Safe Help In Your Home

Step Two: Creating a precise description of your clients' preferences so you can advise your staff

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There are predictable bones of contention when people work in other people’s homes.
How do your employees learn their clients’ personal preferences for all the little things? Your clients’ satisfaction depends on your employees’ attention to detail and the quality of the time they spend together. We’ll show you how to figure out the interaction first, then take a look at the tasks.

Getting started

People may not be pleased that they need help. They lose privacy by having somebody in their home. They may feel disrespected and intruded upon in any number of ways. To offer the best services to your clients, you’ll want to learn their preferences for sociability and boundaries as well as what they want your employee to do. Focusing on these characteristics will help you select the employee most likely to fit well with each client.

Explain to each prospective client that you want to facilitate as harmonious a match as possible so you’re going to ask some detailed questions. Add that you’ll go over this information with the person you intend to send and will help the two of them get off to a good start. Also make clear that you’ll be available to assist at any point and that you want the client to let you know how things are going.

Fit questions

Tolerance for strangers and differences: How do you feel about having a stranger in your home? Do gender, religion, appearance, marital status, sexual orientation, etc. make a difference?

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 this person?
• Are you worried about somebody working in your home while you are out?
• How would you like the helper to announce his/her arrival and departure?
• Should the helper let you know when he/she goes from one room to another? If he/she goes outside, to take the garbage out, for example?
Your goal here is to learn about your client’s worries. Don’t explain impracticalities or agency policies. 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 you?

Explain that your agency stresses promptness with all its employees, but a little flexibility is sometimes needed. How much 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.

Match for similar attitudes on punctuality. If your client is a stickler and your worker more casual, your client will be dissatisfied no matter how hard and well your worker does otherwise.

Ask your client:
• What time do you usually wake-up in the morning?
• What time do you usually go to bed?
• What is your normal daily routine?
• What days and times do you want an aide to work?
• How would you like the aide to fit into your routine?

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 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 find a fastidious worker 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?
• You must have some beautiful pieces. How would you like these pieces taken care of?
• When the aide cleans, should everything go back exactly in its original place?
• Would you like any parts of your house to be more orderly? Would you like the aide to help with that? To organize with you? without you?
• Do you supply your own cleaning supplies? If not, which cleaning supplies do you want the aide to use?
• Where do you keep cleaning supplies?
• Would you like the aide to include washing, ironing, folding and putting clothes away as part of 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 is your client by ambient noise and other people’s noise?

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 your employee likes to watch TV, play the radio or chat on a cell phone to pass the time while cleaning, this can be a real fit problem. Before you place a worker with a client, find out what noise is okay with the client. May the worker 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. And, what about cell phones and personal conversations?

Ask your client:
• Do you enjoy watching television or listening to certain music?
• Would it bother you if the aide keeps the television on low while working?
• What types of music do you prefer?
• If music bothers you, would you mind if the aide listens to music with earphones while cleaning?
• Are there any types of television shows or music that should never be on?
• May the aide chat on a cell phone while working?

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

Agencies often list companionship as one of the services their helpers provide, and the 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 the client is lonely, the conversation may be a welcome relief. If not, it can be an imposition and an annoyance. Age, education, and different interests can also affect the client’s desire to chat. Do your employee and your client have common interests? Are they likely to enjoy getting to know each other? Do caution your employees about revealing too much personal information—polite clients may feel obligated to listen to conversations even though they feel 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 the aide talk while working?

Boundaries: What’s the difference between being with a friend and being with an employee/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 client would share only with close friends and relatives under better circumstances. How can your employee honor boundaries with clients? What is comfortable for the client? How reciprocal should the relationship be? What topics are off limits? How much of your employee’s personal life does your client want to hear about?

Ask your client:
• Are there any topics that should be off limits to the aide?
• Do you mind if the aide talks about family and friends?
• Would you like conversations to be limited to certain times or topics? Are there things you would like 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? Does the client have to 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 your employee is preparing meals for the client, should he/she prepare enough for both of them? Should your employee eat with the client? Elsewhere? At the same time? Before or after the client eats?

Ask your client:
• Should the aide provide his/her own food? If so where should the aide store it during the shift?
• Do you plan to have the aide cook and shop for food, with or without your help?
• Would you like the aide to eat meals with you or do you prefer eating alone, with family, or with friends?
• Should the aide prepare the meal for both of you or bring food to prepare separately for him/herself?
• When would you like the aide 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 the helper only to use the one in the hall. If having an outsider use any bathroom is a big deal for the client, can you provide help in short segments, perhaps an hour or two a day, rather than six to eight hours in the house. Explain that your client can’t forbid use of a bathroom while showing you understand your client’s discomfort about this issue. If you can schedule visits to make the need less likely, things will go better for your client, your employee and you.

Ask your client:
• Would it bother you if the aide uses a bathroom in your home?
• Which one (if there’s more than one in the home)?
• If you don’t want the aide to use a bathroom in your home, let’s work out a schedule for short visits so the aide can use a bathroom elsewhere.

Smoking: How does smoking affect your client and your employee?

Does either smoke? If so, does the other hate/have allergies to smoke? If so, skip this match.

Some people simply want no smoke in or near the house while others are happy to share a smoke break. May your employee smoke in the house? Near the house? If your employee goes outside to smoke on a break, should he/she go far enough away that smoke doesn’t blow into an open window? If the employee goes that far away, he/she won’t hear call for help. Will this absence create a bone of contention? How many smoking breaks per shift are OK?

If your employee doesn’t smoke but your client does, will the smoke bother your employee?

Ask your client:
• Do you smoke?
• (If the aide smokes and your client doesn’t) When and where should the aide take smoking breaks?
• Will it bother you if the aide leaves the house to smoke?

Work ethic: What causes your 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 the aide finishes the assigned tasks early, what else would you like the aide to do?
• How many days a week do you anticipate needing our services?
• Except for emergencies, how often do you anticipate needing extra hours, later in the evening?
• What time do you expect the aide to arrive in the morning?
• If the aide is unable to stay late when you need extra time, how will that affect you?

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 your employee and your client will be fully compatible, ask about music, television shows, outings, topics of conversation and other areas of interest to your client. Make sure your employee will 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?
• What interests would you like to share with your aide?

Authority: How is help offered?

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? May the aide? 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?
• Would you like the aide to call you by your first or last name?
• Aides can do and help with lots of things. If the aide sees something to help with, should the aide offer or wait until you ask?
• How much would you like the aide to help in your daily routine?
• Would you like the aide to help with small projects around the house?
• When you have an appointment, would you like some assistance getting to and from it?
• If the aide is 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 your employee and your 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. You’ll want to go over the preference list with your employee before matching him/her with the client, and ask him/her to use it as a guide and check in regularly with the client to make sure the client’s preferences are understood and being implemented accurately.

Job Fit Work Sheet Font Size 12

Job Fit Work Sheet Font Size 18

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 tell your employee how 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 an aide 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 either 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?


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 the aide to do while you are eating?
• Share the meal with you?
• Chat while you eat?
• Be nearby but neither eat nor chat?
• Be scarce so you can eat in peace?
• Eat his/her 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?


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?
•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 cans and bins back?


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 the helper do to make you as comfortable as possible? Here are some ideas:
• Avert his/her 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 your employee dislikes, is afraid of or allergic to pets, he/she will have a hard time working in a home with animals. On the other hand, if your employee likes pets, your employee 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?

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Step Three: Setting up a feedback system so you can supervise and guide your staff effectively