Most older adults reach a point in their lives when they need help to get through the day, whether it’s with preparing a meal or getting dressed. When a family member is not available, “home health aides” are often called upon to help your loved ones to age with grace.
With the aging of the Baby Boomer generation, demand is growing for home health aides. But a worker shortage is making it more difficult for families and home care agencies to find caring and competent aides to provide care to seniors.
The industry’s 82% turnover rate exacerbates the difficulties that both agencies and families face recruiting and retaining aides. High turnover is often attributed to low pay, long travel times or insufficient hours. But lack of recognition, poor communication, and negative experiences with families are also among the top 10 reasons for attrition in the field.
These are modifiable risks that you can fix.
As a public health physician and the director of a company that matches home health aides with home care agencies, I have a unique perspective on the challenges experienced by this growing community of workers. The following six tips can help families make their homes a desirable, professional, and safe place to work. Throughout these tips, you will find one major theme: respect. A home health aide who feels appreciated can provide great care for your loved one and also offer gifts to your family: peace of mind, a lower stress level and time to do other things. Get to know the aides who work with your loved ones and never forget the value that they can bring into your life and the life of your loved one.
Think of your home as a workplace. You are responsible for the work environment. At your own office, youmay have a break room, refrigerator, and microwave to warm up your lunch. It’s your responsibility to create a welcoming and safe work environment. Home health aides should be encouraged to use the kitchen for lunch or dinner breaks, including the refrigerator and the microwave. Also, be sure to remove workplace hazards
Be attentive to the power difference between you and the home health aide. Don’t fall into the trap of askingaides to do work outside of their job description or pressuring them by asserting your position as the “boss.” Think of the people caring for your loved one as colleagues. They are at work and following a care plan developed by a nurse. It’s okay if they do not appear to be moving around and working every minute, as long as they are following the care plan. They are not servants; they are caregiving professionals.
Keep your home health aide safe from abuse or harassment. More than one in five home care aides reported verbal abuse from clients and their family members, according to a Massachusetts survey of nearly 1,000 home care workers. Those who experienced verbal abuse in the study also reported physical abuse 11 times more frequently. A recent book on African immigrant home care workers by Dr. Cati Coe underscores the frequency of racial slurs, humiliating insults, denigration, and aggression directed towards home health aides.
Sadly, sexual abuse also happens. Be very careful to respect the space and privacy of the aides caring for your loved ones. There are good reasons that female aides avoid home environments where they are alone with male clients or male family members.
One example from Coe’s book involved a woman we’ll call Jane. Jane was working as a live-in aide and caring for an older male client who lived with his middle-aged son. Wisely, she protected herself at night by placing a chair against the door of her bedroom. At 1 am, the son knocked on her door. When he learned of her strategy, he forbade her to do that in his house. The next morning, she called the agency telling them that she had to get out, and it was an emergency. The son’s assertion of control over the space that she occupied made it clear that her safety would not be respected.
Respect cultural differences. About 31% percent of home health aides are immigrants, coming from a wide range of cultures. This means that cultural clashes are commonplace. Starting with the initial interview, try to share and learn about any religious and cultural differences that may present confusion. The sooner you get to know your aides, and allow them to understand you, the more effectively you can work together and understand the hurdles you might need to tackle together.
In January 2017, I moderated a focus group with several Maryland home care workers. One aide told the group that her client wouldn’t let her use her kitchen while she was on her lunch break. The aide had planned to heat a meal she brought with her to work in the microwave. It turns out the family kept a Kosher kitchen, but no one had explained Judaism or Kosher kitchens to the home health aide in advance. This aide was deeply offended that the family thought that she was too “dirty” to use their kitchen. That was her first and last day in that home.
Communicate expectations clearly.
It helps to describe your family member’s quirks, pet peeves, and preferences to each new home health aide in the interview process. Think of common, challenging scenarios that you have faced caring for your loved one and ask aides to describe how they would approach them, literally. Start a conversation, develop shared expectations about care, and maintain open communication. Since poor communication is a top reason for turnover among home health aides, your clear communication of expectations may help you to retain your staff for a longer period.
Say, “Thank you.”
Despite challenges, most home health aides are compassionate and committed individuals who are in the profession because they love working with people, especially older adults. I’ve seen this kind of dedication more times than I can count. They have a passion for caring and often wonder why their efforts aren’t more appreciated. When you see them improving the daily life for someone in your family, show them gratitude.
Recognizing the humanity, passion, and commitment of home health aides will help you attract and retain the best aides for your loved ones. It may seem simple, but open communication, genuine, uncompromising respect, and a safe, welcoming workplace with amenities will take you a very long way.
Dr. Charlene Brown is the CEO & Founder of CNA Simulations VR and Caregiver Jobs Now, a caregiver marketplace and jobs platform connecting caregiving professionals to meaningful jobs in senior care. She is Board-certified in Preventive Medicine, a graduate of Harvard Medical School, and licensed to practice medicine in the State of Maryland.