CabanaDay

I would add to bring the food/snacks and water/drinks in a cooler and use the disposable "blue ice" packs. In addition bring your own napkins/utensils. It makes a good impression that you are self-sufficient, there to work, and not some unwelcome house guest. Almost every family will eventually tell you to make yourself at home. But let them offer after a few weeks of seeing you didn't automatically expect it.

One way to gauge a typical pay rate in your area is to call a private duty agency and ask what they would charge for the services you are expected to perform. One-half that number should be your starting pay rate. Another method would be to call a private duty agency and tell them you are planning to begin work in the area, have experience doing the services you are expected to perform, and ask what is the typical rate of pay you might expect.

You said you were in Miami, FL. Here is a link to search by Facility (including Home Health Agency) state inspection reports. Click on "Search by Facility Type/Location" to get started. You can try choosing "Home Health Agency" and enter a zip code, or a county. I never even apply to an agency for work until I look here. The records have recently been culled in some way to only include the last few years results. But it's a starting point in seeing both the type of deficiencies the State writes up often, and the agencies that get written up for a lot of deficiencies and/or complaints repeatedly. For example, after you chose an individual Home Health Agency from the search results, click on AHCA Reports: "Inspection Reports"

A bladder holding 10 liters, 2.6 gallons, of urine? Wow, just wow!

I work for both companies. I have not worked 12 hour shifts for Maxim. But for both companies I am never allowed to make the schedule the way I want it. I take breaks only if a competent family member is present and notified. I worked 12 hour shifts for many months for a Bayada client with TBI. We ate together or I did not eat. To me that crossed professional boundaries and made for a stressful work environment. But that is what my CM and the client's family wanted so that's what I did.

I'll agree there is a growing availability of technology based products targeted to the aging-in-place market. But there really isn't a growing need. Technology based products for aging-in-place seniors work no better in the home than they do in facilities. By the time Mom or Dad need medication reminders, it's far too late for them to be helped by an automated pill minder. I'll argue that every senior doing well with an automated, computerized, $500 med reminder system would do just as well with a $4.99 plastic pill minder. The same goes for in-home proximity alarms, bed alarms, automatic lights, and a host of other aids. Seniors at risk for falls, wandering, and missed medication, manage to forget their pills, fall, and wander off from the best "tech advanced" facilities every day. Nothing beats a living breathing CNA visiting the home for a few hours a day (as your wife surely knows.) And no home care agency wants to sell seniors a one time item to replace staff. It's much more lucrative to bill staff hours than sell devices. You have an uphill battle bringing tech to home care.

I'll add that if something seems abusive, stop. If you witness neglect, including self-neglect, report it. But I'd also like to ask, in the absence of strong Nursing Management support, what good ways can HHAides use to educate family members that their actions are hurtful to our goals of providing Personal Care.

Working as an HHAide for a licensed Home Health Agency. Client has diagnosis of Alzheimers. No skilled care in the home. No Medicare licensed Home Health Agency in the home. Client is lucid, firm, and articulate in refusals of Personal Care... shaving, incontinence care, baths, brief changes etc. How should we handle this? Nurse manager states we are to assist and support family, and explains this is not like working at a facility. Family is very firm with, "Go shave him now!" or "Change his diaper now" which prohibits any "go with the flow... pick your battles" type one on one care. Client becomes combative when pushed. He will sweep our hands away, push us back. Where is the line between abuse and neglect here? We want to provide care but the family makes it hard. Most of us feel more confortable, when we have no support from Nursing Management or family, to accept clients wishes, mark the refusal, and leave him wet and unshaven. Thoughts?

I received samples of the Abri-Flex Extra Pull-ups and Abri-Let booster pads. Indeed these are superior products. Abeena is a country of Danish origin. The packaging has instructions for donning and doffing the Pull-on Briefs in sixteen languages complete with line drawing diagrams approximating "Incontinent Vitruvian Man." For US dwellers imagine the instructions for assembling "IKEA disposable briefs." I put together a presentation for family members including daily intakes and ml/kg/hr urine output to show we were trying to put a bucket of liquid into a thimble. Then I sold them on more expensive disposable pull-on briefs by showing they were less expensive than doing an extra load of laundry each day and throwing away 3 to 5 chux pads each AM. First order arrived today. I think maybe the client and I will both sleep a little easier tonight.

Yes! Thanks. NorthShore. Also trying Prevail Adjustable Underwear which has the polymer beads (granuals). By weight based guess it appears we need to contain about 1300 cc. Well, the guard pad currently in use is part of the problem. Think designed for female "Poise Pad" placed in a male's Pull-up brief. One side of the pad is covered in adhesive and stuck to the diaper. As such, the excess urine (once the "Poise Pad" is saturated) flows around the "Poise Pad" instead of being drawn into the diaper. When forced to use a "Poise Pad," my answer has always been to slit the adhesive backing lengthwise several times. (Before sticking it to the brief!) Again, recall there is no aide at bedtime, just family. To untrained, inexperienced family, the answer is to stuff a second "Poise Pad" into the Pull-up brief. Which actually makes more urine flow into the bedding since now the leg opening elastic is overstretched. To restate, the family just won't be convinced to try a fitted brief (non Pull-up) based on the difficulty of changing a tape-on fitted brief. Client is mechanical lifted into bed for incontinence care and family is used to logrolling several times to pull up the Pull-ups. Thus the high absorbency Pull-up used with no "Poise Pad" overnight is my suggestion. Obviously an RN visit or Medical Social Worker visit would be a better choice. Maybe I used the word "diaper" when I asked at the office and that's why I'm being shunned. :)

I agree but I have done Medicaid bath visits where Medicaid provided top of the line briefs --- the ones with dry granuals inside instead of absorbent fibers. They seemed to hold a liter and a half. But they were unlabeled. And a year ago. Yes we tried and they gave up. Only way to do it would be remove all the briefs from the home... path of least resistance leads to the package of Depends pull-ups used during ther day. I even tried the old trick of pre-taping the tape-ons so they are in the form of a pull-up. There is no aide in the home at bedtime. So any teaching has to be in the morning. A hands on learning session each night, one hour, for a week would do it if the agency wasn't so busy a client manager could sell them on the idea, or a nurse manager could intervene. So we are still looking for super absorbent pull-ups.

I disagree. Millions of men and women manage their own nocturia every night by wearing absorbent incontinence pads or fitted briefs, or both. They sleep, or at least stay in bed, for eight hours or more, get up, wash up, and away they go with their day --- for years. I think the right thing is finding a better brief the family is comfortable with using. They are doing a great job allowing a parent to live-in. They just need some help.

Ha ha ha! I used the term diaper in this forum in hopes that would better clarify the difference between, well Pull-up Adult Briefs and, um Adult Briefs. I'm terribly sorry Diane if reading the word diaper offended you.

I don't understand the question. Please elaborate.

Client is incontinent of urine and feces and alone overnight 8 to 10 hours. I do bath visits. Client's shirts, sheets, pillows, everything are often soaked in urine. Maybe it's not out there. But I'd like to find an overnight diaper in a pull up. Family is reluctant to accept any change, so if it's pull-ups (Depends Underwear) during the day, they want pull-ups at night. I have educated on overnight diapers including showing family how to put on tape-ups but the best I could get them to do was adding guards (Poise pads) to the Depends. Has anyone found a high absorbency/overnight pull up? I'd really like the brand and name or UPC number.