Hiring a home care aide represents a major transition in family caregiving, especially when the care recipient is a person with dementia (PWD), less able to express his or her needs. Initial encounters may stress both sides.

Family members may feel uncomfortable letting a “stranger” into their home and feel guilty relinquishing caregiving tasks, and may feel uncertainty about the trajectory of dementia.

The home care worker may feel anxious entering a work situation with many unknowns regarding expectations, demands and personalities. These suggestions can help families develop partnership relationships with home care aides:

Clearly define expectations and duties:

• Identify activities of daily living (dressing, toileting, eating) the PWD can’t do alone.
• Agree upon a schedule of care and tasks.
• Identify caregiving tasks a PWD (or family) prefers the care worker avoid, either because the PWD might feel uncomfortable or family members want to continue to provide it.
• Provide important phone numbers and emergency procedures.
• Develop backup plans for substitutes if the care worker cannot work.
• Develop a system of communication, e.g., leave instructions in writing, develop checklists of completed tasks or problems, maintain a daily log of the day’s events.
• Identify dietary requirements and restrictions, allergies, meds, exercise and endurance levels.
• Agree on policies (smoking, eating, using the phone on the job, payment and benefits).

The more the care worker knows about the PWD’s background, history and preferences, the better able he or she will be to converse, develop rapport and treat the PWD as a unique individual.

Information family members might share with the home care worker:

• Life history highlights
• Persons who hold influence with the PWD (a physician, favorite child)
• Pet peeves; ideas of appropriate behavior, habits and routines; food, entertainment and activity preferences; favorite conversation topics, e.g., pets, possessions, grandchildren
• What upsets or triggers challenging behaviors
• Special phrases or behaviors that may signal a need, signs of pain and other symptoms

For more information about what you should know in order to develop a successful partnership relationship with a home care aide, go to this address.

CENTER ON AGING — University of Hawai‘i at Mānoa
2430 Campus Road, Gartley Hall, 201B, Honolulu, 96822
808-956-5001 | map3@hawaii.edu