Not So Good Care

I have several different Home Care Aides who come in to help me with my personal care and exercises. Their ability ranges from poor to excellent, as you would find in almost any group. I don't get a lot of choice with respect to HCA's; they are assigned to me. If they are incompetent or act inappropriately, I can ask for a different HCA; I don't get to choose. Once again, an HCA is assigned.

My experience is fairly wide with respect to care workers. After more than a year, I have had perhaps a dozen or more of them into my home. In that time, I've had one who was so bad that I called the agency and said I never wanted to see here again. I've had a couple who've been problematic, while most of the rest have ranged from average to, in one or two cases, excellent.

The HCA who comes on Monday is on the low end of average, perhaps bordering on poor. As with many of these women, she is a new immigrant. Her English communications skills are poor at best, with me having to ask her for things several times before she understands. Her memory skills are equally poor; from one week to the next she will forget what to do. I have to guide her through things every Monday.

What her situation really points out is the difference between someone who knows "what" to do with my care and exercises, and someone who understands "why" it is being done. This is not a language thing; my other care givers are virtually all ESL workers. Quite frankly, I think my Monday HCA is operating a somewhat less than an optimal intelligence level. I will ask her something and you can see the gears turning before she gets it. Sometimes I must ask three or four times for something she does every week. Sure, part of it is language. The other part is slow processing.

Today, I found myself in the shower, done, dripping, ready for help to get out. She was on her phone, taking the time to finish her conversation before helping me. She can only do one thing at a time; this time it was finish her call before attending to the client who was sitting in the shower, soaking and cold. There are constant moments like that, where you can see her deciding what to do, not knowing where to go next.

This is the kind of HCA I don't want when I get worse. I need care-givers who understand why I need care, who understand the purpose of the various activities, who can see a need and respond to it. I need someone who gets it, and does it without my having to ask. After all, one day I won't be able to ask.