Safe Help In Your Home

Step Two: What do you want help with? Figuring out the tasks

I want to hire in-home help
I provide in-home help
I work for an agency that places workers in clients' homes
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Now we’ll help you create a detailed description of each task so the aide will have enough information to help you the way you want 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.
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?
•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 interest in eating. On the other hand, collaborative meal preparation can provide the opportunity to be engaged and active.

Do you enjoy any aspect of meal preparation and cleaning or want the entire operation handled independently?
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?
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?
• Make him/herself scarce so you can eat in peace?
• Eat his/her own food while being scarce?
Taking medication:

Do you take more than one medication each day? At different times? With different restrictions (on an empty stomach/with food, etc.)? Can you follow the instructions for each medication without getting them mixed up? Do you use a pill tray?
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 your view—or making many trips carrying small enough loads in order to be able to see over them.
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 to reach when you want to empty them? Can you readily lift them? If not, how do you empty them? Reline them? Do you have to put all the trash into a large bin and haul it to the curb each week? How hard is this for you? What about the recycling bins?
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?


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, common with older people, is a major risk factor for physical abuse. 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.

Choosing the right helper for these intimate tasks involves assessing sensitivity as well as skill. Making a good choice starts with your definition of privacy and your level of discomfort receiving assistance with toileting and bathing from qualified helpers.

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?

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 you have a history of sexual abuse or rape, a male aide may trigger anxiety despite impeccable behavior.

You may want to dismiss the aide because he makes you uncomfortable. Take these concerns about discomfort seriously even if you have no history of abuse. People don’t like to think about the possibility that an aide might abuse or molest a client, but it does happen.

We give you guidelines (Screening Candidates to Reduce the Risk of Abuse and Neglect) to reduce the risk of hiring somebody who will abuse you, but nothing’s foolproof and feelings of discomfort that are more than personal embarrassment should be addressed immediately. Even if the aide isn’t grooming you for victimization, the feelings of discomfort in such an intimate setting mean that a change is necessary and urgent.

•Do you prefer a man or woman to help you?
•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 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. You might want assistance that would make it easier to keep your pet at home and in good health and spirits.

There are various dog walking and pet sitting services, and some are fully bonded and insured. Local animal shelters and veterinary practices have referral lists. Neighbors with pets probably have recommendations too. A responsible teenage neighbor looking for pocket money might also be a good resource.
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: Hiring Safe and Appropriate Staff