Are you faced with trying out an aide for the first time? This can be a source of anxiety for many families bringing in a new professional caregiver. In fact, some families will refuse a new caregiver, and go without help, in an effort to avoid the perceived stress of this situation. Unfortunately, this avoidance hurts both the patient and the family caregiver, especially over the long haul of extended illness. I’d like to share some advice on how others in your situation have successfully coped with “breaking in a new caregiver.”

Tip # 1: Keep up the continuity of your schedule of care & respite. Going without a caregiver means reverting back to having no help and no backup. Skipping help tremendously increases the stress on the family caregiver. It dumps all the responsibility back onto the spouse and family. Going without help usually means cancelling all the plans you have for the day. This is either medically unsound, such as cancelling a doctor’s appointment, or emotionally upsetting. All of these factors need priority over your “fear factor” of having a new caregiver come over to fill in.

Tip # 2: Avoid the stress of “having to tell a new person what to do.” Write down your care routine, or save it on your computer, and have a copy ready to give to the new caregiver. This is what the professionals at home health care agencies and nurse registries do all the time! If you want breakfast at a certain time, put it on your list. If you want your sheets changed every Friday, put it on your list. Create your “to do list” and update it over time. Then you are always prepared to “break in a new caregiver.” You can expand your list to include your medications, your list of doctor’s, regular appointments, such as the salon, diet restrictions, and anything else specific to you. Your new caregiver can keep your list handy, rather than ask you a bunch of questions. Remember, over time, your caregiver will learn your routines. Just be patient until then.

Tip # 3: Rome was not built in a day, but you can build a good foundation with your new caregiver. First impressions can be tricky. Most of us are picky about certain things, especially within our homes. One client that I know is picky about her floors. When her new caregiver arrived, she asked her to remove her shoes to prevent tracking in dirt. The caregiver followed this rule, but she also felt insulted. As the day went on, the relationship deteriorated to the point that the new caregiver wanted to quit. If you sense that something is negative in the new relationship, please pluck up the courage to tactfully discuss it. If your caregiver belongs to a home health agency or a nurse registry, then you have the additional advantage of discretely calling them. Sometimes a third party intervention can help clear the air. Better to risk an uncomfortable conversation than to have to start over, again, with another new caregiver.

Tip # 4: Whenever possible, have your spouse or family caregiver present at the beginning of the shift of a first-time caregiver. This gives you extra “trainees” to help break in the new caregiver. It also helps family members get to know the new caregiver, which increases their comfort level. It is also a good idea to share emergency contact information with the new caregiver. Add this to your list, the names and telephone numbers of those loved ones that you would want to be contacted in an emergency.

P.S. The dirty shoe story is true and it has a happy ending. I was tipped off by the client’s son that his mom and the new aide were not getting along. I visited the client and the aide the same day, in an effort to help reconcile their differences. The aide told me her side of the story, privately, and the client told me her opinion, privately. I successfully reassured the aide that the “no shoes in the house” rule was not unusual and she should not take it personally. I made it clear to both parties that this was a two way street, and both sides had options. Fortunately, both decided to give each other another chance. It worked out.

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