Introduce and Integrate a Caregiver: Six Essential Tips / Alzheimer’s and Other Dementias

This is the Whole Care Network. Music Helping you tell your story one podcast at a time. Content presented in the following podcast is for information purposes only. Views and opinions expressed in this podcast are solely those of the host and guest and may not represent the views and opinions of the Whole Care Network. Always consult with your physician for any medical advice and always consult with your attorney for any legal advice. And thank you for listening to the Whole Care Network. Music Sometimes it's easy. Sometimes it's hard. In this episode, we're talking about introducing and integrating outside caregivers into your care support team. We're bringing six tips. Welcome. We're Sue Ryan and Nancy Treister. This podcast brings our years of experience in a variety of family caregiving roles to prepare you to navigate your caregiving journey. We're sharing our personal experiences, not medical advice. And because it's our passion to support you on your journey, we believe no topic is on limits. Let's get started. Music You might be adding a caregiver into your home. You might be hiring a caregiver for your loved one who lives alone. You might be adding a caregiver to your care support team in a care community. No matter where you're hiring a new caregiver into your support team, integrating and introducing a new caregiver can be tricky. Sometimes your care receiver doesn't think they need any help. No, really? Yes, it happens. It doesn't? It's not unusual. How about that? Don't give up. Don't give up easily. Be patient. Take the time to let the process play out. We're going to talk about that today. When we brought a new caregiver into our home, my husband told the new caregiver for at least the first couple of weeks. Every time she came, he said, you need to go home. After a while, he was okay with her being there for a while. You need to go home. He said, I'm not going home just yet. She recently started caregiving for someone new. She told me the exact same thing is happening at the beginning. Every now and then after a while, he says, you need to go home. She said, I just smile at him and say, nope, it's not time for me to go home yet. Anyway, realize this is a process. We're going to talk you through it. Outside caregivers, whether they come into our home, there where our loved one is when we're not there, or whether they come in to a care community, provide valuable, valuable, valuable support and insights for us. Yes, when they're in the communities, there are another set of eyes and ears to give us information and also to help the care team provide the best care for our loved one. Tip one is to create a welcoming environment for them. We want them to want to care for our loved one. And so when we're in our home, there are some things that are really, really helpful for us to do to create that welcoming environment. When they come, provide a brief tour of your home highlighting for them where to find the different rooms, where to find the things that will be helpful for them and also where you keep the products that they're going to be using to care for your loved one. Ensure they have access to the basics like drinking water, the refrigerator, the bathroom, a place to take breaks. What do they like to drink? What snacks do they prefer? Have things around that help them feel welcome. Make sure they know how to operate the necessary household objects, like one of the most important ones here. We've got the TV or if there's a camera they're going to be using to monitor, but then if they're going to be preparing food, things that, you know, in the kitchen and things like that. So anything that's going to help them to be able to operate the things in the home, create a special Wi-Fi access or give them access to your Wi-Fi so they can be connected all the time. And show them where their personal effects go. A purse, a jacket, a backpack, whatever those are, show them specifically where they can put those. And then this may seem like a small thing and it's really not. Create a little welcome basket for them, something that shows that you're intentionally welcoming them into your home. Then if they're coming into the care community and it's a little bit different, one of the things that's really important is for you to, with them, introduce them into the leadership team and the team of their peers who are in the care community. And this shows the leadership team and the peers, you support this person being there and that it matters and you have conversations with them so they know that you are encouraging open dialogue that you want them to work together, that you're supporting this caregiver that they're important. So, I think it's important to teach them about the community itself, help them understand the community, how it's organized, show them around, show them the places where they can take your loved one, show them where they can take a break and have them get familiar and answer any questions that you've got. So, when it's with our care receiver, we want to make sure we're scheduling it at the best time of day for them, whatever that time is, when it's going to be easiest for them to be receptive because they're in the best mood. And begin with something that is a shared pleasant activity, something that they enjoy doing that they're already comfortable with that the new caregiver can kind of join or be a part of, looking at photos, sharing a meal. If your loved one is living at home and they're resisting outside help, we want to start by telling them the truth they need to hear and you'll hear us talk about this in many episodes. There's the truth and the truth our loved one needs to hear. And what they need to hear is something that's going to be comforting and reassuring to them. And so, if they're somewhat resistant, the way we may choose to introduce our caregiver in the beginning, is they're actually there to be providing us help. And we're introducing them to be a support mechanism for us. So we're not focusing on our loved one, we're, it's focusing on this. And it's a little bit of a different shift, but it can make it a whole lot easier for them. So, we're going to ask, for example, the caregiver to do something that would be a normal part of what they would do. Some of the light household work, like maybe changing a bed or fixing lunch. When we're talking with our care receiver, introduce them, well, this is Sarah, and she's going to be doing some things around the home to help me. So the truth they need to hear is something that we're not bringing somebody in to help you because we can't handle things. And then simplify it. You have, invite them to come along on errands with you or go to a doctor's appointment, go to the grocery store, go get something to eat. So do things that are gently integrating them into the, to your lives. And it's more on the fact that they're a part of the team with you. I like that. So, and you know, don't be surprised if particularly the first visit that you don't need them to stay the whole time. So chances are you signed up for a four hour minimum, either with a private caregiver or with a care service. And sometimes that first visit is you're sort of run out of things to do or is a look, get starts, get a little bit awkward with your care receiver. So don't be shy about after a period of time, if one of those two things happens, sending the caregiver home early. But realize if you do that, you're going to, they're going to get paid by the agency for the whole four hours, or if they're private, you need to pay them for the whole four hours, four hours, because you booked those four hours. They didn't give the, those two hours to someone else. So you need to pay them for the whole time. But just don't be shy about the first visit, just cutting it short if that feels like the appropriate thing to do. And don't be surprised if it does. Now, if your loved one lives alone, try to get and you can't, and you can't be there. Try to get a friend or family member. First, obviously, if you can be there great, but if you can't try to get a friend or a family member to be there so that they're, there's a third person to sort of judge how things are going. You don't want to just be reliant on your care receiver to tell you how this out went with this person. It'd be nice to have, you know, another opinion. If that's not possible. Sometimes you live in New York and your mother lives in Florida and you're helping hire someone and you get a caregiver to come to their house, but you, you can't be there and there's not a family member who can be there. Some of the best ways to introduce the new family, the new caregiver is to think of them like a friend. What would you ask a friend to do for your mother? Take your mother out to lunch, help her run an errand or two, come up with some activity that would be typically what a friend would do to help her and just leverage the paid caregiver to do those activities. It's just a good way to gradually introduce the concept of there's someone who else is going to be involved in the care. Another thing that you can be doing with that when you're not going to be there, no one else is going to be able to be there with the caregiver the first time and you live out of town. If your caregiver is able to use like zoom if you're used to having either any kind of a face time or anything like that, go ahead and have one of those so that your care, your loved one gets the message that the caregiver is someone that who you're familiar with and you're already comfortable with and you can kind of mimic what that would look like and have a little bit of a conversation there. If that's part of the way that communication can still be going. So we've introduced the new caregiver. Now, tip three is we want to educate the new caregiver on our loved one. The first thing you're going to do is you're going to go through the care plan with the new caregiver. Now, soon I have an episode on what is a care plan and how to create a care plan. So listen to that episode to get a lot more detail about the care plan. But for your care plan, you don't want to overwhelm the new caregiver, but so you need to show them where the care plan is and how to get to it. But go through the parts of the care plan that they'll be responsible for today and then ease them into other parts of the care plan over time. Once you decide this person is the right person and all is good, you can expand on the care plan. So that's part of how we're going to help our new caregiver get to know our loved one. We want to share photos. We want to tell them about our care receivers background, what they did for a living, where they used to live, really just get them immersed in who they're going to be taking care of. If it's appropriate, you can sit down the three of you and let the care receiver tell their own story if they're open to it. That's a good way for the two of them to start to get to know each other or flip through photo books together. Totally up to you whether that's appropriate, but it's a good way to get them to get to know each other just a bit. Now, part of we've introduced the new caregiver, we've educated them some on our loved one. Now we're going to begin to build trust and that is tip four. We're going to build trust but build it gradually. Some ideas here are to try. Now, first, let me say a professional caregiver is going to know how to do things often better than you do. Absolutely. I've learned so many things. A new caregiver would come in and they'd say, well, why do you do it that way? I don't know. This is kind of how we do it. They'd say, well, here's how I've always done it. And I'll be like, oh, that's a really good idea. So you will learn so much from them, but at least initially ask them to try to stick to the way that your routine is because your routine is what your care receiver is familiar with. And you can slowly change it over time, but just ask them to honor the way you do things for now. And then slowly, but surely is everything as trust is built. You can start to integrate some of their ideas and I promise you probably better ways of doing things into the way you handle things. Also start with less intimate tasks. So for the first few visits, they don't need to be helping your loved one shower or change their clothes or changing their depend like product. At least let your loved one get to know them a little bit before they're taking off their clothes in front of them. Just something to keep in mind, not necessarily what needs to happen day one. So check those more intimate activities and schedule those in after we build some trust. Now, once you see that trust has started to build, this is your chance to slip out for a little while and leave the two of them alone together. So you'll know when the right time is usually it's only a few visits in and you'll say, I need to run to the grocery store or go pick up the dry cleaning or run to the doctor's appointment and you'll leave the two of them alone together. And that really is when you're off to the races and all is good and you should be able to leave them alone and get work done or whatever you need to get done while your caregivers there. Another thing that helps us with those transitions is tip five, which is being very clear about communications and expectations with the other caregiver. And what we want to make sure that we're encouraging, giving permission for, modeling with them, supporting them, everything is open communication is sharing things is we want them to feel comfortable. Like Nancy just mentioned that they caregiver had a better way of doing something. If they didn't feel comfortable telling you that they wouldn't tell you and they may know something that's really, really great. They will know something too. That's what the net is you need to open the door so that those things can come flooding in. We need to we need to open the door. So it's important in any new relationship you're learning that make sure you keep sharing with them and reinforcing because not everybody is that way that we want the open line of communication. We want them to share with us the things that would make it easier. We want them to feel comfortable if there's something they see that could be done differently, or if there's a way that we could be supporting them getting something to help them. They need some more time. Anything that we can be doing. So one of the things that we start with is asking them what's helpful for you to know. Another thing that's very, very helpful is to have conversations about meal arrangements. When we finally brought in a caregiver for my grandmother, she was on a very restrictive kind of diet. And we had offered to feed her. We had offered to help her to allow her to have meals because she was preparing the meals for my grandmother. She said, No, I'll bring my own meals in because I have specific requirements. What we want to make sure of is that if they're comfortable eating the same food we do and they want to eat along with our care receiver that they're welcome to do that. If that's something that you've got, if you've got a boundary and you don't want them to then make sure from the very beginning, they don't expect that you're going to feed them. Yes. So it don't start if you're not going to keep it up. I think is what you're saying Sue. And that's the truth. It's two sides of it. It's don't start it if you're not going to keep it up. Don't start it to be nice at the beginning if you're not going to do it. And then the other thing is they're not really expecting that you're going to feed them, you know, three square meals if they're going to be there. So get really, really clear up front with what that is and honor it. And there may be some times when there's an exception, but really make sure that there's no confusion about it. So Sue, that that leads me to tip six because tip six is about treating them with respect. Yes. And you would not believe the horror stories I have heard from caregivers about what people have said and done around them as if they were invisible. It's so sad. It's really terrible. So first, you also mentioned in the setting communication and expectations. I think that's treating them with respect. Open lines of communication so that they can tell you if there's a better way to do something. They don't feel shy about doing it. So that's one awesome. But the second one is also to ask them about themselves, get to know them. Now, here's a tight line you walk. Don't pry, but show an interest in them and their background and their living situation and what's going on in their life. If they want to share it with you, they will. If they don't want to share it with you, recognize that boundary and back off, you know, without stepping over it. So just show an interest and if they want to, if that, if that appeals to them grade, if it doesn't back away. Acknowledge when something really good happens, if your loved one's struggling with finishing a meal and they managed to get them to eat the entire meal. Say, wow, that was awesome that you, that you got them to do that or that we got through that, that whole sandwich. So just acknowledge them and recognize accomplishments. We want them to want to come to your house because they have just as big a right to say, I'm not coming back as you do to say, I don't want them to come back. Exactly. One of the things though that this is not the absence of is that there are going to be times where you need to have constructive conversations when something hasn't worked the way that you would have preferred it. You, when you're setting up communications and you're talking with them and you're, you're getting that trusted relationship. It makes it easier when you're having a conversation about something that you would have preferred had gone a different way, or for them to know that they could reach out to you the same way. So we want to catch them in the act of doing something well. And if there's the other side of it, we want to all feel that we can have those conversations as well. That's a really good point. Yeah. If you want to be able to say when things didn't go well, you want to also make sure that you're saying the things do go well. That's really good point. Yeah. And then watch the, my last one is huge. This is my soapbox. Watch what you say and do around them. And let me give a couple of examples here. If you smoke, don't ask them if it's okay if you smoke around them. I promise you, you're the employer. They're going to say it's okay. Most people are going to say it is okay and they don't really mean it. So do not smoke around people. Your caregivers go out in the garage or somewhere else to have a cigarette. You were, I promise you, I can tell me a caregiver's come to my house and complain about the person who smoked in front of them. And I said, well, did you tell them not to smoke? Well, no, they asked me and I said it was okay. I'm like, why? But anyway, don't, don't do it. Well, because they didn't feel comfortable that they could have told them that. So we want to make sure that they can feel that. But don't do it anyway. Yeah. But don't do it. Just don't do it. Yeah. And then, and then the second one, and this is really my, my big soapbox is don't think that don't act like they're invisible. So if friends come over to sit in your house and have a conversation and visit and the caregivers there with your care receiver. Don't talk about religion and politics and things that are very divisive, because you don't know what side they're on and they don't want to hear it. And it is, you put them in a very uncomfortable situation when you go down that path, you may be on the same page with your friends, but you don't know about the care, the caregiver. I had a caregiver tell me that one time she was at someone's house and the conversation got so offensive to her that she literally looked at the person who hired her and said, I'll be in my car. Let come get me if you need me. She couldn't even sit in the house anymore. So please just be aware that they're there and treat them like you would anyone do not go down that path. Yeah. One of the things that we've learned is those first few visits may not go as smoothly as you would like. It doesn't mean it's not going to ultimately work out. We want to give it some time. And one of the things where our caregiver knows more than we do that we want there to be instant chemistry that everything goes smoothly and they just zips right into it, and it may not be that way. And in the story that Nancy shared, the caregiver knew that the care receiver was going to be a little resistant. She knew how to handle that. So if you have those conversations, if there's some challenging times in that first few visits, talk with the caregiver and say, do you feel this is something they're going to get through, or do you feel that we need to look at someone else? Don't give up after the first visit and don't assume that if your loved one doesn't like them the first time, that you just need to get somebody else because it's most likely that they're not going to like the second or the third or the fourth or however many you get. True. And frankly, even for yourself. So my mother told me more than once that a certain caregiver, a new one would come and say how'd it go? Oh, I don't think it's going to work out. Well, she said that about all of them on the first couple of visits. And one of the ones that she said for several visits turned out to be her favorite caregiver for my dad. And even my husband's main caregiver who was with us for almost four years. When she first came the first few times, I thought, this isn't really what I need. She's not the right fit. She needed to get to know us. I needed to get to know her better. And she turned out to be of all the caregivers I've had and we've had many between the households that we had care receivers in. She turned out to be by far the best. And yet if you'd asked me in the first few visits, I'd have said, I don't think it's going to work out. So please practice the blessing of patience. Yes. And work through it. And you'll ultimately figure it out down the road after sometimes it's like my husband works out right away. Sometimes it's like my grandmother and you pray for patients. Right. And sometimes it won't be the right caregiver. I don't want to pretend it's, it's all about patience. Sometimes it's just not right. And that's okay too. That's okay too. But through, but by going through these tips, we get clarity on that. I agree. It's easier to get clarity, but do know that you're need, niggling that it's not right. May need a little more time before you really make that decision. So let's summarize. In this episode, we talked about how to introduce and integrate a caregiver into your care support team. We shared six tips. Create a what one, create a welcoming environment to introduce the new caregiver. Three, educate the new caregiver on your loved one. For Bill trust, gradually. Five, be clear about communications and expectations. And six, treat them with respect. We want the caregiver to want to come back to our house. We definitely do. Now, if you have tips that you think would help people integrate a new caregiver into their care support team, please leave those on our Facebook page or our Instagram page. The links are in the show notes. Anything we talked about here where we feel like you need more information on, there'll be a link in the show notes for that as well. If you like this podcast, please follow it or subscribe to it. Please share it with other people as well. We really, really appreciate it. We're all on this journey together. Yes, we are.