One of the essential challenges of caregiving agencies is assigning the right caregivers to each case. The temptation to fill a case quickly often supersedes the careful thought and due consideration each assignment merits. This challenge should be addressed from seven perspectives.
- Personal care and homemaker services. Does the client need help with personal care (bathing, dressing, etc), homemaker services (meal preparation, shopping, taking medicines, etc.), or both? Clearly the caregiver must have competence in the area or areas of need. While this is the first consideration of assignment, there is a corollary. A superior agency will assign its best caregiver(s) available for every case. The best caregivers should always take precedence in client assignments.
- Client needs relative to family needs. Caregiving agencies serve both clients (end users) and their families. Caregivers must be able to work with both and resolve issues that frequently arise. A good agency recognizes and respects the differing sensitivities and expectations its clients may have relative to their families. The best caregivers must be comfortable and adept at navigating the murky waters of challenging family dynamics.
- Essential skills. There are essential skills beyond those requisite to personal care and homemaker services. How well does the caregiver communicate? Are her interpersonal skills suited to the client (and family) needing service? If cooking or transportation is of particular importance, how do the caregiver’s skills measure up? Every case is unique, and elements of service in a plan of care have different values. The validity of assignment choices will quickly become manifest in the field, with adjustments made depending on client/family assessment of performance.
- Passive vs. active approach to care. Some clients need a caregiver who will direct them (active approach), while others need one who knows how to stay in the background but still accomplish her job (passive approach). In some cases both approaches are required, depending on circumstance and time. The best caregiving agencies consider the approach of care best suited to each client.
- Personality and judgment. Clients need caregivers with personalities that mesh with their own. For instance, a client who enjoys calm and limited conversation would quickly resent a caregiver who loves to talk. Judgment in interpersonal relationships, job execution, and decision-making is critical to exemplary caregiving. There is no scientific formula to this element of caregiver assignment. Knowing one’s caregivers is of paramount importance. Agency staff must consider caregiver performance from other cases and use intuition influenced by in-home client assessments.
- Role of provider, caregiver, and family. Caregivers are accountable to three parties: clients, client families, and their agency. The best caregiving agencies give their caregivers much latitude to serve their clients optimally. A caregiver’s first job is to serve their clients and their families and to use their training and skills to best represent their agency. Everything a caregiver does or fails to do can impact the caregiver agency, its other caregivers, and the agency’s standing in the community. Caregivers ultimately determine the business viability of their agencies.
- Site considerations. Where a caregiver delivers service influences what she can and cannot do. In a private home setting she is free to exercise the full array of her talents and skills in serving clients. In senior communities, hospitals, and long-term care facilities, caregivers are restricted in what services they can deliver. In some cases caregivers may only provide companionship and alert site staff to address all personal care issues. Good agencies always consider the site of care in making caregiver assignments. Caregivers are often better in some settings than others.