Help for managing carers

[Caticat]

My mum has mid stage dementia and is living in her own home with live-in and hourly carers. She seems happy but the carers are driving me round the bend!
I don't know how, but I have ended up as the care manager as they are all employed directly rather than through an agency. I need to professionalise the way I manage them - ie put some forms and processes and procedures in place so that I am setting the standards. At the moment they are criticising each other the whole time for not doing things right - carer wars! I am already looking for new carers, but these are among the best carers for Mum that I have come across, and I don't want to get rid of them now just to get incompetent carers again.
If you are employing carers directly, how did you do this? What forms do you use? What is in your care plan? Can you point me at useful resources?
Thanks

 

[Jessbow]

He who pays the piper calls the tune!

take time and write out a specific care plan, as detailed as you can-
A basic timetable with explicit instructions if needs be under the separate headings

breakfast~
Wash & dress
Morning activity
Lunch etc etc

then for each heading specify what you want them to do.

Breakfast- Mum has cereal and toast, with or without marmalade/jam.Please offer her a choice
Washing up needs to be done/dishes put in dishwasher /whatever

Wash & dress- Mum needs a shower in the morning. Clean clothes, soiled/wet pad wrapped & disposed of in outside bin

Lunch- Mum needs to be toileted and lunch prepared. A sandwich or something on toast.
Plates/utensils need washing up/clearing/dishwasher


Etc etc

Sit and have a think,add as much detail as you can then present as ''this is what is going to happen for the sake of continuity for mum''.

Does the bed need changing daily? if not, stipulate when it does.
Ditto the odd things like putting bins out

You also need perhaps a toileting recording sheet, and certainly a medication recording sheet. Time , dose, administered by...……..

 

[Ohso]

I have two great carers for mum and they use a book called a Home care record book, which they complete each visit and look back to see how she was on the days the other carer is in, they write notes to each other to look out for anything noteworthy and highlight any issues.
I looked on line for something similar and best I could find is this

Caregiver Log Book: A Daily Record
https://www.amazon.co.uk/Caregiver-Log-Book-Daily-Record/dp/1519178735

It might be worth trying.
I also print off a weekly planner, where we all record holidays/days off/mums appointments etc, this is clearly on view in mums room and so everyone can see what is coming up ( community nurse visits etc or evenings when I need additional cover as I am away)

I also make food and freeze it so there is a ready supply and buy pudding from a well known delivery service ( I didnt like the look of the meals so just buy reduced sugar deserts) if I feel that mum needs variety I mention it to the carers and they suggest other things which helps me out greatly.

I am lucky, so is mum, the agency carers were not so great, so with them I constantly left notes for them of exactly what I hoped they would do while there and left a meal planner with suggestions for each of her meals, with BIG reminders to encourage her to drink plenty, I am sure they read them but didnt seem to take notice but if you are paying privately they will hopefully do as asked.

Good luck, sounds like you would want to keep them so just a little communication between everyone might help lay the ground rules.

I havent done it yet but did think of a watsap group on our phones to keep in contact but so far the calender and talking has been enough.

 

[InnerGeek]

My dad has agency carers, but they are only one element of a larger support package that I have put in place for him. We communicate centrally through an A4 page-a-day diary and there is a large whiteboard on his kitchen wall with the week's activities written up. Future appointments are recorded in the diary and anything of particular note or that might need to be communicated across the board is also entered there.

What has helped is to have clear division of labour between the elements of the package, so shopping for example is managed by his befriender as it is easier than trying to keep everyone appraised of the finer points of his ever changing food foibles and advice given.

Of course, there is some crossover and the various parties chat willingly when their paths cross, but they are all very good at pulling in the same direction.

One thing I have had to learn is not to be afraid to pull rank. I am dad's primary carer and what I say goes. I am the only one who attends all medical appointments, talks to all the various agencies and assessors, draws the threads of his care together. If a carer tries to pull in a direction that works against above I've been given, or against what I know to be dad's best interests, I'll be kind and polite but firm in what should happen.

I keep a printed 'this is me' file with the care notes, this gives some of dad's personal life history as well as medical background and details of his ailments. It also contains bullet points of what support dad should receive at each visit, though this is currently out of date as his needs have changed so much since I last updated it.

Meds are recorded by the carers on their agency MAR chart but it's just a schedule of medication name, dose, date and time signed off by the carer as they administer it.

Good luck getting it sorted to your satisfaction, you'll probably find everyone is a lot happier once you've got it all nailed down.