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I recently hired an agency caregiver to help my husband who survived a serious stroke 3 years ago. My husband has been medically assessed and would qualify for living in a skilled nursing facility, but I want to keep him at home as long as possible. Husband is paralyzed on entire left side of body. He can transfer from bed to wheelchair and back with the help of one person. He needs help with all the ADL's. He is generally mentally sound. I have been his sole caregiver for 3 years and it's (beyond) time for me to get some help.


Last month I hired an "experienced" caregiver through a reputable agency who didn't train him. Giving the new caregiver the benefit of the doubt, I've been training him myself for the past 3 weeks (30 hours per week).


It's become apparent to my husband and me that this caregiver has very real challenges both physical and mental. He's a very odd and gentle person who constantly needs quite a bit of reassurance from us that he's doing okay... When we offer the most gentle constructive criticism that we can, he looks wounded but he tries to hide it. We feel sorry for him. We suspect that the caregiver is genuinely disabled, and that this is his first caregiver job. We've learned that he's in his late 40's, lives alone, has never been married, has no partner, no kids, no outside activities, and his only interest is collecting reptiles. He's never travelled, he can't cook, or do math. He literally has trouble distinguishing left from right. After 90 hours of caregiving my husband, he still can't remember which side of my husband's body is paralyzed. He can't figure out which shoe goes on which foot when he dresses my husband. Yesterday he put on my husband's pants backwards. Sigh.


We've come to the conclusion that this caregiver needs to be replaced as soon as the holidays are over.


What is the most gentle and kind way to fire our caregiver? Do I say nothing at all to the caregiver and simply phone the agency to ask for a replacement? That just seems so abrupt and cold.


Do I level with the agency about this caregiver, or do I simply tell the agency that the caregiver chemistry isn't right?


I'd like to avoid causing hurt feelings to this caregiver as much as possible. I think being fired is going to traumatize him.


Does anyone know a kinder way to do this?

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You phone the agency and you tell them JUST EXACTLY what you wrote us here.
In fact, read it to them; give them a copy of it.
You have been nothing but kind here, and very understanding.
That this gentleman isn't up to the job may have to do with training, or it may have to do simply with him, as you suggested. In all truth it isn't on you to guess about that. You are paying decent wages and must have an adequate caregiver.

This is very sad and you are very kind and I can imagine your anquish, but this is not your fault. Nor, seemingly is it the job of this caregiver. He may be just fine in an in-facility caregiving job where he can be assigned where he works best and can do best, and slowly gets trained and acclimated.

So sorry.
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First of all, you do not do the firing of this caregiver. The agency he works for does.

You call the agency and tell them that he is a very nice person but is an incompetent and ineffective caregiver and you will not allow him into your home again.

Caregiving for someone with a serious condition like your husband is serious work. There is no room for indulgence to a caregiver that is special "needs". The agency should never have even hired someone like this. I would not be surprised to hear that the state is paying most of his wages. Businesses will hire a person with disabilities because they don't even have to pay them minimum. The state pays most of their wages then thanks the company for hiring them. That is fine, but mentally disabled people should not be providing care for people with serious conditions.

If I were you and I say this as the owner of a homecare agency, you would be wise to start using a different homecare agency.
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LostinPlace Dec 21, 2023
Well, thanks for your reply which caused all the pieces to fall into place for me. Your scenario totally makes sense - - That the agency knowingly provided me with a subpar, unskilled caregiver because the state would pay most of the caregiver's wages. The agency put their own profits above any consideration for the level of care my husband required.
I agree with your advice to switch to a different agency for the next caregiver.
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Update: I called the agency yesterday to stop the current caregiver visits and to discuss this caregiver's shortcomings. I explained in detail why he wasn't providing the level of care that my husband requires as well as why I consider him a real safety risk to my husband.

The agency manager I spoke with sounded genuinely surprised, shocked, and even appalled as I continued to describe our caregiver experiences. She kept apologizing for how the caregiver continually mishandled things despite the training he was given. She apologized for her agency's misjudgement regarding selecting this caregiver for our needs. She sounded increasingly embarrassed as I gave her more and more examples about the caregiver's performance. I hope I'm not imagining that she sounded a little ashamed about the agency she's working for.

I stated that I want a state certified aide from a reputable 40+ hour training program. (Factoid: In our state (FL) aide certification requires only 12 hours of training but the more reputable 40+ hour certification aide programs are also available. Guess which certification program most Florida caregiver agencies use!)

The agency manager promised to send us a replacement caregiver who has much much more relevant experience and skills. I'm a bit skeptical at this point, but I'm willing to see if the agency actually comes through this time. I plan on switching to another agency very quickly if I'm not satisfied with the replacement caregiver.

So thank you, everyone - for all your helpful advice and support regarding how to handle the sub-par caregiver. situation. I have to say I'm very impressed and pleased with this forum and the caregiver wisdom of the people who participate in it. Thanks again!
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AlvaDeer Dec 27, 2023
Thank you so much for your response and your update. So few come back to do this for us. You are your own EXPERT now and can help others here, and I hope if you have time you will do this. As you will see we are none of us alone in our problems on AC.
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Don't say anything to the caregiver. Instead you give the agency an earful about how dare they send out someone who can't do the most basic things like remember left from right. You let the agency do the firing and replacing with an actual experienced aid. Immediately. The agency needs to know in no uncertain terms that caregiving is not an appropriate job for this person.
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olddude Dec 21, 2023
Apparently the interview process at the agency is simply checking for a heartbeat.
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The agency will handle this situation for you. They will assign another caregiver for you if you request one and inform the former caregiver that they are no longer needed in your home.
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BurntCaregiver Dec 21, 2023
@Need

They should use a different agency altogether.
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Dyslexic has to do with being able to read. This man may be a high level Autistic. Burnt has worked as an aide so knows what she is talking about. Line up a different agency. Make it clear what DHs needs are and you want a State certified aide. This means the person has completed a course and the Nursing Board, in my State anyway, has certified they passed it.

I would not tell this person ur not happy with him. Just call the agency and tell them he is not capable to care for your husband. That you do wonder if he has some challenges that they may not be aware of. He also came to you, it seems, untrained and seems unsuited for this type of work. You feel be is not cerified.

If a certified aide is like the nurses I worked for, he should be able to show you certification when requested. The nurses had to have their licence posted at their desk.
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BurntCaregiver Dec 29, 2023
@JoAnn

In my state a CNA has to complete several months of training both classroom and practical.
I don't know what rules other states have. Here a person can become an APCNA which is cheaper than going to nursing school. That's a whole other story.
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It’s not your job to let him go. Call agency and tell them you need a more experienced caregiver with transferring skills, etc. Basically, a caregiver who worked with similar type patients previously. He won’t show up as soon as you tell agency. You can choose to use a different agency as well. So no worries..it’s not your job to let him go. In addition, his personal life or anything other than pertaining to the job of taking care of your husband shouldn’t even be discussed! Good luck in finding an experienced caregiver. They’re out there…just keep trying. Hugs 🤗
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PeggySue2020 Dec 26, 2023
There’s a bunch of posts missing from this thread including the op telling us that they got rid of him via the agency,
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I think you need to level with this caregiver that he's not able to meet your husband's needs and give him specific examples, as you've given us, with putting pants on backwards and shoes on the wrong feet etc. It's nothing personal, he simply does not have the experience required to care for a man who's paralyzed on one side of his body. You need a CG with THAT SPECIFIC EXPERIENCE. You like him very much, thank him for his service thus far and wish him the best of luck moving forward.

Then I'd get on the horn and give this agency a piece of my mind! They hired a disabled person who's unable to do even BASIC caregiving functions for petesake, when they KNEW the situation they were putting him into and hubbies needs! Plus the CG is demanding his favorite foods be available, puts clothing on backwards, shoes on the wrong feet and has NO SHORT TERM MEMORY. This level of caregiver is unacceptable to send to any client period. Either they send you a truly EXPERIENCED caregiver with a proven track record and references you can check, or you'll have to leave them a negative Google review and find a more reputable agency to deal with. Don't mince words. Don't try to be sweet and nice. This is business and you've been ripped off, plain and simple.

Wishing you the best of luck with all of this.
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Here is a situation where being nice is not kind.

You seem a very nice and kind person. I think if you can view the 'special needs' caregiver as an employee of the agency and not a lost puppy to be rescued, you will be on your way to having the agency reassign him in a timely manner, like by the 28th.

Often, Special Needs persons do have a very sweet nature. It is not a kindness to treat him any different than any other employee. imo.
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LostinPlace Dec 27, 2023
Very astute comment - much appreciated. I liked your metaphor about the puppy - very appropriate. You're right, this is not a puppy rescue! :-)
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Be honest and nice at the same time. No point hiding the truth. Also, you want to protect other elderly people from him. You would also have benefitted if he hadn’t come into your life in the first place. The caregiver almost sounds like he has dementia or is retarded. It sounds dangerous having him as a caregiver. He could make serious medical mistakes.
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BurntCaregiver Dec 21, 2023
It is dangerous. I don't know why a caregiving agency hired someone like this unless they are getting an incentive fromt he state to hire special needs employees.
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