Caregiver’s Toolbox Ep. 23 “Managing Expectations – Low Hour Cases”
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Caregiver’s Toolbox Ep. 23 “Managing Expectations – Low Hour Cases”
Ryan McEniff:
Welcome to the Caregivers Toolbox, tools for everyday caregiving. On this podcast, we give education and information on topics related to senior healthcare. This podcast is brought to you by Minute Women Home Care, a home health agency in Lexington, Massachusetts, my name’s Ryan McNiff, and let’s get into it.
Hello everybody. And welcome to another episode of the Caregiver’s Toolbox, tools for everyday caregiving, where we provide education and information relating to senior healthcare topics. I’m here with Janet. My name is Ryan and today’s topic is about managing expectations when handling or looking at a private home care company.
One of the things that Janet and I do all day is managing expectations of not only the clients, but of the caregivers as well, but we’re going to focus on clients because most of you are listening to this podcast because you have somebody that’s involved with some type of needing care, whether that’s private, nursing home, assisted living, or maybe you’re doing it yourself. So we can get into it. But what we’re going to tackle is really four subjects, it’s going to be dealing with cases where there are low hours. It’s going to be dealing with cases that have high hours. We’re going to be talking about managing expectations for live ins, and then also kind of a gray area that can be difficult, or we find difficult is about cleaning. And what is expected with cleaning. So, Janet, how are you today, first?
Janet:
I’m good. It is… The sun is shining, the tides going out. Weather’s good.
Ryan McEniff:
Well, it is finally warm around here, which is nice. In Massachusetts, we’ve had quite a bit of rain and kind of cold. It hasn’t felt like so summer until yesterday,.but with getting into this and moving right along, we’re going to talk about low hours first. So what do you look at is kind of the managing expectations of people that have low hours of cases or low hours of weekly services?
Janet:
Well, when people are looking around and they’re looking for low hours, a lot of times they’re understandably trying to contain costs and they’re trying to see how few hours they can work with. When what I like to encourage people is to, put that aside for a few minutes and tell me what it is that you think you need. And oftentimes once you get into that conversation and they say, well, they only want two hours and maybe it’s both parents and there’s going to be some personal care. Then when you talk about the situation you find out that it is going to take your parents longer, to get from A to B, to take a bath. And the time may be more unless you want them to feel very rushed. So what I like to encourage people is to have a sense of what it is that they feel they need. And then we explain and justify what we think the hours are around that.
Ryan McEniff:
Absolutely. And by all means, people can say, “Hey, my budget is three hours a day, three days a week.” But that doesn’t… You’re not going to be able to get everything done in those three hours. So you might be doing personal care for the majority of the time. And then if you’re lucky, you can make a meal, but you’re not going to be able to take them down to the library or whatever it might be.
Janet:
Yeah. I mean, we had just not long ago a request for a couple and they wanted no more than three hours in the morning and no more than three hours at night. And yet they went to bed early. And when we had had the conversation, it made more sense that actually a six hour shift made more sense, so that neither parent would be rushed when they took their bath and food was prepared and it ended up being a more relaxing situation for them.
Ryan McEniff:
Yeah.
Janet:
So it’s good to talk it through. What is the need and absolutely respect the cost. But if you’re trying to go hours first, it’s tough.
Ryan McEniff:
And so with the low hours obviously in a business, we’re looking for people that are maximizing the amount of hours, right? 24 hours a day or 12 or 12 hours a day. I mean, that should come to no surprise, right? We’re a company that needs to stay solvent. But by saying there’s low hours, we are not trying to dismiss the cost that is involved with having somebody in your home…
Janet:
Absolutely.
Ryan McEniff:
… For nine hours a week or three hours, three times a week or four hours for 12 hours. There’s still a large amount of cost involved for that. And it is expensive. It just gets astronomically expensive once you start doing 24 hours a day. And one of the problems that comes with this is that people expect the same amount of… The expectation is the same for a high hour case with the low hour numbers. And what I mean by that is that the way that we operate in this industry, not just our company is that all of our caregivers are per diem caregivers. They work for us when we have a job they don’t work with for us when we don’t have a job. And it’s the same with every other competitor in the area. And my guess is across the country.
So when we get a call from somebody that says, “Hey, Ryan, I want 12 hours a week of care. Monday, Wednesday, Friday for four hours at a time.” I immediately know that this case is going to have challenges that a case where somebody says, I want 40 or 60 hours a week, isn’t going to have. And those challenges are going to be having consistency of caregivers. That’s one of the biggest complaints that anybody’s going to get, where they get a caregiver that they like, and they want to keep that caregiver. And then that caregiver comes to us and says, “If you don’t give me a new job that gives me 40 hours a week, I’m going to go to another agency that offers me a job that’s 40 hours a week.” And then we’re put in a position where we have a client that really likes a caregiver, but we know behind the scenes, that caregiver isn’t going to be lasting very long.
And it’s not because the caregiver is unhappy with the job. It’s not because they don’t like the family. It’s because they need to put food on their table. And because of that, they need to maximize the amount of hours that they’re working. And so when somebody comes in and says, “Well, we want the same caregiver three days a week, or we want the same caregiver seven days a week for three hours a day.” We know that that’s a promise that more than likely we’re not going to be able to keep. And so we try to be honest about that. And that’s where this podcast came out about managing expectations, because I know that there are companies out there that promise the world and completely under deliver. And we try to keep the expectations relative and then over deliver on the promises. So we’ll say, “Hey, there’s that possibility that you could have a caregiver seven days a week. And even if we do find that caregiver seven days a week, I can’t guarantee you she’s going to be there in a month or two months.”
So when you go with low hours, though, we know that it is a lot of money to you, to these caregivers and to compare to other cases that are out there, those are not the most desirable cases for caregivers. I’d love to be able to fill every single case every single time with caregivers continuity. And I would do it if I could, but that’s one of the managing of the expectations of a low hour case that you’re going to have turnover with these caregivers, because they are going to jump regardless to another job, whether that’s with me or with a competitor that provides them 40 hours a week or 36 hours a week, or whatever that might be. Wouldn’t you agree, Janet?
Janet:
I do agree. And what happens when there’s short hours they could be the greatest caregiver, but they may be committing to another case that has longer hours. So it becomes a tug of war for those cases and short hours, people are tending to fill their schedules so that… And also we have some fabulous caregivers that for short hours, if it’s more of a travel for them, then that puts traffic and all of that into it. So they say, “Well, it’s really not worth it to me to sit in traffic for such a short amount of time at that assignment.” And they would rather go to another assignment.
Ryan McEniff:
Absolutely. And I think what people need to do is put themselves in that position, right? Would you travel an hour to work for three hours and then travel home another hour? Or 40 minutes to work three hours to travel home. So an hour and a half round trip. And once you start thinking about that, you start realizing that you’re limiting the amount of caregivers that we can call on to really people that are in your immediate area. And so that limits the amount of caregivers that are going to be willing to take your case, which makes it more difficult.
So that might end up being where you call us up and we might not have caregivers in a specific town, but then you might call another company and they happen to have a few caregivers right in that specific town and they can provide that services a little bit better. So it’s not saying that it can’t happen. It’s just saying you’re going to have to find that, that diamond in the rough scenario with the right agency that you like that has the caregiver, that’s able to drive the 15 minutes to do short hours rather than driving 40 minutes.
Janet:
Yeah. And it’s like, even when you think about going to work, if you go to an office or something, you go to work, how much of your morning do you spend hanging up your coat, getting yourself together and to sit down and do your work and then you have to, at the end of the day, pack yourself up, make sure everything’s the way it should be to leave? If you have short hours, you still have to perform that, get yourself settled in and get yourself out the door. And the actual care time is just scrunched. So it’s a different mentality.
Ryan McEniff:
Absolutely. It is. So to summarize kind of what we’re talking about with these managing expectations, and we’re specifically talking about low hours in this one and the next podcast will do high hours and then live in and then cleaning. When you go and you get anything under 20 hours a week, I would say, would you say that’s a good rough number?
Janet:
Yeah. I would say that’s…
Ryan McEniff:
Maybe a little bit more 25 hours a week. You’re going to be having the difficulties of caregivers that are not going to be on the job as long as you might like them to be. You might have to be willing to change the days that you want. You’re going to have to be just as flexible, unfortunately, as the agency needs to be flexible because it’s not as desirable of a case, even though your parents might be the nicest people in the world and lovely to get along with that certainly helps.
Obviously, if it’s a nightmare situation where hoarder, or somebody’s just a nasty person, it’s going to make it that much more difficult to cover that case. But the fact of the matter is these caregivers are doing this for their livelihood to provide for their families. So as nice as you might be 12 hours a week, isn’t cutting it for them. And they need that 40. That’s not to say that it can’t happen. There have been times Janet, where we’ve kind of… What do we call stacked hours on. So they’re leaving a case and they come over after they’ve finished one case, and then it’s a 15 minute drive to come to the low hour case. But it doesn’t always… That’s hit in the bullseye in archery and it doesn’t always happen.
Janet:
Exactly. And also with short hours and the whole concept of having caregiver turnover, you have to keep in mind if the person that we’re caring for has any form of dementia, that can compound it, because it’s almost like they’re meeting new people. Or there are some people there isn’t dementia, but they just are not comfortable with change.
Ryan McEniff:
Absolutely.
Janet:
And you have to factor that in.
Ryan McEniff:
Excellent. So we’ll wrap up this podcast and we’ll have a few more on managing expectations. Thank you very much for listening our podcasts come out on a weekly basis. If you have any feedback, please let us know on Twitter and have a great day.
Thank you for listening to the Caregivers Toolbox podcast, which is brought to you by Minute Women Home Care Services, located in Lexington, Massachusetts. Call us at 1-844-BESTCARE if you have caregiving questions or needs. For comments regarding the podcast, find us on Twitter. Our handle is @MWhomecare. Thanks again. And we look forward to hearing from you.