The home health care agency that the VA selected for a personal care aide to come out to our home, I feel is not the best agency. We have had problems with the aides from day one. Some left to get a better job and others just come in late. The problem is I had to request to change aide because she was coming to my home 20 minutes late to care for my husband. The agency last week sent the same aide I got rid of before and that was very frustrating, because I got rid of her because my husband had a fall under her care. The issue now is this agency does not give me advance notice of the name of the aid or any background...they just show up at my door. I don't feel comfortable because I don't know what kind of training they have. My husband has Parkinson disease, dementia and stroke patient . Would you feel the same way if it was happening to you and your love one in your home?
If I was in your situation I certainly would like to know when to expect people to arrive, even if it was a range like 'between 7 - 8am'. In my mind it should be an easy thing to ask what sort of training these aides are certified for...your husband has very specific needs after all.
Could you maybe raise these concerns with the VA directly? They might have other agency options for you to look at.
A difference might be the length of the visits. Is your aide coming for short care visits? We had ours 32 hours a week. It was her job and she treated it professionally. An agency is going to have a much greater challenge staffing short shifts. If an aide is serving more than one client in the same day there is the logistics of travel time, trying to be equitable in who gets the short shifts, and difficulty of last-minute fill-ins. Also, if our aide missed a day it only impacted our schedule, but for short-shifts several households would be impacted.
For short shifts I think you need to be a little more flexible than if you had an aide for an entire day. But I would expect the day of the week to be honored absolutely, unless prior arrangements are made. "We are short-staffed next Wednesday because area schools are having teacher conferences. Would it be OK to come M, Th, and Fr this week?" Obviously they can't schedule illnesses in advance! But they should do as much advance planning as possible.
For short shifts I wouldn't expect the exact same time each day, but I would expect that a time range could be given, and you should be called if it isn't going to be within that window on a particular day.
I think you should talk to the manager at the agency and see what they consider to be fulfilling their contract. Also ask about the minimum training of their aides.
Our Hospice visits were irregular. Days changed, times changed, and occasionally staff changed. I think this is to be expected. After all, if a nurse is with a client who is actively dying she probably isn't going to say, "Well I have another client. I have to leave now"! I imagine it is similar for aides. Because of the nature of the situation they probably can't always follow the schedule exactly. Also the person on hospice is supposed to have 24/7 care, so it shouldn't be as if they are going to be alone if the aide doesn't come when expected.
Statewise I hope you can get this worked out. Let us know how it goes!
I worked for a nonprofit visiting nurse facility. We sometimes worked with the local Homecare out of the hospital. Usually people go back to their homes. So, the homecare tends to just come. Probably because if having therapy at home, you should not be leaving your house. Me, they were coming to my house to care for Mom. I told them I needed a schedule and what was good for me in the time they had. I was flexible as long as it was 10am or after. I Didn't want people coming and go in my house. I would have expected the same from Hospice. It only takes a phone call.
As for sending the same aide, that in most cases doesn’t happen. Home care staff too call in sick, have car problems, etc & flexibility on the client’s part is necessary. But courtesy from the home care staff is necessary as well.
The trouble is, they might not be that much better. Everyone working in elder care knows that continuity - having the same few people - is important. I haven't yet met an agency that managed to put it reliably into practice.
So do see if you have options; but at the same time call the current agency and have a polite but serious conversation with a senior manager about your concerns - give them another chance to do better.