Step Five: Creating a clear, precise description of the tasks to do things the way your client wants

Ask your client:

• How comfortable/anxious are you about having a stranger in your home?
• What have other people working in your home done that’s made you comfortable? Uncomfortable?
• Are you worried about being alone with me?
• Are you worried about my working in your home while you are out?
• How would you like me to announce my arrival and departure?
• Should I let you know when I go from one room to another? If I go outside, to take the garbage out, for example?

Your goal here is to learn about your client’s worries. Don’t get defensive or justify yourself. Just listen. At the end, sum up what you’ve heard so your client knows you understand.

• Promptness: How important are promptness and timeliness to your client?

Does promptness matter to your client? Does your client believe people who are late are demonstrating rudeness or disrespect? Talk about this value up front. Some people are sticklers for punctuality and are really annoyed by lateness. Others aren’t. Some people resent altering routines to accommodate a late worker while others are not bothered about a little lateness.

Ask your client:

• What days do you want me to work?
• What time do you normally wake-up in the morning?
• What time would you like me to arrive?
• What is your normal daily routine?
• How would you like me to fit into your routine?
• Are you open to flexible hours? If I get here a half hour late, could I work later in the evening?
• How would you like me to contact you if an emergency arises and I am running late?

• Cleaning: Is your client tidy or messy?

A gardener may do a beautiful job trimming hedges and edging lawns but may be careless about tidying up after the job. A housekeeper may leave floors sparkling but forget, in the rush to the next job, to put away all the cleaning supplies.

Is everything in your client’s home always clean and in its place? Does your client have fragile, expensive, or breakable things? Does your client worry that an aide will move and break a treasured item while cleaning? If so, you’ll have to be fastidious for this to be a good fit.

Are things in your client’s house a bit cluttered? Does your client worry that a helper will move or even throw out things?

Ask your client:

• How often do you like having your house cleaned?
• Do you want everything cleaned every time?
• I see that you have some beautiful pieces. How would you like these pieces taken care of?
• When I clean, do you mind if I move things? Do you prefer that everything goes back exactly in its original place?
• Would you like any parts of your house to be more orderly? Would you like me to help? Would you prefer that I organize without you?
• Do you supply your own cleaning supplies? If not, which cleaning supplies do you want me to use?
• Where do you keep cleaning supplies?
• Would you like me to include washing, ironing, folding and putting clothes away in my house cleaning?

• Noise: Does your client like peace and quiet or prefer a livelier environment?

Does your client keep the television or radio on for company, perhaps at a considerable volume? Or, does your client get annoyed by talking, traffic, music, or phone conversations preferring a calm, quiet home? How affected are you by noise around you?

Many workers use noise as a way to pass time. Gardeners, electricians, or carpenters may play/blare a radio while working. Housekeepers may want to keep the television on while cleaning. These days it seems like everyone talks on a cell phone while working, arguing with nearest and dearest or having emotional conversations with love interests or contentious ones with children.

If you like to watch TV, play the radio or chat on your cell phone to pass the time while cleaning, this can be a real fit problem. Find out before you begin to work for this client what noise is okay. May you watch TV? play music? How loudly? Are there types of music that are just not acceptable? Is classical music okay but rap not okay? What about headphones? They stifle the noise but also block communication. May you make and receive phone calls while at work? On the client’s phone? On your cell phone?

Ask your client:

• Do you enjoy watching television or listening to certain music?
• Would it bother you if I keep the television on low while I’m working?
• What types of music do you prefer?
• If music bothers you, would you mind if I listen to music with earphones while I am cleaning?
• Are there any types of television shows or music that I should never have on?
• May I give your phone number to my family so they can reach me in an emergency?
• May my children phone me when they get home from school?
• May I chat on my cell phone while cleaning?

• Familiarity: Does your client see casual conversation with you as a form of companionship, a burden, or inappropriate familiarity?

Agencies often list companionship as one of the services their helpers provide, and helpers often make valiant attempts to engage their clients in conversation. Similarly, extroverted aides, repair people, and taxi drivers chat simply because that’s what extroverts do.

If your client is lonely, such conversation may be a welcome relief. If not, it can be an imposition and an annoyance. Age, education, and different interests can also affect your client’s desire to chat. Do you and your client have common interests? Do you enjoy getting to know each other? Don’t reveal too much personal information—your client may feel obligated to listen to a conversation that feels inappropriately familiar.

Ask your client:

• What do you enjoy doing in your spare time?
• Do you enjoying chatting? Do you enjoy listening to somebody else’s stories?
• Do you have a favorite restaurant, movie, or television show that you enjoy talking about?
• Are there any topics that you do not enjoy talking about?
• Should we chat while I work?

• Boundaries: What’s the difference between being with a friend and being with an employer/client?

No matter what level of conversation occurs, people who work in others’ homes are involved in intimate activities with non-intimates. They know about personal habits and shortcomings—things the employer would share only with close friends and relatives under better circumstances. How can you honor boundaries with an in-home client? What is comfortable for the client? How reciprocal should the relationship be? What topics are off limits? How much of your personal life does your client want to hear about?

Ask your client:

• Are there any topics off limits to me?
• Do you mind if I talk about my family and friends?
• Would you like our conversations to be just between us? Are there things you would like me to keep confidential?

• Eating expectations: What happens at mealtimes?

Should workers eat in the house? Do they bring their own food? Do they put their food in the refrigerator? Should the client offer coffee, tea, water? Does the client feel obligated and burdened by the need to offer something to drink?

Some people readily offer coffee and a snack to employees and may even welcome the conversation that accompanies a shared cup of coffee. Others don’t mind somebody putting a sandwich in the refrigerator or getting a glass of water but would resent having to cater and host coffee and meal breaks. Still others may want the kitchen off limits to workers and may not want them to eat on the premises.

If you are preparing meals for the client, should you prepare enough for both of you? Should you eat with the client? Elsewhere? At the same time? Before or after the client eats?

Ask your client:

• Should I provide my own food? If so where should I store it during my shift?
• Do you plan to have me cook and shop for food, with or without your help?
• Would you like me to eat meals with you or do you prefer eating alone, with family, or with friends?
• If we eat together, should I prepare the meal for both of us or should I bring my own food to prepare for myself?
• When would you like me to eat and where?
• Are there any foods you would not want in the house? Do you have allergies to any foods?

• Bathroom use: Is your client comfortable with others using the bathroom?

If there is more than one bathroom in the client’s home, the client may want you only to use the one in the hall. If having an outsider use any bathroom is a big deal for the client, you may prefer to help in short segments, perhaps an hour or two a day, rather than spending six to eight hours in the house. Your client can’t forbid use of a bathroom, but may be very uncomfortable about this issue. If you can schedule visits to make the need less likely, things will go better for both of you.

Ask your client:

• Would it bother you if I use a bathroom in your home?
• Which one (if there’s more than one in the home)?
• If you don’t want me to use a bathroom in your home, let’s work out a schedule for me to work only a couple of hours at a time, so that I can use a bathroom elsewhere.

• Smoking: How does smoking affect you?

Some people simply want no smoke in or near the house while others are happy to share a smoke break. May you smoke in the house? Near the house? If you go outside to smoke on your break, should you go far enough away that smoke doesn’t blow into an open window? If you’re that far away, does your absence create a bone of contention? How many smoking breaks per shift are OK?

If you don’t smoke but your client does, will the smoke bother you?

Ask your client:

• Do you smoke?
• (If you, the helper, smoke and your client doesn’t) I smoke and I don’t want my smoke to bother you. When should I take smoking breaks?
• Will it bother you if I leave the house to smoke?
• How far away should I go so my smoke doesn’t bother you?

• Work ethic: What causes your employer/client to feel that people aren’t working hard enough or taking their work seriously enough?

Is it punctuality? Few if any breaks? A willingness to stay late if something unexpected comes up?

Ask your client:

• What annoys you about people’s work habits?
• If I finish my assigned tasks early, what would you like me to do?
• How many days a week do you anticipate needing my services?
• Except for emergencies, how often do you anticipate needing extra hours, later in the evening?
• What time do you expect me to arrive in the morning?
• If I’m unable to stay late when you need extra time, how will that affect you?
• I’d like to take a 10 or 15 minute break mid-morning and mid-afternoon. Is that OK with you?
• Should I let you know when I’m about to start my break?

• Compatibility: What level of compatibility is important? What areas of difference are unacceptable?

Age and income differences between older people and those who work for them can make compatibility difficult. While it is unlikely you and your client will be fully compatible, ask about music, television shows, outings, topics of conversation and other areas of interest to your client. Honor these lest you create an impossible fit.

Ask your client:

• Do you like to read? What types of books?
• What’s your favorite radio station?
• What topics are most interesting to you?
• What topics do you prefer not to talk about?
• Do you like to go to movies, concerts, presentations, book stores, or other outside activites?

Authority: How do you offer to help?

Many people find accepting help difficult for all sorts of reasons. They may find it more trouble to train the helper than to do it themselves. They may believe the helper won’t do the work exactly the way they want it done or an assistant may intrude on privacy. Or they may like to do things themselves and not rely on others. They may not want to cede control over their daily life much less have an aide tell them what to do and when to do it.

Informality, common these days, may feel more like haste and disrespect. Does your client want to be addressed in a certain way? May you use your client’s first name?
Does certain language (“guy” or “dude,” for example) imply disrespect to your client?

Ask your client:

• Would you like me to call you by your first or last name?
• I can do or help with lots of things. If I see something I think I could help with, do you want me to offer or wait until you ask?
• How much would you like me to help in your daily routine?
• Would you like my help with small projects around the house?
• When you have an appointment, would you like some assistance getting to and from it?
• If I’m doing something that doesn’t suit you, how can I make it easy for you to tell me?

Learn how your client wants workers to behave – how much they should talk, how respectful they should be, how they should handle daily activities like eating, smoking, or going to the bathroom, what boundaries they should observe. Clarity about these topics will help you and your employer/client be a good fit. The Job Fit Work Sheet will take you through each of these considerations so you can create a preference list that will make clear your client’s likes and dislikes in detail.

What does your client want help with? Figuring out the tasks

Now we’ll help you create a detailed description of each task so you’ll have enough information to help the way your client wants to be helped.

• Shopping for groceries

Some people enjoy grocery shopping and would miss the activity. They may like the social connection of seeing and talking to other people in the store; they may enjoy slowly wandering down the aisles looking at and feeling the fresh fruits and vegetables, or they may want to keep control over decisions about what is purchased and how much money is spent. Ask your client--

Do you want help:
•Deciding how much to spend?
•Making grocery lists?
•Getting to and from the store?
•Selecting the groceries?
•Navigating the aisles?
•Putting the groceries into the cart, onto the checkout counter?
•Paying?
•Carrying the groceries to the car and into the house?
•Unpacking the groceries?
•Doing the whole thing?

Grocery related issues - Do you want:
• Someone to follow along patiently while you shop?
• Someone to chat with while you are shopping?
• Someone to talk to the store clerks for you if you need help finding an item?
• Someone to handle the payment at check out?
• To do shopping on a regular schedule…when?
• To buy only specific brands or specific product sizes?

• Preparing meals and cleaning up:

Meal preparation can take lots of time, particularly if a care provider likes to cook or wants to provide a substantial meal. In some cases, the level of effort put into meals may not match your client’s interest in eating. On the other hand, collaborative meal preparation can provide the opportunity to be engaged and active.

Does your client enjoy any aspect of meal preparation and cleaning or want the entire operation handled independently? Ask your client--

Do you want help:
•Creating menus for homemade meals and making sure the right food is in the house?
•Deciding what to eat for each meal?
•Deciding when to eat?
•Cooking the entire meal?
•Preparing or cooking the part of the meal you do not enjoy handling?
• Setting the table?
•Serving the meal?
•Clearing the table?
•Washing the dishes?
• Drying the dishes?
•Putting the dishes away?

Meal preparation and cleaning issues - Do you want:
•Formal, elaborate or simple, quick meals?
•To supervise meal preparation or clean up or to be uninvolved?
• Any specific cooking or cleaning procedures followed?
•Conversation while meals are being prepared or put away?

• Eating:

What help would make meals as pleasant as possible and encourage nutritional, substantial, regular eating? Ask your client--

Do you want help:
• Getting to and leaving the table?
• Putting food on your plate?
• Cutting food?

Eating related issues - Do you want:
• To eat in a certain place?
• To eat at certain times?
• To listen to the radio or television while eating?
• Conversation while you are eating?
• Any topics to be off limits?

What do you want me to do while you are eating?
• Share the meal with you?
• Chat while you eat?
• Be nearby but neither eat nor chat?
• Make myself scarce so you can eat in peace?
• Eat my own food while being scarce?

• Taking medication:

Does your client take more than one medication each day? At different times? With different restrictions (on an empty stomach/with food, etc.)? Can your client follow the instructions for each medication without getting them mixed up? Does your client use a pill tray? Ask your client--

Do you want help:
•Checking to see that your medicines are current and that you have enough for the week?
•Calling the doctor if medicines run out or are out of date?
•Calling the doctor if a medicine creates problems?
•Putting medicines into daily dispensers?
•Putting the dispenser out where you will see it and remember to take the medicine?
•Being reminded when to take which medicine?
•Being given the correct medicine at the correct time?
•Being reminded about over the counter medicines, drinking, or other activities that may interfere with your medicine?

•Laundry:

Doing laundry involves bending, lifting, carrying and often walking up and down stairs while carrying a load that may obstruct the view—or making many trips carrying small enough loads in order to be able to see over them. Ask your client:

Do you want help:
• Making sure laundry supplies - detergent, fabric softeners – are always stocked?
• Moving the laundry from a basket to the laundry room?
• Sorting the laundry?
• Washing, drying, and folding?
• Ironing?
• Putting the clean laundry on the bed or back in the correct place?

•Taking Out the Garbage

Are there small garbage cans in every room? Are they lined with trash bags? How easy are they for your client to reach when it’s time to empty them? Can your client readily lift them? Reline them? Does your client have to put all the trash into a large bin and haul it to the curb each week? How hard is this for him/her? What about the recycling bins? Ask your client--

Do you want help:
•Replacing liners in the trash cans?
•Emptying the trash and moving the bags to the garage or pick up point?
•Taking trash you have emptied to the pick up point?
•Separating recycling from trash?
•Carrying the recycling bin to the pick up point?
•Putting the various bins and cans back?

• Companionship:

Ask your client—

Do you want someone:
•To sit with you and chat while you eat, watch television, or work around the house?
•To plan and take you on outings to the movies, museums, parks, meetings, presentations or other destinations?
•To go for walks together?
•To be in the house but not spend much time chatting?
•To read to or with you?
•To talk about the daily news, neighborhood gossip, politics, arts, or other specific topics?
•To go through photographs and other mementos with you and put them in albums?
•To clean out an attic or closets to sort through belongings or memorabilia?

Companionship related issues:
•What are your skills and interests?
•Are there times of the day or specific activities that are lonely?

• Toileting, bathing, grooming, hygiene:

Getting on and off toilet seats or getting in and out of the tub or shower can become difficult with age. Slipping—possibly breaking a hip—is a serious concern. Incontinence is unfortunately a common problem with older people. Assisting a wobbly person with intimate behaviors requires of the helper patience and sensitivity. It requires a lot more of the person needing help—overcoming embarrassment and the loss of autonomy, privacy and dignity. Ask your client--

Do you want help:
•Getting into and out of the bathroom?
•Getting on or off the toilet?
•Getting into and out of the shower or bath?
•Steadying yourself in the shower or bath?
•Washing in the shower or bath?
•Washing at the sink?
•Putting on and taking off make up?
•Brushing teeth/dealing with dentures?
•Combing hair?
•Washing hair?
•Shaving?

Toileting, bathing, grooming, hygiene-related issues:
As people get weaker, an additional constraint appears. If they need just a little assistance getting on and off toilet seats and shower chairs (called “transferring” in the lingo), most in-home aides have the strength to help. However, if people need to be lifted, few women are strong enough so the aides for more seriously disabled people will likely be men. Both women and men tend to find it more embarrassing to have a male aide help with bathing and dressing. Worse still, if someone has a history of sexual abuse or rape, a male aide may trigger anxiety despite impeccable behavior. Ask your client:

•What is it about being helped with toileting or grooming that makes you uncomfortable?
• What can I do to make you as comfortable as possible? Here are some ideas:

• Avert my eyes
• Not talk except as necessary
• Settle you on the toilet seat, then wait outside the bathroom until you are ready to be lifted off the toilet seat

• Pet care

Pet owners often make decisions about their own health and circumstances based on the impact the decisions would have on their pets. Pet owners want assistance that makes it easier to keep the pet at home and in good health and spirits. If you dislike, are afraid of or allergic to pets, you’ll have a hard time working in a home with animals. If, on the other hand, you like pets, you and your client may be a very good fit based on this shared interest. Ask your client--

Do you want help:
• Walking the pet?
• Feeding and watering the pet?
• Cleaning up after the pet, inside or out?
• Getting the pet ready to go to the vet?
• Taking the pet to the vet?
• Staying with the pet if you are out of town or in the hospital?