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Agency Care - Carers UK Forum

Agency Care

For issues specific to caring for someone with dementia.
My Dad was diagnosed with Vascular Dementia a couple of months ago and has this week just started receiving daily visits from carers. This was arranged by the local authority.

The carers are meant to come in for a half hour visit at lunchtime and they're supposed to make Dad a sandwich, check his fridge for out of date or mouldy food, make him a cup of tea and help him to put on any laundry he may have (because he's not very good at getting the correct wash cycle to get his clothes properly clean).
They're meant to come for a 45min visit in the evening, in which they're meant to make him dinner, help him have a shower twice a week (he can wash himself but he needs someone to help put on his rubber leg protectors to keep his ulcer bandages dry), make sure he's had a proper wash all the other days, make sure he changes into his pyjamas and generally check to ensure he's safe and well and everything is secure in his flat.

They've been coming since Monday, but Dad still hasn't had a shower - they've asked him, but he just says "No thanks". They also haven't made him a hot meal either - it's been sandwiches every night, even though he has microwave ready meals in the freezer. They're also meant to help him have a shave, but they haven't done this either.

I'm not entirely sure where I stand with this - although Dad has VD, he is still considered to have capacity, but his memory means he doesn't remember to do these things for himself - he needs prompting and persuading rather than actual full physical assistance.

The other evening Dad pretty much turned the carer away, saying he had nothing for him to do this evening.

I think I need to speak to the care agency and discuss what we can do...
Hi Pope Pourri
I have similar problems , I prepared the care plan with the care plan with the agency and I have told them never to ask Dad questions. The inevitable answer is "No, go away leave me alone" or something similar. He never thinks he needs anything doing by anyone except me "because my daughter will do it". Every time we get a new carer, especially a youngster we go through this . You just need to keep repeating to the agency- never ask Dad anything because he just refuses or declines. You need someone confident and persuasive or they are no help to you or Dad so let them knopw- frequently if necessary. Are you in aposition toread teh daily written reports? If so keep phoning to explain every day until they get it.
Are you able to create a spread sheeet or word document with a list of daily duties/timetable/reminders etc . Copy in to agency manager and complain every day something has not been ticked off. I'm afraid agencies need micromanagent by and large.
The secret with dementia is to never ask a question that requires the person with dementia to make a choice.

So never ask "do you want tea or coffee ?" - instead say "it's time for a cup of tea".
Never ask "what do you want for supper?" - say "it's time for supper, I've made you a nice shepherd's pie, come and eat it before it gets cold".

and never ask "do you want a shower/shave today ?" - much better to say "today's the day for your shower".

Agency workers caring for someone with dementia should already know this but take the easy way out and then fill in the care plan with statements like "meal offered but refused" "shower offered but refused" :shock:
susieq wrote:The secret with dementia is to never ask a question that requires the person with dementia to make a choice.

So never ask "do you want tea or coffee ?" - instead say "it's time for a cup of tea".
Never ask "what do you want for supper?" - say "it's time for supper, I've made you a nice shepherd's pie, come and eat it before it gets cold".

and never ask "do you want a shower/shave today ?" - much better to say "today's the day for your shower".

Agency workers caring for someone with dementia should already know this but take the easy way out and then fill in the care plan with statements like "meal offered but refused" "shower offered but refused" :shock:
Useful info Susie. Thanks.
Pope_Pourri wrote:My Dad was diagnosed with Vascular Dementia a couple of months ago and has this week just started receiving daily visits from carers. This was arranged by the local authority.

The carers are meant to come in for a half hour visit at lunchtime and they're supposed to make Dad a sandwich, check his fridge for out of date or mouldy food, make him a cup of tea and help him to put on any laundry he may have (because he's not very good at getting the correct wash cycle to get his clothes properly clean).
They're meant to come for a 45min visit in the evening, in which they're meant to make him dinner, help him have a shower twice a week (he can wash himself but he needs someone to help put on his rubber leg protectors to keep his ulcer bandages dry), make sure he's had a proper wash all the other days, make sure he changes into his pyjamas and generally check to ensure he's safe and well and everything is secure in his flat.

They've been coming since Monday, but Dad still hasn't had a shower - they've asked him, but he just says "No thanks". They also haven't made him a hot meal either - it's been sandwiches every night, even though he has microwave ready meals in the freezer. They're also meant to help him have a shave, but they haven't done this either.

I'm not entirely sure where I stand with this - although Dad has VD, he is still considered to have capacity, but his memory means he doesn't remember to do these things for himself - he needs prompting and persuading rather than actual full physical assistance.

The other evening Dad pretty much turned the carer away, saying he had nothing for him to do this evening.

I think I need to speak to the care agency and discuss what we can do...
Haven't you had a review of your Dad's care? My Mum has only had Morning carers for a month but she has a review next week where she can tell them how things are going and I also have my say too.
Hi Penny - he's only had the care for seven days so far, so we haven't quite got to the review stage yet.
Well, the latest - Dad had a row with one of his carers today because she refused to help him put his shoes on! He wanted to pop out and get his hair cut so he asked her to help him on with the shoes and she said she couldn't because she doesn't know how to do that particular type of shoe (it's not rocket science - there are two velcro straps and that's it). I think it's because they're orthotic shoes, so they look a bit "special", but in actual fact they're just ordinary shoes made to fit my dad's massive hooves.
My dad promptly took his shoes downstairs to the manager in his housing scheme (with the carer in tow). The scheme manager gave the carer a piece of her mind and the carer just walked out! Without a word. So the manager then rang the care agency and gave them both barrels about their staff refusing to put on a client's shoes when he requests it. Now Dad is all confused - this appears to have set him off tonight.
Devil's advocate. - Maybe she didn't know what to do about him saying he was going out? Maybe she hadn't been instructed as to whether he was safe to go out on his own or not and thought that not putting on his shoes was a good way to delay him until she had found the answer?
Hello Pope pourri
There is something in what Elaine has said. In the nursing home staff often have to say things to redirect the issue. The ' kind lies' as I call them. Is your Dad still ok with going to the barbers on his own?
It's a rollercoaster emotional time and trying to help relatives keep their independence for as long as possible is only a good thing.
I do feel for you
I doubt it Elaine- you haven't met as many carers as I have! Remembering I am one myself so totally neutral so to speak but some of them can't make a cup of tea or boil an egg so it doesn't surprise me that a pair of shoes is beyond their mental capacity. I am obviously not trying to insult most of my fellow care givers but some of them out there give the occupation a bad reputation.
If they are that hapless and you are self funding , immediately start looking for a good agency and change asap. If the carers come via Social Services get on the phone to them immediately and explain that you need someone with a brain.