FINDING good QUALIFIED caregivers shouldn't be a challenge, but it is! We've been working with…read morevarious caregivers and companies since 2019. In the beginning our needs were less involved for our aging family member who suffered a stroke, evolution of health does change quite a bit as we are now requiring hospice level care in 2025. In Portland Home Instead and Visiting Angels are the largest and most popular companies, there are many other smaller organizations, they're all basically the same, mainly just a different sized pool of caregivers. Most companies are TERRIBLE at least 50% percent of the time. You'd think when you spend $20K a month you'd at least get reliable care - Be ready for no-shows, caregivers who can't figure out a lock box to get inside, can't cook, don't know how to make coffee, don't speak English, might burn your house down letting toast catch on fire ... it really is a treacherous and dangerous path sometimes.
Home Instead will sell you the typical spiel that they're in business because they care about people, not making a paycheck. Of course nothing could be further from the truth. Home Instead Portland and Beaverton is currently $46 an hour as of January 2025, and seems to increase rates every year or more. Interesting fact, H.I. in Texas is currently $36 an hour. H.I. might negotiate the rate if you push, but not much.
Complaints - Where do I start?! Despite currently needing hospice level care, H.I. still sends us newbies and greenhorns hired right out of high school or off the street with ZERO experience. It takes constant calling and complaining and adding people to the 'Do not return' list before finally getting some decent qualified caregivers. Caregivers should have some basic level of training, seems H.I. doesn't always follow that protocol even though they say all caregivers have training. It takes a lot of trial and error to get decent caregivers, and then once you do they decide to leave or move on to pursue other things. Consistency counts. Bed to wheelchair transfers is often a must, amazing how many have no idea how to do this safely or without another person. Some caregivers will sit in another room their entire shift and only interact with the client when called on, others feel like they need to be busy doing something the entire time. Leaving the client alone the entire time is completely unacceptable and should not be allowed, especially if they have breathing or choking issues, but it still happens. Be sure to let the provider know of poor service! Other complaints over the years - no social skills, no shows, constantly late, falling asleep, smoking weed during shift, can't read basic instructions, improper toileting care, lack of cleanliness, rough handling, verbal etiquette, and even theft.
Senior aging is a delicate process and care usually evolves until their passing away. At 97 years of age suffering from a former stroke in 2019 our dearest family member has required special care for many years. If you're new to working with caregivers you'll quickly discover a two things:
ONE - it's ridiculously expensive and will drain your bank accounts! And sadly mostly insurance DO NOT cover the hourly costs. Average rate 2024 in Oregon is $45 hour ($18-$25 goes to caregiver) and it constantly increases! In the beginning we only needed 4 hours, then 8, now we're at 14 hour 8AM-10PM, that's $20K a month just in caregiving!!
TWO - the quality of caregivers and companies varies a lot and has a very limited and repetitive pool of caregivers. Sometimes you get great caregivers, sometimes you don't, doesn't matter what company or what level of care required. It's amazing how many caregiver seem to have ZERO people skills or training. We constantly put caregivers on the do not return list.
There are 3 basic levels of caregiving most companies provide:
(1) BASIC CARE - provides companionship, bathroom assistance, meals, light house keeping and monitoring. Usually greenhorns fresh out of high school or off the street it would seem. Sometimes we'd get caregivers with zero experience or training.
(2) ADVANCED CARE - includes palliative care, ability to do bed or wheelchair transfers, more help with mobility issues, meals, help with meds, toileting, chores, higher level of attention to care and monitoring, advanced health tasks and help keeping things sanitary.
(3) HOSPICE CARE - as advanced care as possible without being a nurse or holding a medical degree. Should be required to spend quality time and companionship, meals, know how to work with dementia or other illness, help with meds (med monitoring), emotional support, toileting, diaper changing, full body cleansing (bed bound clients) etc.
Eventually our elder family member will pass, and we'll no longer need any of these services or business. Their final days certainly shouldn't be filled with worry of poor care or haggling the rate.
