Q: I hired a caregiver to help with my husband who has dementia, but all they do is sit and watch TV with him. How can I get them to do more?
A: When hiring in-home care, it is helpful to clearly communicate your expectations and provide a list of responsibilities you would like the caregiver to perform.
It is important to recognize that even when a caregiver appears to be simply watching television with your husband, they are still providing valuable supervision, ensuring they are available if he needs assistance, and offering companionship and social engagement.
That said, most families want to make the best use of the caregiving support they are paying for. For this reason, I recommend creating a clear list of tasks and responsibilities. If you are working with a homecare agency, discuss your expectations with the agency representative. Many agencies can provide a list of services that caregivers are authorized to provide.
For example, home care aids can assist not only with personal care activities, such as bathing and dressing, but also with engaging your husband in activities and exercise, preparing meals, performing light housekeeping, changing and washing bed linens, and taking out the trash. Consider the caregiving tasks that would be most helpful to delegate so that you can reduce some of the demands placed on you.
A checklist of “typical caregiving duties” can be downloaded from the Senior Concerns website at https://www.seniorconcerns.org/resources/
This checklist can serve as a useful tool when discussing expectations with a caregiver. It is also helpful to provide a list of things you do not want done. For example, if there are certain foods or beverages your husband should not have, or specific household practices you do not permit, be sure to communicate those boundaries clearly.
Do not assume a caregiver automatically knows your preferences or your husband’s level of need. Provide specific guidance about the assistance you expect. For example, do you want the caregiver to help him stand up from a chair or assist him in the bathroom, or simply remain nearby in case he requests help?
If the caregiver will be alone with your husband, make sure emergency information is posted in a visible location, including the home address, emergency contacts, and any other information that would be needed if paramedics or emergency services must be called.
Once you establish clear roles for the caregiver, be sure to check in with them regularly. Make sure they are following through and ask them for feedback. They may have ideas on ways to engage with your husband, or tips that will make the day flow smoothly.
Remember, you are managing the caregiving relationship. Do not hesitate to ask for the support you need. By providing clear expectations and instructions, you help set the caregiver up for success and ensure your husband receives the best possible care.
Martha Shapiro can be reached at Senior Concerns at 805-497-0189 or by email at mshapiro@seniorconcerns.org.
