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dev123, one agency would have charged $75/hour for a nurse and another would charge $85/hour. That's about what contract nurses get, and they have to be well qualified.
I suspect the workers are independent contractors. Perhaps this is for financial reasons so the agency doesn't have to pay benefits for its workers.
I've also discovered there's a wide variation in the competence and professionalism. I had two top notch nurses, but the physical therapist was mediocre.
When I have time, they need to be investigated and I intend to pursue this. Even a friend of mine who lives in a small town hired Visiting Angels for his Mom and all she did was talk about herself constantly. I'm in a big city and everyone, and I do mean everyone tells me the same thing. Luckily I had experience as a care giver and can go most things but I needed someone to help me lift. Do I think they care about the patients? Not really. Perhaps a few do. Most of them are from other cultures and it's easy money. Personally I still get up at 5 a.m. even tho my Mom has passed to make sure an aide is awake and not on her/his phone or sleeping. PTST.So you need to vet them very well and I truly suggest going off the grid. They actually make more money as the Agencies not only screw the customer but also the employee. It may be a question of illegal hiring where i am. I am not alone in this very daunting experience.
One evening caregiver had a strong feeling that my Dad should go visit Mom who was in long-term-care. Dad didn't want to because he already saw my Mom at lunch time [his caregiver would help feed Mom], he was tired. But she insisted and nagged him until he finally said yes. I don't know how that caregiver knew, but would be last visit to see Mom as Mom passed the next morning in the wee early hours. Dad was forever grateful that she convinced him to visit.
Dad's daily caregivers would eves-drop on telephone calls that Dad got. If it sounded like Dad was talking to a telemarketer, the caregiver would ask Dad for the phone to see what was this all about. Whenever the doorbell rang, they were very protective as to who was at the door. Both would also check the wastebaskets and recycling for unpaid bills as one noticed that Dad was throwing out unopened bills. Eventually those bills got transferred to my address.
There are a lot of good Agencies out there, it's just trying to find the one that works best for your situation.
I think it takes a certain level of confidence to successfully work with and handle elders, especially those with dementia.
One agency with which I've been negotiating has minimal in-house training standards as well as 2 years of related experience. It's also the most expensive on an hourly basis.
I know it isn't always easy to get the same person each day, I just happened to be in the right place at the right time. As mentioned before, the 2nd shift the Agency couldn't get someone on a regular schedule. Dad sometimes got caregivers just out of high school, someone who was going to college, so this was a way to earn some extra money and to have time to study. Not much conversation going on, as the age difference was too great as my Dad was in his 90's, had a busy day with his first shift caregiver, thus was tired after dinner, so he would doze off in his recliner.
The Home Instead that I used, there was a company 3 ring binder that the caregivers would leave notes on what they did during their shift. Thus it kept the bedding from being washed twice in the same day, or other duplication on chores.
I had excellent luck with Home Instead. They were a godsend for me. My Dad needed around the clock care. Thus, 3 shifts, 8 hours each. Dad picked out the caregivers he liked best and I asked the Agency if it was possible to schedule those two on a regular schedule [7a to 3p one person weekdays, the other weekends]. Bravo, Dad had these two wonderful caregiver for the same shifts over a year.
The evening 8 hours shift [3 to 11p] was more difficult to fill, so Dad didn't mind whomever the Agency sent him. The over-night shift [11p to 7a], he had usually the same two caregivers taking turns as all they did was over-night care, thus they were able to stay awake the whole time.
Once Dad moved to senior living, he didn't need the late afternoon and night shift, unless he had gone to the hospital and needed extra eyes and ears when he returned. Thus, he kept the morning shift. It was a good routine for him as his memory started to slip.
On weekends and on holidays, the cost was time and a half. And Dad's favorite caregivers were more than happy to work the holidays. Dad was in his 90's, a fall risk, some dementia, but so easy going that caring for him was simple. Any time one of the regulars couldn't make it in, the Agency had no problem with filling that slot as everyone wanted to work with Dad :)
The 2 regular caregivers did buck the rules when Dad was on Hospice, as they didn't want anyone else taking care of Dad during his final few days. Each one took a 12 hour shift. Some how they worked it out with their Agency.
The only OT issue I've encountered has been addressed contractually, between the franchise holder and the client, with an additional charge of $1 per hour for weekends. I do recall one with whom I spoke did charge time and a half for holidays, but I don't know whether that remains with the agency or is paid to the worker.
I've learned that home health care companies address weekend work by using Independent Contractors as opposed to employees. Some of these IC workers have other full time jobs, some just work on weekends. But these aren't companies that provide staff on a continual ongoing basis, only for the duration of the home health care.
I'm going over all my notes today, to start over again and not waste time with ones I've already contacted. If I find any that sound promising, I'll P'M you. Regardless of how I feel about them, I wouldn't make public recommendations.
FreqFlyer is one of the regular and knowledgeable posters here. She's used HI for her parents. I believe she had 3 workers, each for a successive shift. I'll PM her; she might have some suggestions on dealing with the HI management, although, again, the local franchise management may have its own policies.
One agency that was recommended sounded perfect, individually owned, not a franchise, friendly owner, but they didn't cover our area. And that's one of the biggest problems - twofold, actually....I think the franchises have a dominance in the home care industry, and from what I've learned, aren't very flexible.