Safe and Sound at Home: Part 6 How to Manage the Care Relationship


Once you have settled on an agency or caregiver, your participation should not end. In fact, your job as manager is just beginning. The following pages give you a working blueprint to help make the relationship between you, your loved one, and the caregiver the best possible.

Establishing a professional work environment

Regardless of which hiring model you have chosen, the relationship will be best served if you take the time to plan and establish priorities. Below is a list of ideas to help make the working relationship a success. 

  • Practical preparations

Put valuables in a secure place. Provide a work environment that is safe, reasonably clean and logically and efficiently organized. Find out what supplies (gloves, briefs, etc.) may be needed in the home and keep the home adequately stocked with these items.

  • Communicate expectations

Begin the employer-employee relationship with clear and honest communication. Create the habit of regularly asking questions and welcoming feedback. Give praise when praise is due and address concerns sooner rather than later.

  • Create a care plan

A full-service agency will supply you and the caregiver with a care plan and 7-day shift report (or daily shift report) after interviewing you and the care recipient. If you are using the private-hire model, you will have to prepare these documents on your own (see samples below.) The care plan merely reflects the job description, and can be broken up into time segments of a day or lists of activities to be completed, along with helpful details about the recipient. You must be explicit in which tasks are essential to complete and when, and which tasks are optional.

A preliminary list of tasks' details for the Client Care Plan may include, but should not be limited to, the following:

  • Cooking: Arrange weekly menu, prepare shopping list and buy groceries. Prepare warm, healthy dinners with small portions. Throw old food away.
  • Personal Care: Assist with shower. Use the shower bench and use care to make sure the water is not too hot. Provide dressing assistance. Assist with toileting and briefs. Empty bedside urinal as needed.
  • Mobility: Fall precaution is very important. Remove all obstacles and encourage the use of a cane or walker.
  • Housekeeping: Change the bed linens on Wednesdays and do all laundry weekly. Wash and put away all dishes after meals.

A typical Client Care Plan would look similar to this one. It would include the items mentioned above and any other particulars that need to be addressed that are out of the ordinary. This document should be kept with the others in the Care Log Book (see below.) A full-service agency will supply a Client Care Plan after interviewing you and your loved one, and possibly his primary-care physician and case manager.

  • Create a 7-Day Shift Report

The 7-Day Shift Report (some agencies use a daily shift report) contains a "Time Card" and automobile-use record section and a daily check list for monitoring tasks involving personal care, eliminations, meals, housekeeping, safety, mobility, and medication reminders, among many others (see example.)

  • Create a Narrative Note form

The Narrative Note Form provides a place for the caregiver to summarize a day's activities along with any changes in client's condition, mood, and conversation. This form gives you the opportunity to track the client-caregiver relationship, providing a written history of events.

  • Assemble a Care Log Book

A binder or folder should contain all pertinent documents: the Care Plan, the 7-Day Shift Report, the Narrative Notes forms, and the Rules of the House document. Consistent monitoring and evaluation of the Care Log Book will provide a communication tool among all parties and will keep the caregiver motivated to do her best.

  • Observation

Drop in unexpectedly to see how your loved one and caregiver are doing. Observe how he responds to the caregiver. Does he appear afraid? Does it appear that the meals are appropriate, varied, and balanced?

  • Rules of the house

Be clear about what is acceptable in the household and what is not. Some homeowners put their feet on the coffee table - others are offended by it. Watching television, bringing in and listening to music, and bringing foods into the home may be other areas where clear guidelines need to be established. Avoid the "I have a guest in my home" syndrome when dealing with a caregiver. They are employed to provide service as a caregiver.