Saturday, February 04, 2006

Caregiver Charades

The two keys to my sanity are Mom's residence and her private caregivers.
Ocean View Assisted Living is an excellent facility--newly built, beautifully decorated, with great food and a staff of kind and loving people.
But soon after Mom moved in, I realized she needed a private caregiver. She preferred sitting in her own room with her own television rather than being out in the common area. Yet she needed someone to talk to, and she had to be kept from trying to walk and falling. Bathing each night and dressing each morning were also areas where having a private caregiver would be better than depending on a staff of 4-5 responsible for 28 residents.
Ocean View gave me a list of private agencies, and I chose one.
It has worked out well, for the most part. The agency is Filipina-owned and operated, so all the caregivers have been Filipinas.
Jona works the day shift, 6 am to 2 pm, six days per week. I do Sundays.
For over a year Connie worked the night shift Monday through Friday, 6 pm to 6 am, and Racquel worked Saturday and Sunday nights, staying until 8 am on Sundays so I didn't have to arrive earlier. She was very devoted to Mom, fussing over her and waiting on her hand and foot. She also substituted whenever Connie or Jona needed a night or day off.
Whenever there was a holiday and no one else wanted to work, Racquel was given the job. Other caregivers appeared (such as a friend of Connie) and were given preference to Racquel.
It soon became apparent that Racquel was lowest on the agency's list, perhaps because she was the most recent immigrant and her English was not as good, or perhaps because of status distinctions within Filipino culture.
In January, however, I cut back the night shift hours, deciding that the Ocean View staff could keep an eye on Mom from 10 pm to 6 am. I changed Connie and Racquel's hours to 2 pm to 10 pm.
This created a scenario out of the book Who Stole My Cheese?
Anna, the scheduler at the agency, gave Saturday night to Connie to boost her income. (Connie and her husband had just bought a house.)
That change left Racquel with one night per week, only 8 hours instead of the 26 hours she had had earlier.
I told Anna that Racquel should still have two nights, 16 hours, but Anna insisted on scheduling Connie, and I accepted her decision.
Until today.
In the past week Anna has made three scheduling errors.
#1 On Thursday night a week ago she left me a message saying "Jona won't work Friday because of her grandmother's funeral service, and Racquel can't substitute." That meant I would have to show up at 6 am Friday, but I knew Anna was wrong. The funeral was Saturday. I knew Jona was working Friday. Instead of showing up early Friday, I came Saturday and did the am shift.
#2 But then on Sunday I learned that Racquel actually could have worked Saturday. I could have had the whole day to myself. Anna had not checked with Racquel for several days and did not realize she was actually available.
(Racquel had begun working for another agency because she got so few hours from Anna. Her hospice patient from that agency had died on Tuesday; she had attended the funeral Wednesday, and she had not called Anna to request more work. She avoids calling Anna because Anna speaks harshly to her.)
#3 Then Anna called me Thursday night this week and said, "Connie will not be working tomorrow. Racquel will work instead."
"Oh--what hours will Racquel be working?" I asked. Connie usually comes at 5 pm on Friday instead of 2 pm.
"2 to 10 pm," Anna reported.
"Great," I answered. That meant I could leave Mom with Racquel immediately after the P.E.O. meeting, rather than caring for her until 5 pm.
When Racquel wasn't there exactly at 2 pm, I kept waiting but then left, confident she'd arrive soon.
She arrived at 2:25 pm but another caregiver from the agency noticed and told her that Connie was coming. Racquel then received a call from Anna saying that she should go home--Connie was planning to be there at 5 pm.
"It's Saturday that Connie is going to be off, not today," Anna told her.
Obediently, Racquel started back home, two bus rides away.
Mom was alone from 3 to 5 pm, except for the Sunrise staff. When I called at 4 pm to make sure Racquel was there, an Ocean View staff member told me she hadn't come.
I called Anna, who said, "Connie is coming today. It's tomorrow that Racquel will be working."
She didn't apologize for giving me the wrong information.
"Anna, I waited an hour for Racquel. I would have made other arrangements if I knew Connie was coming. I need to hear you say 'I'm sorry.'"
Anna apologized but did not reveal that she had actually given Racquel misinformation too and sent her home.
When I found out today that Racquel had been sent back, I called Anna again.
"Anna, I hear you sent Racquel home yesterday," I began.
She answered cheerfully, speaking as if it had been Racquel's error.
"Anna, do you plan to pay Racquel for her time yesterday?" I then asked. "She took two buses to get to work, stayed an hour, and took two buses home."
"No, because I don't want to charge you," she said.
"Look, Anna, that's not fair. I am going to pay Racquel for her time, and I don't want this to happen again. From now on Racquel works Saturday and Sunday 2 pm to 10 pm. Connie works Monday through Friday, as before. I can't have you calling with misinformation and then not paying Racquel for her time."
"But Connie needs the hours--she might not continue to work for you if she can't work Saturday night," Anna protested.
"That's okay--if Connie can't work, I'll give her shift to the Ocean View staff. But I can't have changes every week in the schedule and have you giving wrong information to me. It costs me time and money when you make these mistakes. Connie has a family and can't really work six nights. If she has just five nights, she'll be less likely to change the schedule. I hope this kind of a mix-up will not happen again."
That's the end of the story--I hope.
But my long-term goal, if Mom declines in her activity level, requiring less care, is to eliminate the private caregivers completely. She won't like that--she's still mad at me for taking away her nighttime caregivers.

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