Finding and training a back-up caregiver.

Who’s got your back?  If you are like many caregivers providing care for a parent or sibling, chances are, you don’t have your other siblings or family members flocking to your rescue, and your options are limited. Having someone to walk alongside of you on this journey is not only comforting but absolutely necessary. 

You may already be aware of the shortage of available caregiving support staff in our country? Research according to Bureau of Labor Statistics is showing that this shortage is expected to grow. 

“Employment of home health and personal care aides is projected to grow 33 percent from 2020 to 2030, much faster than the average for all occupations.”

“As the baby-boom generation ages and the elderly population grows, the demand for the services of home health and personal care aides will continue to increase.”

This is discouraging for sure, so it is important to start planning now on training your own trusted individual for the job. This article is all about helping you with that.  

First, let’s agree that a back up caregiver does not need to be skilled or have previous experience. Of course, that is helpful but it is not necessary. In my opinion and experience, it is more important to find a person with a well matched personality for your loved one and that wants to be there. In my professional experience, as an occupational therapist, someone who has a heart of service is more valuable than one with years of experience who is lacking in that area.  

Training your own back up caregiver is a good investment of your time and energy for the consideration of your health.  Here are some unfortunate facts to consider. There is a growing shortage of skilled care providers across all settings despite increased pay offers.  This is being faced by hospitals, home care agencies and nursing home facilities.  Bureau of Labor Statistics shares data reflecting the following, 

 “Employment of home health and personal care aides is projected to grow 33 percent from 2020 to 2030, much faster than the average for all occupations.

About 599,800 openings for home health and personal care aides are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.”

 So, if you wait until you need the help to contact an agency, chances are, you will not find the relief you are looking for in a timely manner, which is unhealthy for you and affects your loved one. A survey gathered by the AARP Caregiving in the U.S. 2020 reveals that family caregivers face a higher rate of physical health decline than the average, non-caregiving, population. 

“The drop-off in caregiver self-rated health since 2015 is happening across most subgroups of caregivers. Caregivers report significantly worse health across all hours of care and ages of recipients; among both low- and high-income caregivers; among all marital statuses; and among both those who had a choice and those who had no choice in providing care.”

Consider these next two benefits of finding and training a back up caregiver. First, you can minimize your associated risks if you have the opportunity to invest time for your health and well being, engaging in activities that inspire and rejuvenate you. Second, you need to consider the likelihood of needing a back up caregiver should you become unable to fulfill your current role as a caregiver for a period of time.  

Exposure to different caregivers may benefit your loved one in terms of increasing their socialization, energy level, and participation level during daily activities.  A simple change of pace and a different personality for your loved one to engage with can make a big difference in their experience.

Then, there is the concern that an emergency arrives, such as needing to have an immediate back up in your absence or in the case of requiring a second person to assist you with mobilizing your loved one in or out of the home.  You will be relieved to already have a trusted on-call person. 

Now, let’s discuss where to start on your road of training a back up caregiver.  First, make note of the people you know that have accommodating personalities, live in proximity and care about you. Taking stock of their personality traits and how they may match well with your loved one is the first step. Keep in mind that this person does not need to have a similar personality to you and remember that those with a heart of service are the most desireable.    

DO THEY HAVE WHAT IT TAKES?: Now to consider the physical requirements. If your loved one requires a heavy assist to get up from a chair or off the toilet, you will want to be sure that the person you are recruiting can manage that. Using good body mechanics and the right equipment ( a walker when recommended, a cane or a gait belt for example) requires proper direction following and the strength of the caregiver. Teaching your new recruit how to use their body as an assist in combination with the equipment needed should be delivered with modeling ( you show them) and with simple verbal directives.  When you are able, consider recording you and your LO completing the necessary transfers and/or mobility, so that your recruit has a good reference.  

LIST IT AND SIMPLIFY: Make a list of the areas that you find most taxing in physical effort and time. This is a great time to consider how these areas can be simplified, causing less strain to you in the future while also making the experience safer in your absence. It’s common to continue down a familiar path even though it is not the most efficient.  Creating a list of how you assist throughout the day, your routine, will be helpful for your back up in knowing what to expect. It can be difficult to make these lists on the fly, so consider making one as you go through the day. Make notes of problem areas, challenges, and time requirements that stand out to you. In the initial stages of your back up attending to your loved one, any areas of significant challenge are best to be minimized or avoided to allow for trust building and positive experiences.  

SET THE MOOD: Now you have a back up caregiver and they are ready to familiarize themself with your loved one and the task. Create a welcoming, low pressure atmosphere for them to get to know your loved one, if they don’t already, and to observe you and your loved one during a daily task that requires mobility assist (ie: getting  up from the chair, couch, recliner, bed). This is often the most concerning area for caregivers new to the scene.  How someone moves, how much help they need to get up and walk, and where the fall risks are should be the targeted areas of training. 

ASSISTANT TO THE ASSISTANT: The next step is to allow them to stand in for you while you are present as an observer, offering tips as needed or an extra hand is absolutely necessary while keeping a focus on building confidence for both your loved one and the person in training.  Consider having your back up over while you are home but engaged in an activity such as cooking, housekeep, finances. This will allow you to get work done and be accessible to answer questions or provide an additional hand if needed.  

LANGUAGE: Begin using consistent language when you are helping your loved one with a task.  Keep your verbal cues of assistance consistent and concise. Make note of what you say and share them with your back up person. Have them written down and show your back up. This is one of simplest ways to carry over consistency between you and your back up caregiver. If you aren’t being consistent and concise in your verbal prompts already, this will create an effective advantage that will serve you in the future. 

NOT COMMON SENSE: What seems like common sense to you may not be. Approaches that you use, the use of equipment (ie: walker, cane, shower chair, grab bars, bed rails, rails anywhere in the house) is one of the most common areas that are not properly demonstrated because it seems like common sense. Be sure to show how your Loved one uses these items and when. 

LAUNCH DATE: At this point you have a clear idea of the process to both find and train your back up caregiver so the next step is, planning out a date to launch your efforts. Put a date on the calendar and match it to an event that you want or need to do. This way, you will avoid putting it off. You will be working toward a specific date and goal with mini goals and their associated dates leading up to it. Without this last piece, if you are like most people, you will read this article and think that it’s a great idea but you won’t execute it.  Don’t wait until you are in a desperate situation for help and then just place someone in the role because that is a very stressful and unsuccessful approach.