Tips for establishing a plan of action for replacing your caregiver when they quit suddenly and the difficulties of finding a qualified caregiver in the current climate.
Over the course of twenty years as my caregiver, I’ve come to notice a few t hings. My mother
has had a revolving door of caregivers in t he past 15 years of her illness. During the early
stages of my caregiving journey with my mother, we needed a caregiver for short-term stays
when I went to work. Although my mother was still mobile with the use of a walker or rollator,
she was still a fall risk.
The need substantially increased after my mother returned home from a lengthy stay at a skilled nursing facility. This happened a few times over the span of 5-10 years. Typically, after being discharged from a hospital visit, my mother would be released to a skilled nursing facility for physical therapy before returning home.
Multiple sclerosis is a progressive disease, but its advancement can be slowed with continued exercise and regular muscle use. My mother’s physical therapy proved to be quite helpful in her treatment plan. Initially, she was able to walk for small distances in the facility with her walker or rollator under the watchful eye of her therapist.
My mother enjoyed the walks and appreciated the accolades from her therapist about her
progress. Typically, before the end of her 90-day stay at the facility, my mother would be
released with an order for at-home therapy.
The first time my mother was scheduled for release from a skilled nursing facility, I did not have a team of caregivers at my disposal and I had no idea where to start the process of finding one. All I knew was that I needed to hire one quickly.
With no frame of reference or real understanding of the qualities that were important to me, I
hurriedly hired my first caregiver to watch over my mother at home while I was at work. At that time, my mother’s needs were nowhere near as advanced as they are today. She was more mobile and independent, which simplified the hiring process for me.
As her disease progressed over time, my mother’s needs increased. She required more
assistance with her routine personal care, meal prep and light laundry. Knowing this, my
mother took matters into her own hands and made a deal with Rosa, her caregiver who was
intending to leave her employer to work with us full- time. Truthfully, the hiring process was
improper and I do not recommend going about your hiring process like t his due to state and
federal labor laws. But, I will admit that bringing the care provider on full- time proved to be a
good decision and satisfied our needs for nearly a decade.
Rosa lived within 15 minutes of our home and could get to our house twice per day, every day, rain or shine...or the dead of winter. The only bad news was that Rosa refused to take a break!
Eventually, my mother ran out of money to pay Rosa, who was showing signs of burnout. My mother informed me about three months before her last check, that I would need to pick up the payments. Rosa’s monthly pay was more than $3,000 and, at that rate, it was understandable how my mother ran out of money. But picking up that tab wouldn’t prove to be very easy f or me.
I’d failed to do the appropriate elder care planning in advance, so we had no choice other than to apply for Medicaid. This lengthy process would take several months to complete and I was afraid we wouldn’t have enough time to get approved without disrupting my mother’s at-home care.
I’ll share my experience with the Medicaid application process in a separate blog, but allow me to say, this i s not a decision to make on impulse. Lesson l earned!
It was very difficult to break it to a very loyal Rosa that we had to l et her go. Since we were very happy with her service, we asked if she’d be willing o sign a contract and move to an agency that accepted our insurance. Initially, she agreed, but she later decided to decline the offer. She eventually resigned, but before leaving, she referred us to Diane while we were going through the application process for Medicaid.
It took over a year to be accepted, and it became even more complicated with scheduling. We discovered that we needed more than one caregiver because no one replacement caregiver would cover he entire week. We eventually used a combination of agency-provided care paid for by Medicaid and the services of two additional private-pay caregivers.
Medicaid provided about 30 hours a week, which was the maximum number of provided care recipient hours. For about a year, we had three different caregivers, and for t he most part, I operated with peace of mind knowing that my mother’s needs were taken care of.
Unfortunately, he private caregiver was diagnosed with kidney disease and could no longer
continue her schedule. But the remaining caregivers picked up those hours privately. For
another three months, we were able to make things work. Then, another caregiver decided to quit without notice because lifting my mother was hurting her back.
And...we were down to one caregiver.
I assumed the caregiver’s employment agency would inform me of her resignation and would provide a replacement for her, but I ’d assumed incorrectly. I was told t o call my back up caregiver. But, wait. What back up?
Luckily, our remaining caregiver stepped up to help out on the days she wasn’t scheduled with us. But...she was now left working 7 days a week and twice a day. I learned that this would inevitably lead to burn out and I knew we couldn’t lose our last caregiver!
I called every agency in the area that accepted Medicaid, but no agency had available workers. Finally, after two weeks of having no luck, I contacted a private-pay agency and was able to get caregiving assistance on a week-to-week basis.
So, you’re caught up to present day and so far, we’re doing well! We’re utilizing an agency that provides good benefits o t heir workers and attracts more quality employees than other
agencies that don’t.
My advice when there’s a caregiver shortage, as there is today, i s to go where there’s a
likelihood of available workers! It will help you with filling the position sooner than later.
Below, please find some takeaways for what to do when a caregiver suddenly quits.
1). Always be recruiting. Ask friends, neighbors and co-workers for referrals. Collect
information for agencies and caregivers for backup. You never know when a caregiver will be
unable to come to work due to an illness, family issue, or weather delays.
2). Complete your research and contract with a reputable agency in the caregiver industry.
There’s a severe caregiver worker shortage and premium agencies that take care of their
employees can deliver. Great employers attract better workers.
3) Consider going to Care.com or an agency that provides private a caregiver for hire at a
reduced rate. It will be your responsibility to interview them for a proper fit and ensure they clear a background check before hiring them. Also, keep in mind that i t takes a few visits to
determine if there’s a connection between the caregiver and your care recipient.
4). Periodically inquire with agencies who accept Medicaid. Just because they don't have an
available worker when you call, doesn’t mean they won’t have one later.
5). Consider a short-term respite with an assisted living or skilled nursing facility. This would be a private pay situation, but it could be a viable option while you’re looking to hire a replacement.
Hopefully, this provides some viable options f or you regarding developing a backup system for your loved one’s ongoing care.
What has worked for you?