder for many reasons involving safety and care.
I think that care is variable for almost any job. I do know that my brother's ALF was remarkable. Over the top in its care. Unusually good. I was so thankful for this. It's so difficult to think our folks aren't getting quality care.
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Geaton 77, I think you have thrown out a viable solution if the ins. co will go for it. My brother and mother have both needed care and we found the agency's people were a lot less competent and lazy compared with the people we found through the local newspaper. You can interview them yourselves and state just what you want done, where the agency people we had, spent all but the minimal time helping and were on the phone or in front of TV instead of doing things for whom they were supposed to. Also, the agencies have so many rules and regulations they are sometimes more trouble than they are worth.
This may be just our experience and it comes with a caveat; my brother was not careful with the aides and some of them robbed him blind! His favorite aide, a truly compassionate person he thought, did everything for my mom and brother, but stole all her jewelry and many, many of his things and took the money to make dinner for the poor people in her building! Like a Robin Hood. We begged him to get cameras in the house and lock up the valuables to no avail. All my mother was saving for us was lost to these women. We did truly have some gems though , cheery, helpful women who would do anything for them, so I wouldn't give up trying if it came to that again. If you protect your valuables and try to weed the bad ones out it may be a big help.
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Geaton777 Feb 2022
I'm sorry to read about the theft by an aid. These predators lurk everywhere. My closest friend has a son with all sorts of behavioral and medical issues. At 18 he already used up his $1 million worth of insurance coverage. My friend worked in HR and spent a lot of time negotiating with insurance companies. They can be flexible, as she has succeeded on a few occasions.
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We used an agency when my dad was very ill. Only one caregiver had to be let go due to being on her phone constantly. The others became more like family & we were very pleased with their care.

Whether you use an agency or private caregivers both require drop in visits & a lot of communication.
This is still well worth the time and energy.

The in home private cameras are wonderful also. We use the NEST brand from Amazon. It has audio, visual and motion notification alerts. Another way to keep an eye on the caregivers.
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The aides that cared for my Mom in her AL and NH always knew I appreciated them. They do the dirty work. I am very aware that they are underpaid and not always appreciated. My daughter is an RN former LPN and she doesn't feel they are paid enough. And sorry, minimum wage or not, you are expected to do a good job. Anyone becoming an aide is very aware of what their job entails. If they don't want to do the job correctly, then find something else.

I see more and more that its "just a job" which has its up side but what happened to a job well done. My jobs were what I did well and I took pride in that no matter how much I made.
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Just gonna throw this out as an option: have you tried to negotiate with the insurance company to find your own aid and then see what it would take for them to approve coverage?

The increase in the aging population and decrease in both birth rates and legal immigration has created the perfect labor shortage storm. You've got nothing to lose in asking the insurance company to work with you on a creative solution.
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I'm sorry, I don't have an answer that will help you but I do have an explanation:

When you pay people barely above minimum wage to deal with bathing, toileting and incontinence, and often physically demanding tasks,
when the employer ignores their concerns and input and treats them as disposable assets,
then throw in families and the care recipient who often treat them as some kind of lower caste person,
and people with dementia who may be overtly sexual, racist and/or violent,
And when someone IS competent, is even the kind of person who always goes the extra mile and who forms a true bond with the person they care for, they not recognized or recompensed in any way and are most often just tossed aside without any thought when their services are no longer needed, so they either begin to feel like they've been played for a fool and emulate those who don't give a ****, or they burn out and leave the profession entirely.
And let's not forget that demand far outstrips the number of people willing to do this work so there is no fear of losing a job because it's a simple matter to just move on to a different agency or client.
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Smgreco Feb 2022
And the thing that sucks is we are that grateful family, I’m studying to be a therapist, so working in the health care field, I have a therapist bc of my issues with depression and anxiety, my mom has a therapist, so we are empathetic we understand and are grateful for a job well done. I can understand and empathize with a job well done. We try to make the job as easy as possible in terms of us taking care of food. We give money for Christmas and birthday gifts. The previous care taker was allowed to sleep on a big comfy bed when my grandma was asleep.

there’s also the cultural component. my grandma is Hispanic so all of our care givers have been Hispanic. I know my cultural and I know the good the bad the ugly. They’d tell
on themselves with how they spoke about their families their significant others. Can’t tell you how many times they’ve caught me eating or chilling before going to work or school and told me something personal that made my eyes bug out, like ma’am why?? So I understand people being burnt out but I also understand people being in the wrong field for the wrong reasons. We’re not honest as a society that not every woman is empathetic caring and compassionate those are personality traits that men can have just as well and are honed skills. I worked as a paraprofessional for 5 years for students with disabilities and it’s similar there too. I was very good at my job loved it put in the effort but driven out due to low wages and not being respected. Some people who I worked with were kind women immigrant women doing the best they could. A lot were incompetent and brutes, some talked about hitting the kids in front of me. (I reported it, nothing was done) not having fair wages and good benefits makes a lot of skilled workers leave in so many fields so I totally get that.


But we are also tired. This is a long goodbye for us. I’m watching someone I love slowly fade away. My mom is one of 7 and only three siblings help. I have one aunt who is great but is in florida so she helps financially. My mom is a teacher I’m in school and trying to keep my head above a mental health crisis which I know is a part of my history. It’s just a lot. I feel like I’m failing my grandma I’m tired and sad and I know something will give and I’ll rise above but for now I’m very tired.
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