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Personal Care Assistant (PCA)

Personal Care Assistant (PCA), Choosing the right one

Many people with disabilities rely, at some point in our lives, on the services of a Home Health Aide (HHA) or Personal Care Assistant (PCA). And it’s no secret that this is a challenging relationship, both to establish and maintain. Listed below are five tips to help make the process a little easier and successful.

Dependable Personal Care Assitant (PCA)

1.  Finding a dependable PCA is not an easy task. When we do find one, we are so grateful that it’s very easy to make the mortal mistake of treating him/her like a guest in our home. If you have suffered through a series of nightmarish PCAs who may have left you to skip meals or soil yourself, it is totally understandable that you would want to do anything to make a good PCA want to keep you as a client. Instead of handing them your remote control or adding them to your will, focus on setting boundaries. This will have much more productive, long-term results.

Everyone’s boundaries are different. Have you thought about what your boundaries are? If not, try asking yourself the following questions to help you get started:

• Are there any rooms in your home that you do not want your PCA in?
• Do you find any specific behaviors or language offensive, which your PCA should refrain from while in your home?
• Do you have a dress code for your PCAs?
• Do you care if your PCA talks on the phone or texts during his/her shift?

2. Express what you expect from your Personal Care Assistant. If your PCA doesn’t know what you expect from him/her, then he/she is doomed to disappoint you. Nobody benefits from setting your PCA up for failure. Make a detailed list of chores and tasks that need to be done on a regular basis. If you are unable to do this yourself, tell your PCA to grab a pen and paper so he/she can write it out for you.

3. Privacy. Making the time and space for a little private time every day could help your relationship with your PCA as well as with yourself. Sometimes we all just need to hear our own thoughts and meditate. There are many variables that can make it challenging for a person with a disability to have privacy. Perhaps the person with disabilities requires a PCA to be with them for most of the day and/or night. Maybe the client lives in a very small apartment with a roommate — throw a PCA in the mix and things can get crowded. If you simply must always be in the same room with a caregiver, pop in some ear buds, close your eyes and hang a “Do Not Disturb” sign.

4. Provide dietary information. Again, you hired a PCA, not Miss Cleo from the psychic hotline. If you don’t communicate what you like to eat and how you like it to be prepared, you could be in for a scary surprise. Gather a few detailed recipes or cookbooks for your PCA to use in preparing your meals, and designate a spot in your kitchen to keep these helpful items.

5. Give feedback and use your manners. It is important to remember that your PCA is not your mother or other relative who is taking care of you out of familial obligation. It does take a caring person to do this type of job well, but ultimately, it is just their job. Depending on the level of care your PCA provides, it may be a rather dirty job at times. Show some gratitude; say “please” and “thank you” throughout the day. Give sincere compliments that show you appreciate his/her care.

This also may prove helpful when you need to give negative feedback. For example, if you occasionally say things like, “Lunch was exceptionally good today. I really liked the way it was prepared,” your PCA may be more receptive to statements like “Thanks for making what I wanted for lunch, but next time, please set the oven timer so it doesn’t over cook.”

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Home Care

Tips for Choosing Home Care

The first step to finding the right kind of home care agency is determining what level of care is needed. There are two main categories of in-home care services: skilled care, which provides for medical needs, and custodial care. Custodial care may include environmental assistance-help with housekeeping, shopping, meal preparation and the like-or personal care, such as bathing, dressing, and feeding. Some agencies only provide one type of care; others may include both types. Different types of home care companies may work together to provide an integrated system of services for a care recipient
Types of Home Care Organizations

Home health agencies
Hospices
Homemaker and home care aide (HCA) agencies
Staffing and private-duty agencies

Top Questions to Ask Home Care Agencies

Once you have determined the type of home care services your loved one needs and have a list of appropriate agencies, it’s a good idea to interview and evaluate the agencies to compare them. Use the following checklist to help you choose the right home care agency for your loved one.

Does the home care provider supply literature explaining its services, eligibility requirements, fees, and funding sources? Many agencies furnish care recipients with a detailed “Patient Bill of Rights” that outlines the rights and responsibilities of the providers, care recipients, and caregivers alike. An annual report and other educational materials also can provide helpful information about the provider.

How long has this agency been providing home care services?
Is the agency Medicare certified?
Is the agency licensed by the state?
Can the agency explain what Medicare or insurance will cover and what the client must pay? The agency should have an established track record and be able to provide references.

What range of home care services does the agency provide?
Do they offer the specific services you need (e.g. physical therapy, occupational therapy, etc.)?
Can they meet any special needs you may have (e.g. language or cultural preferences)?

How does this provider select and train its employees?
Does it perform background checks on staff?
Does it have written personnel policies, benefits packages, and malpractice insurance? You’re more likely to get a committed and dedicated aide when the company selects its staff carefully and supports them with the proper policies, protections, and incentives. The extent of the background check varies state to state.
Are nurses or therapists required to evaluate your loved one’s home care needs? If so, would they consult with his or her physicians and family members? The various care-givers serving your loved one need to communicate effectively with each other; for example, if a doctor prescribes physical therapy, all the home-care aides should be working together to further this goal. Medicare-certified agencies are required to have this sort of coordination.

Does this provider include the client and his or her family members in developing the plan of care?
Are they involved in making care plan changes?
Is the client’s course of treatment documented, detailing the specific tasks to be carried out by each professional caregiver?
Does the provider assign supervisors to oversee the quality of care that clients are receiving in their homes? If so, how often do these individuals make visits?
Who can the care recipient and his or her family members call with questions or complaints?
How does the agency follow up on and resolve problems? This helps ensure that the caregivers are performing the services correctly, and responding to the care recipient’s changing needs.
What are the financial procedures of the agency?
Do they furnish written statements explaining all of the costs and payment plan options associated with the home care services it provides?
What procedures does the provider have in place to handle emergencies?
Are its caregivers available 24 hours a day, seven days a week? Not all home care agencies are available 24 hours a day, or guarantee replacement coverage if the assigned aide is unable to come.

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