This is part of a series of articles that walk families through the decision process of hiring a home care agency. Additional topics include how to have a conversation with your loved one about home care, aligning expectations with home care agencies, and choosing between residential options and at-home care. Click here for our full series of articles on home care.

When hiring an agency to provide home care, you need to have a clear understanding of the specific parameters of care employees will provide. There are limits to the tasks which a companion aide can provide, and this may hinder the ability to provide appropriate care for your loved one’s needs.

In the context of non-medical home care, there may be restrictions around what an agency will allow its employees to do for a client. There is a great deal of liability involved when providing care to another person. As a result, companies may be very diligent in their refusal to provide certain services. 

Caregivers can’t provide medical help, and what’s medical might surprise you

For example, many home care companies do not want a caregiver opening a pill bottle. The pills already need to be in a dispenser and all the caregiver can do is remind the client, “It’s time to take your pill.”

For example, a client with a catheter which requires a urine bag to be emptied might require someone to come from a home health care company, or a private-duty caregiver who is credentialed as an LPN (licensed practical nurse).

Caregivers may have limitations regarding their ability to apply eye drops, antibiotic ointment, or other dressings required to avoid infection. These kinds of specific tasks need to be discussed to ensure transparency in an agency’s ability to provide the level of care needed.

There is no doubt that competent individuals are capable of performing many of the tasks that carry such high liability for companies. Families do it all the time: they figure out what’s needed and they do it. While those personal decisions may be made by family members, it’s important to understand and respect the limitations of an agency’s ability to allow its employees to do the same.

What exactly counts as “light housekeeping?”

A conversation is required to clarify what is considered to be light housekeeping and what is beyond the scope of what a caregiver will provide.

Scrubbing toilets, bleaching the grout between bathroom tiles, or cleaning windows are defined as ‘deep cleaning’ which is not part of the caregiver’s role in caring for a client. 

What’s reasonable to expect? Light housekeeping can include vacuuming, dusting, cleaning the kitchen area before and after a meal. It’s common sense to tidy up, yet dialogues are necessary to understand expectations, as something as seemingly simple as ‘tidying up’ can have different meanings for people. For families who would like ongoing deep cleanings, a separate housekeeping service is recommended. 

Make sure to discuss transportation

Have a clear understanding whether the caregiver is going to provide transportation using the  vehicle belonging to your loved one or that of the caregiver. Avoid frustration and gaps in communication by having these conversations and reaching agreement at the onset of care.  

About the Author

Karen Faith Gordon specializes in providing support to individuals and families addressing issues of aging. Services provided include mental health counseling, grief counseling, patient advocacy, medical care coordination, real estate and placement guidance to address short and long term care needs, and adaptive yoga for optimal well being.

In a system fraught with bumpy rides, Karen provides guidance, direction, and reassurance to achieve optimal well-being for older adults and those caring for them.

Karen’s ideal client is someone who is facing the challenges of a spouse/parent/loved one who is experiencing cognitive or physical decline. This client seeks guidance and support from a knowledgeable expert to create a plan to address short- and long-term needs.

Her relationships with clients, colleagues, and providers of care reflect years of collaborative effort to achieve best outcomes. She has presented to audiences locally and nationally to educate on topics of care management, affordable health care, and the benefits of yoga and aging.