When an older adult becomes a caregiver to a spouse and finally hires various professional caregivers to help reduce the workload, it’s not always a smooth transition. After all, it takes time to adjust to strangers routinely coming into your home, which may feel like an invasion of privacy. And if you’ve never served anyone’s boss before, you might not be comfortable delegating tasks.
Unfortunately, you may need to get comfortable feeling uncomfortable, or the situation will become a problem destined to end in disappointment. Unless expectations and caregiving duties are established at the start and redefined throughout the relationship as the needs of the care recipient change with age or the progression of an illness, caregiving spouses may find themselves picking up the slack rather than taking a respite from their duties—the very reason they hired outside help.
Many times, caregiving spouses fail to realize that hiring a caregiver has a two-fold purpose: to ensure your loved one’s needs are met and give you a break to catch up with a friend, exercise, pursue a hobby, or simply take a deep breath and relax. Caregiving is a full-time job, and like any working person, spouses need time off to decompress and rejuvenate. Take it easy on yourself and follow these tips for organizing and managing the caregiver relationship.
Hire a professional agency
“Work with a professional organization versus finding someone on a website who says, ‘I’m a caregiver,’” said Margaret Haynes, COO of Right at Home in Omaha, Nebraska, who reminds clients that agencies screen caregivers, conduct background checks and provide training.
“The great thing about agencies is they are helping families 24/7, 365, and you don’t have to know all the answers,” she said. “They are there to help walk you through the process.”
Whether you’re in a crisis situation – your spouse was just discharged from the hospital, for example – or your care recipient has an illness that gradually becomes worse, the agency can help you navigate their care.
Choose an appropriate level of care
Home care falls under two categories: homemaker companion and personal caregiver. A homemaker companion is there for companionship, to give the primary caregiver a respite and provide mental stimulation to the care recipient by playing cards, painting pottery, doing puzzles or any other activity they enjoy, which focuses on the care recipient’s abilities rather than their disability, Haynes said. They also perform light housekeeping duties, such as vacuuming, dusting, doing laundry and cooking simple meals.
While a homemaker companion is a role often filled by retirees who enjoy helping others, a personal caregiver has licensure – such as a certified nursing assistant, home health aide or registered nurse – and their duties are more hands-on. Personal caregivers assist with activities of daily living: grooming, dressing, toileting, showering, walking, chaperoning to doctor appointments or events, and dispensing medications. In time, the lines blur and the personal caregiver may also perform the duties of a homemaker companion.
To help families determine a caregiver’s duties, Right at Home has an Adult Caregiving Guide that includes a needs assessment. Haynes recommends putting together a caregiving plan that allows the care recipient to live their best life and plays to what they’re capable of doing versus what they cannot do. In order for care recipients to be happy, Haynes said, let them maintain as much independence as possible and do all the activities they can do for themselves rather than bring a caregiver in to do everything for them.
Schedule an orientation
Get family involved and let them help you organize caregiving duties.
“You want the agency to come and visit in the home and actually see what the home environment is,” Haynes said.
Allow the agency to identify a caregiver or match a team of caregivers to meet your loved one’s requirements. If your spouse has dementia, for example, look for a caregiver who has training and experience caring for clients with cognitive issues.
Marcy Reif, agency coordinator at In Home Caregivers in Highland Park, Illinois, suggests the family personally interview the prospective caregivers to find someone who meshes well with their personalities.
“I always look for kindness because not everybody is kind,” she said. “They can be nice but not kind.”
She also suggests finding somebody who is caring and speaks the same language.
Reif shows up with the caregiver on their first day to go over expectations and what the client would like done during a daytime versus a nighttime shift. Everyone’s preferences are different. A woman might want assistance putting on makeup. Someone with balance issues will need help in and out of a chair, walking to the restroom and showering. Reif has caregivers take older adults to the bathroom every two hours and get them up and walking once every hour, even if it’s just circling the living room or moving from one chair to another. The exercise makes them feel better.
Post caregiver duties
Understand that caregiving needs change, Reif said, and the plan will need to be updated regularly. Write caregiver duties on a dry erase board and ask caregivers to check it every day.
“Usually, family comes to visit once a week,” she said. “If they see something they want done, they can put it on the board.”
This is especially helpful to caregiving spouses who aren’t comfortable delegating tasks. Still, all they have to say is three words: I need help, Reif said, and that should spur a caregiver to action.
Identify caregiver don’ts
For whatever reason, if a caregiver isn’t working out, let the agency handle the firing and replace them with someone who’s a better fit. Warning signs it may be time to let go of a caregiver include:
- Talking or playing games on their phone
- Showing up late
- Acting lazy
“At the end of the day, the question, which is a great one, is, ‘How do you manage this?’” Haynes said. “[The answer is] through really good communication.”
A professional home care agency can set expectations with you for caregivers at the initial assessment. Once those expectations are established, all the caregiver has to do is meet them. Best of all, the caregiving spouse can go back to being just a spouse and that makes all the effort worth it.