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As caregivers for my brother, our family has been told a lot of things over the years. Probably the hardest to hear and understand was regarding home aid services: “well, you know that home aids don’t make very much money”. I am not sure how to interpret this statement.
At the most difficult time in my brother’s life, we need help at home with his day to day care. These are services that traditional insurance rarely pays for, though Medicaid does support this service for some types of patients. For the rest or for better options that don’t take insurance, aid services are completely out of pocket. When home services became available through Steve’s Medicaid plan, we had a vision of caring, thoughtful people that understand the family needs and would be willing to become a part of our life.
As it turned out, multiple aids were interviewed and hired from multiple agencies. We never found someone that worked in our situation. For us, common themes were noted:
- Most were recently “trained”. Few correctly understood common aid skills such as transferring, lifting and bathing. Most were either very young or much older.
- It was very difficult to find someone that could speak our language (English). I was challenged to understand why it was so difficult to meet this need. I felt that those in our community that lacked English proficiency fared better regarding this issue.
- Practically all of the aids were single parents, lacked transportation, or had their own health problems making them unreliable for my family. The key to trust and security in these situations is reliability.
- For those that lasted more than a few weeks, most left for better paying jobs.
For the aids that came to our door, we did not accept a “warm body”. Those that we found to be literally sleeping on the job, listening to music, eating our food, or doing things to my brother that were inappropriate were let go. One disgruntled aid reported my mom to Adult Protective Services for not feeding my brother. That was fun.
My belief is that this is not just about paying more for aids to deliver better care. Part of the challenge in this industry as well as in other areas, is that we are not hiring the right people. We are not adequately selling the beauty of assisting families through the difficult stages of life. We are not weeding out inappropriate applicants.
Being an aid does not require advanced math skills. But it does require a healthy amount of empathy, common sense, a willingness to partner with family members and to take on the risk of becoming emotionally involved with those that require care, often at the end of life. No–pay is not great, but the value that good aids bring to families is immeasurable. It is unfortunate that our society does not reward more for keeping families together. We know that failure to support families through difficult times can result in greater ER use, inpatient hospitalization, and increased illness for caregivers, both physical and mental.
It is good that these workers now have minimum wage benefits:
Those that run aid agencies should to do a better job at attracting the right talent for these important roles. Check in with families early in the care process to determine gaps that need adjustments. Do not tolerate the uncertainty created by poor work effort. Families deserve more than what they are getting. We need to develop a better way to promote quality transparency within this service category for family caregivers.
What are your thoughts and experience?
Steven Gregory 