How Can I Get My Stubborn Elderly Father to Accept a Caregiver in His Home?

Ohhh, I had this exact situation while I was caring for my parents, so I know how exasperating it is! I actually went through 40 caregivers the first year—well, most only there for about ten minutes as my father would be so nasty they’d run out of the house or he’d throw them out. After much trial and tears, I finally figured out how to handle the many complexities of the situation—so I want to share what I unfortunately had to learn the hard way!

First, keep in mind that any kind of change can be frightening for elders and their fear of the unknown can become greatly intensified. Ask your father’s doctor to assure your father as well as sternly advise that he must have a caregiver now, as he writes a “prescription” for one. Also, have the doctor indicate that otherwise he may have to file some legal action to assure his safety. This might work to scare your father into acceptance.

You can also have an agency that supplies all levels of caregivers come to the house to discuss the many options available and help convince your father how much easier his life would be with help. Assure your father that you will monitor a caregiver to make sure things are done properly.

If none of that works and you think your father is about to injure himself or someone else, contact your county’s Adult Protective Services (APS) and ask them to send a social worker to talk to your father about how they will have to step in soon. Their report goes to the local police department, so a uniformed officer will visit him soon as well, which may be the tipping point for convincing your father of the seriousness of the situation.

HIRE AGENCY OR PRIVATELY?
Decide if you want to hire a caregiver from an agency, which is more expensive but the caregivers are supervised and replaceable if there is an emergency. Or, if you want to find someone on your own, understand that it will require a lot more work and on-going supervision. When you talk to the agencies, be sure to ask right away if they are bonded and members of any state or national home care organizations, and then verify that.

Some agencies will do extensive background checks and drug screenings, but others will not. Inquire as to exactly what background checks have been done on the caregivers you are considering and get everything in writing. Be sure to ask: Do they check in the county, state or nationwide? What types of crimes do they search for, felonies or misdemeanors too? How many years back do they check? If an agency will not put this information in writing for you, they probably have not done background checks. To investigate applicants on your own, you can review public records on real estate, social security, DMV and taxes.

Understand that it is illegal for the police to run a “check” on an individual for you, unless there is probable cause of an outstanding warrant for their arrest. Instead, ask the applicant over the phone if they’d mind having their picture and fingerprints taken when they come for the interview, just as a safety precaution these days. This is usually enough to scare off any with a criminal record.

MAKE LIST OF REQUIRED QUALITIES
Before you begin interviewing caregivers, involve your father in the process by making a list together of the non-negotiable qualities you both want in your caregiver. Include all responsibilities now and what they may become as your father’s health declines. Give the final list to family members and friends, so it is clear what orders are appropriate and what will and won’t be expected.

Don’t waste time interviewing caregivers in-person who did not meet your minimum requirements over the phone, for example: Will they clean up vomit, poop, and change diapers if necessary? Do they have a valid driver’s license and current insurance card you can copy? Will they give you their social security number so you can pay taxes properly? How far away do they live? Do they have adequate eldercare experience? Will they give you checkable references? Do they speak, read and write your language at a reasonable level? Have they ever been arrested and/or convicted? Will they sign a waiver to have a complete background check run on them? If you get a lot of hesitancy or refusal over the phone, save yourself the time of interviewing in-person.

REFERENCES ESSENTIAL
Always ask for numerous references from prospective caregivers. If you are using an agency, ask to speak to some families who are using their caregivers now, to get a clear picture of how the agency is being managed right then. Find out if the applicant has been punctual, reliable, what duties they have performed and are capable of doing, and what problems have occurred. Talk to previous employers, co-workers, landlords, neighbors, relatives and friends. In addition, by visiting the applicant in their own home, you will see the level of cleanliness and organization you can expect in your father’s home.

Don’t forget to block all 976 and international calls on your father’s phone. And if he has Long-Term Care Insurance be sure that the agency will accept direct payment from the LTC company. And always pack and lock up valuables to remove temptation from those who come into your father’s home.

Once the caregiving begins, your father will probably make unreasonable demands. Therefore, the written list will assure the caregiver of their true responsibilities. And when complaining about the caregiver inevitably starts, don’t automatically defend the caregiver to your father and get into a heated argument. Simply assure your father you will get to the bottom of the problem and do so. If the complaints are well founded, report to the agency or take appropriate action on your own. If the complaints are superficial, strengthen your caregiver’s resiliency on how to handle their difficult patient.

NANNY-CAMS
You can also install a nanny-cam so you can see for yourself what is happening in your father’s home. Make sure the caregiver knows that camera(s) are there, somewhere, as it is far better to deter abuse from happening than to see your elderly father being beaten by a vengeful caregiver after-the-fact. There are many systems available these days and they are easily researchable online. Some install a 90-degree camera lens in a lamp, clock radio, smoke detector, Kleenex box, phone, or just about anywhere.

You may be surprised at the amount of work required for caring for an elderly person. Toileting, diapering, bathing, brushing and flossing teeth, shaving, fixing hair, soaking feet, applying ointments, moisturizers and makeup, cleaning wax out of ears, trimming nails, dressing, shopping, cooking, serving, feeding, administering medications, housekeeping, laundry, running errands, answering phone calls, keeping medical and dental appointments, providing social interaction, chauffeuring, monitoring medical devices—and also providing emotional support!

In addition, when caring for a challenging elder recognize that you are expecting your caregiver to be a “psychologist” in the trenches, asking them to tolerate behavior from someone who may be uncooperative, nasty, manipulative, and maybe even physically combative. And if dementia exists, be sure your caregiver understands how subtle and intermittent it can be and how they should cope with illogical and irrational behavior. Realize that even mild dementia can cause unfounded complaints that may cause the caregiver unnecessary stress, yet the patient may forget about it by the next day.

Be sensitive to the stress and needs of your caregiver. Give praise often, overlook minor mistakes, and then allow for a learning curve. Make it clear to everyone that your father does not have the authority to fire the caregiver, or you’ll go through all this many times. And I assure you that after you’ve had a few caregivers who don’t show up or for whom you spend all your time helping with their problems, you will soon realize that when you find a great caregiver—they are worth their weight in GOLD!

Jacqueline Marcell
Author “Elder Rage”: www.ElderRage.com
Host “Coping with Caregiving” Radio Show www.wsRadio.com/CopingWithCaregiving
Jacqueline’s Lecture on CD: 12 Experts, 14 hrs of Help.