How can you find the very best home health aides? There is a traditional debate, among consumers and professionals, as to whether it is better to hire help through an agency or through “friends.” If you are currently seeking home health care services, you must wrestle with this issue, and decide for yourself. I want to give you some insight on both sides of this argument. I obviously vote for using a licensed home health agency or nurse registry. I’d like to explain my reasons, based on my professional experience of 25 years.

First of all, let’s define the ideal qualifications for a prospective home health aide:

#1 Is a caring, loving, “nice” personality

– no one wants “rude,” or “impatient”

#2 Is experience in helping with your needs

-Alzheimer’s experience, Hip Surgery experience

#3 Is secondary personality traits suited to your needs

-“quiet type,” or “take-charge personality”

#4 Is reliability, dependability, and dedication on the job

-always on time, always shows up, willing to work

#5 Is credibility

-proof of credentials and references, proof of I.D.

#6 Is trustworthiness

-clean criminal background check, truthful, honest communication

#7 Is respect for your preferences

-puts your needs ahead of their own

#8 Is cooperation

-does what he/she is asked to do, does not undermine others

#9 Maintains professionalism on the job

-does not take things personally, does not gossip or display anger

#10 Speaks English clearly and communicates effectively.

Which aides seek job opportunities with licensed home health agencies and nurse registries? The ones who can meet all of the above qualifications, and live up to the expectations. Moreover, they are willing to work in cooperation with several parties. They are responsible to the client and the client’s family. They must keep in touch with the agency or registry. In addition, the aide must be legally eligible to work in the U.S.

Which aides only want to work “privately?” They want “cash only, under the table.” The typical reasons are: hiding income from the I.R.S., illegally working in the U.S., a criminal record, hiding income from the public assistance agencies, hiding income from the unemployment agencies, hiding income from the child support programs, and/or working under an alias. These aides also shun any outside involvement. They become so good at taking over the client’s problems, that they just “take over.” Once the client relies on them completely, then they are in more control than the client or the client’s family. I call this “the tail wagging the dog.”

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