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My 85 year old mother with dementia recently entered a hospice program and the home health care aide that they've been sending to my home to bathe my mom makes me feel very uncomfortable. The first thing that I noticed was that she wasn't bathing my mother at all when she thought I was occupied with other tasks and not watching her, this happened three of the four times she came to my home so far. There was just one time when the head nurse happened to be in my home, then she performed her job, I only imagine because her boss was there and she wanted to impress her.
Another thing is this person makes me feel very uncomfortable in my own home. She's not friendly at all and rarely says two words the whole ten minutes she's in my home. She also seems to have shifty eyes that betray her trustworthiness.
So I talked to the head nurse about not sending this woman to my home. I didn't want to get this woman in trouble so I told the head nurse that I was able to manage bathing my mom myself and didn't need the home health care aide, the head nurse seemed to try making an issue of it and repeatedly told me how important it was for this home health care aide to come to my home and bathe my mother even though I'm the one that bathes my mother every single day.
My issue seems to be that since I'm doing all the work why should this untrustworthy home health care aide be sent to my home to do nothing.
Am I wrong viewing things this way?

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Just my opinion, but I would report her. She should not be in hospice if she is not doing her job. I have heard wonderful things about hospice, a bad apple in the bunch should be weeded out. What if she was taking care of someone that doesn't have someone there watching. I also know of someone in hospice in our town that was fired. I know her and I sure wouldn't want her taking care of my loved one.
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The head nurse was adamant because of the money.... instead of her trying to convince you you needed this service, she should have been trying to find out if there was a problem.... they have to keep a census in order to be paid.... like goldbrand said, I have never heard anything but wonderful things about hospice, and my own experiances with them have been wonderful... so, report her, to me this is like child abuse, if not reported then this person goes on to do this to others....and if there was ever a time an elder needs to feel safe and cared for,it's the end of life... I am happy you followed your feelings, but please report her....
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Ditto what they said and don't worry about it. "I'm not sure, but she seemed to not be bathing my mom, either way, I haven't felt as comfortable with her as I'd like". If you do want the service, ask if someone else may be available, perhaps she just wasn't the right fit for your family? Find a way to get the help you deserve. If you prefer to bathe mom, maybe get help with something else. Agencies are used to switching staff out to find the right fit.
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Thank you all for your very helpful replies. I forgot to mention that I get up at 7am and the very first thing that I do is check on my mother then change her diaper and bathe her. I always do my best to keep my mother clean, since she has dementia she sometimes rips off her diaper and gets waste on her hands and body, oddly enough the head nurse recommended that I stopped bathing my mother and let her stay filthy until the home health care aide arrives which is around 11am... So I told her no, I just can't let my mother linger in filth and that I will continue to bathe her when I get up.
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If you don't trust the aide you could try telling the Agency that the aide & your Mom "are not a good fit" (if you are worried about getting the aide in trouble). I stopped a rude Nurse from coming for Medicare skilled visits with my Mother after a hospital stay by saying that to the agency. They sent out a different nurse and she was very nice. You could always switch to a new agency also. If your gut instinct is that something is wrong - trust your gut. You and your mom have the right to have caregivers that you are comfortable with.
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RaineSage: Two things: First: Your mom's bathing schedule is better with you. Why leave her like that until 11am. Second: I'm not impressed with the aid or the head nurse. I think you would do all elderly patients a kindness if you would be honest with the head nurse. Just tell her you don't feel her advise was helpful, nor could you follow it in good conscience and tell her the aid is a freeloader who does not bath your mom when she comes.

Sometimes bad behavior can start at the top and work down. Maybe there is another hospice in your area you could switch too. If not, then you really have to speak up. That's part of being an advocate for your mom and you may need help in the future so set the standard.

You are a wonderful daughter. Sending you love and hugs, Cattails
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You have an absolute right to request that the hospice has a different home health aide come instead of the one that you are concerned about. If they cannot or will not change the HHA, then you have an absolute right to change to a different hospice (assuming another one is available and acceptable to you.).
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You should definitely say something. They can send someone else. It is your home and you should not feel uncomfortable with this person. You will not get her in trouble. I have been through all this and the agency will just send her somewhere else. Your mother deserves the best care she can get. Do it for her. Good luck.
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RaineSage, You are a wonderful daughter and your mom is so lucky to have you. After reading all the comments I have to say I, too, was fortunate with the Hospice we chose when my husband was dying; nothing but loving care was rendered. One thing I learned about choosing a Hospice is to ask them about credentialing. Many Hospices have only RNs and others have an RN directing LPNs and CNAs. This scenerio leads to a chain of command that can be inefficient. My advice from a nurse friend of mine was to hire the RN agency for my husband. Another thing to look into is what background checks does the agency perform (since you have observed her looking shifty.) You want to make sure that they check backgrounds across the U.S. and not just in your state. It's too easy for felons to move around. Bottom line is Hospice care = Medicare payments for these businesses. I would seriously consider interviewing other Hospice agencies. God bless you for your tender care of you mom.
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I was a home health aide for ten years. Sometimes personalities don't fit but but as in you case she seems to want the money while doing very little. There are slackers in every profession, and she seems to be one. I have been sent to bathe a person and they refused. That is a different story. I agree that something could happen to someone who has no one to be as vigilent as you. DO report her.
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A bed bath takes way more than 10 minutes! It doesn't matter if you have bathed her at 7 a.m. The aide is supposed to do it again unless you ask him or her not to. Anyone who makes you uncomfortable in your own home should be asked to leave. You are going through enough with the care of your loved one. Stop this relationship ASAP and find another hospice. you have received excellent advice from all.
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I agree. I have nothing but respect for hospice in general but this office sounds like they have a culture of gimme the money rather than helping patients and families thru this difficult transition period. The fact that she did not try to find out what exactly was going on and then wanted you to let her remain in filth until their aide showed up is unacceptable. If there is another hospice in the area, I would definitely switch! Also if you ever have an aide that makes you uncomfortable, any reputable company would send someone else without problems. It is your home and you should NEVER be uncomfortable in your own home! Best of luck to you!
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I didn't read the other replies, but I think she should be reported. The next person will have to deal with it too, and may not even realize she ISN'T doing what she is supposed to. She should not be in that line of work if she doesn't want to DO the work. She should get in trouble.

Also, I would hate to have them later say you can't get assistance since you turned it down. They can be funny like that. I would call her back and say, I am sorry, this is the real reason I didn't want her here...... I just didn't want to be a trouble maker, but after reflecting, I realized I was wrong and needed to confront this issue.
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Imagine the next person not realizing mom/dad is NOT getting a bath... some people CAN'T do it themselves or don't have a clue how too.... if someone is on hospice and doesn't get bathed regularly, the skin can break down really fast! That is a VERY important job!! They need a responsible person doing it.
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She should indeed be reported to her supervisor for not performing the main task of her job. There is probably an overseeing governing body that oversees hospice care agencies. You might start by asking the Ombudsman in your county.
I know the feeling of not wanting to report her but it has to be done as she will just do it in another home. Be very sweet but factual. Also state it appears that it is not a good fit. At last let them try to send out another aid because this is to help you!!!!

I would keep cleaning my mom as you said when you wake up but mom still needs a good overall bathing. Please let someone help you with this.

If an ombudsman is able to help you they will investigate anonymously. I suspect the governing party for hospice would do the same. Let them try a 2nd aid or move on to a different hospice organization.

Please let us know the outcome. Thinking of you
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Ah my dear! Do not feel bad about reporting her. If anything, you may help another family by doing so. Companies will try to re-train aides or caregivers they get negative feedback on if possible, and let them go if not a good fit for clients.

This may not be the profession for them, and you should not cut yourself off from getting good help if available. Just let the head nurse know, and that you would like to try a few aids to find a good fit for you and your Mom.

For sure keep up the good work getting Mom cleaned up in the AM. Many Elders get UTIs, etc., from being left in soiled conditions - and these can and should be prevented. Good on you!! Keep us posted!
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Very good advice from posters on this subject!
Absolutely, gently explain to the aid's supervisor about the situation, and how you feel about this person being in your home.
Your feelings about how helpers behave while in your home, are important!

By reporting the aid's behaviors, you might prevent that kind of neglect or other problems [including possible abuse] in that aid's work for other patients.

It is worth questioning why the supervisor failed to ask about the possibility of problems. That is part of a supervisor's job, to ascertain what is causing a family to request a helper not return. While a worker might be desperate for a job, there is no good reason to keep them working in a niche they do not fit in, or, prevent them getting proper training
There might also be health reasons the aid was not doing the proper job: Perhaps the aid has health issues that make doing the tasks difficult or painful, and the aid might need a different job assignment [we had a couple aids in that category--who gamely came here to help our elder, but was clearly in pain herself].

That said, I have learned over time, that too often, those desperate for work of any kind, can resort to becoming home health aids.
The training does not always get done well, sometimes not enough training,
or, the student fails to understand some things fully, and gets passed off to the work force because agencies need workers---kinda like students in school getting passed to the next grade, because the system does not want to hold them back for any reason---they need the student space, or, they need the person to be part of the workforce sooner than later.

IF few people give feedback that there are problems needing corrected, the system will not respond to fix things; it causes the entire system[s] to degrade over time, until more wake up and realize things are pretty poor, need fixed, and wonder how things spiraled down so badly.
Kinda like a number of other systems we live with these days...
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I think what you are the victim of is, the For Profit Hospice providers. Some are quite good but many others appears not to possess the anticipated compassion Hospice is noted for and have expertise solely in bilking Medicare at the patients expense. Contact your MD, inform his of what can only be described as patient abuse, directing you to allow your mother to remain covered in feces, so their nurse can justify her existence and request a different provider at best or replace the supervising nurse on your case
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Plus with the economy the way it is, it is sad to have her get paid good money to do nothing when there are others who would LOVE to have a job with honest pay for hard work...
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Shame on that head nurse !!! What kind of a nurse is that who would recommend leaving your mother lie in her own waste !! She certainly does NOT have your mother's comfort at heart. In fact. what kind of a heart does she have at all ??? Get rid of both of them. And who cares if their feelings are "hurt". It's the care that your dear mother receives that is the most important !!!
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I agree w/reporting her. No one should have to deal w/someone who doesn't do her job. If she loses her job, she deserves it for being lazy & shame on the head nurse for suggesting that your mother lie in her waste until the HHA arrives. If you would like someone to give her a shower, maybe they could come earlier? Your mother's skin could start to break down if left for hours in her waste. I would report the head nurse as well & if possible, look for another Hospice.
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My MIL doesn't qualify for Hospice yet so we have a Home Health Agency that comes to bathe her and do small stuff. Over 29 months, we've had over 10 and maybe closer to 15 different aids come here. I've lost towels, wash cloths, small knick knacks and I don't know what else. It's impossible to accuse anyone because you haven't seen them do it. My husband has notice it, also. He hired this agency because the owner is a friend of his. Their literature says their girls are bonded. Maybe those are just printed words. I told my husband a few nights ago about my concerns about this agency and of the loss of towels, etc. He sarcastically said "If you want to change agencies, change". I told him I was going to because his Mother needed consistency and I needed one girl coming here. I was tired of the parade myself. There is something wrong when an agency can't keep qualified reliable people. I asked one girl who came here if she knew how to give a bed bath and she said she had never given one but she had seen it done before so how hard could it be? I will change, but I need to wait until MIL is dismissed from the hospital.
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Funnier: Turn over seems to be a common problem with agencies. People come and go all the time. We went through that for 9 months with my dad. However, having things so missing is a problem that I never dealt with. Talk to your local Area on Aging and ask them what in-home care agencies they feel are the best.

Good Luck, Cattails
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I say find another agency to go through. You shouldn't have to put up with anything but the very best care for your mom. I use to have a problem reporting caregivers that I wasn't happy with. Now I don't. It just blows my mind that they seem to hire just whoever and that's who they send our way. The last agency we were with, my mom's had her meds ripped off, not once but twice. I requested that girl be replaced of course. The next caregiver I had complained about a couple times in hopes they would talk to her about how she spoke to my mom, which wasn't outright yelling, but something bordering on it. She finally became gone when my daughter called one day and said that this lady had yelled at her about leaving the back door open. My daughter was waiting for our dog to do her business. Little chihuahua + winter = attentive bathroom breaks. Next comes the caregiver that actually would sit most her shift in her coat watching home improvement shows on my tv and ignore my mom. One day I was home during respite and actually had to cue the girl to do her job and when it came to taking my mom to the bathroom she didn't even know where the disposable underwear were kept. I called the next morning and had her replaced. The next girl was snotty and I dealt with it for a while, but then they (caregiver and/or agency) would change the schedule on me without notifying me and then the girl was coming in and whipping out her book within 5 minutes of arrival, ignoring my mom. Needless to say we are with a different agency now and we're barely there. I feel like I'm there, but with one foot out the door at the same time, because our regular caregiver took a month off from work and we got a replacement that would snap at me, jump over things (one time falling and bruising her knee), watching horror flicks on my mother's tv and spend most of her shift crying about her personal problems.
Good luck to you. Remember that your mom and you come first. Don't put up with crap and don't protect the caregivers, they can fend for themselves. If they get canned, chances are you're not the only one complaining anyway.
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Home care-giving is tough work.
Workers who do it, often cannot qualify to do other work.
There is high turnover of workers at agencies, related to the agencies doing a number of things that make working for the agency a problem:
---assigning workers to environments they specifically asked to be avoided
[like, a non-smoker worker gets assigned to a smoker's house];
---assigning workers back-to-back shifts or rotating shifts or too many hours or coercing them to work beyond their physical limitations, etc.;
---contracts that benefit the agency, not the workers;
---poor training of workers;
---incomplete training of workers;
---Patients poorly assessed: UNder-assessed for level of care actually needed, causing workers to be assigned to clients needing more than they can do, or needing licensed nursing care;
---workers poorly assessed for their backgrounds, personalities, skills, health issues;
---agency gives assignments too far from worker's home;
etc.
So when one signs up to have home health care workers come to the house to care for their loved one, it's often a crap-shoot what kind of care one gets.

"Bonded" is supposed to mean that the agency will cover, or the bonding agent will cover, if the worker does something like theft or other.
IF the agency's brochure says they are "bonded" , then they legally have to be bonded.
IF something is removed from your house, and it was not supposed to be removed, the people who live there, or whoever is the POA for the person cared for, needs to file a police report for the missing items, and state in that report that they think the home-care worker removed it.
There may be other rules to follow, but those are basic. ,
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There are a lot of issues involved with agencies, hiring, training, scheduling, work conditions for caregivers. However, at the end of the day the primary caregiver has to consider the needs of the person they're caring for first. If you aren't happy with a caregiver, then you have every right to have that caregiver replaced. If you aren't happy with an agency, you have every right to change to a different one and you shouldn't feel guilty about that, because your thinking of the well-being of the person you care for.
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Talked to the HH agency and explained your comment to the aide. They can send a new aide for your mom. You can refused to sign the service you provided or you can even call the medicare if the agency refused to change. There are a lot of ways.. you can stop the service of the Home Health and find a new one.... or report to medicare.....Good Luch
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Chimonger, you hit the nail on the head with every comment you made. This agency has committed every offense you stated. I have the name of a good agency that the Area on Aging gave to me and I will call them later today. I am expecting MIL to be released today and have to be ready for that. It's sad that the RN who comes here is the one and only person we look forward to seeing from that agency. We won't see her any longer.
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