Bringing a stranger into your home to help you care for your disabled child can be an extremely difficult decision. Trust is essential. The key to establishing trust is to ensure a clear line of communication between parent and caregiver. These guidelines spell out what you and your child’s caregiver should expect from each other.
Choosing a Healthcare Worker
Home healthcare workers can be hired through agencies or may be individuals who act as private contractors. Either way, always check the provider or licensee’s status with your state Board of Nursing for any complaints or disciplinary action that may be on their record. Most states provide online resources to check the status of each licensee.
An agency will send someone to your home to assess your child’s needs and the level of care needed, and then assign a case manager based on their findings. An individual contractor should also visit and determine if they can provide the level of care you need. Always ask for references and follow up on them. Whoever you hire will be responsible for communicating with you and your child’s primary care doctor and coordinating all healthcare services.
No matter what the caregiver’s credentials, be prepared to spend some initial time training and teaching. After all, no one knows your child like you do.
Before Your Caregiver Arrives
Whenever possible, your healthcare worker should be provided with written notes including:
- Instructions regarding the care you expect, such as how often vital signs are taken, needed position changes, baths, diaper changes, linen changes and hygiene issues.
- A description of your child’s cognitive level and ability to communicate so the caregiver doesn’t have unrealistic expectations in their interactions with your child.
- Information about your child’s likes, dislikes, fears and other issues.
- All current physician orders pertaining to your child.
- Your contact information, along with a back-up phone number if you can’t be reached.
What Your HealthCare Worker Should Expect From You
- An introduction to your child. Many young children express fear or anxiety with strangers. It’s your job to “break the ice,” so to speak, between your child and the healthcare provider.
- Prompt notification about any special circumstances, such as seizure activity or a feeding tube that may have been dislodged.
- A clean, uncluttered, safe and well-lit work area.
- All disposable and non-disposable medical supplies are provided and maintained in a clean and organized fashion.
- All prescription medications are available in a safe, clean area with specific instructions for administration.
- Any adaptive equipment or special supplies, such as hearing aids, feeding tubes or suction equipment, are available, clean and in working order.
- Instruction in the use of adaptive equipment that may be needed during a shift.
- If you go out, information about how long you’ll be gone and how they can contact you.
- Respect during times of family disagreement. Take family disagreements to a private place within the home. Home healthcare providers don’t need to know your personal business.
What You Should Expect from HealthCare Providers in Your Home
- Compassionate, caring, patient behavior and attitude in providing your child’s care.
- A strict protocol in regards to disease prevention. This means any home healthcare worker entering your home should immediately wash their hands before interacting with your child.
- Punctuality. When a healthcare provider schedules a specific time or shift with your child, you have the right to expect them to be on time, every time. If for some unforeseen reason the provider cannot be on time, they should call you and inform you of their delay and estimated time of arrival.
- Advance notice of any need to cancel a shift that allows enough time for you to make other arrangements.
- Confidentiality about and sensitivity to your family’s needs for privacy.
- They speak directly and often to your child, regardless of your child’s cognitive level or ability to communicate.
- Communication skills. Home healthcare providers should write clean, legible and comprehensive notes detailing the care they provide. Notes that are not legible put your child at risk if follow-up caregivers can’t read what medications were given or what care was provided.
- Attentiveness to pressure sores, feeding tubes and oxygen issues.
- Undivided attention. Your healthcare worker should focus their attention on your child at all times and not be distracted by personal phone calls or other non-work related issues.
- A good end of day. Upon completion of their shift, the home healthcare provider should leave your child in a state of good care with all hygiene needs having been attended to, all durable equipment accounted for and disposable medical equipment cleaned up. They should never end their shift with your child or the area in a state of disarray. You shouldn’t have to clean up after your home healthcare provider or perform a task that was their responsibility during their time there.
A Note About Boundaries
Although they have the license, you know your child better than anyone. Never let a home healthcare provider come into your home and dictate to you how they will do their job. You want to build a rapport and relationship with your provider but always keep in mind, you are the employer and they are the employee. They aren’t there to be your friend, they’re there to manage your child’s care in a manner that you’re comfortable with and that provides for the needs of your child.
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