We have been tip toeing around this isue, I think most of us

have, are, or will have to deal with this at some point. I though I would try to be of help.

First remember YOU are the boss. When you (or a loved one) have the intake meeting be sure all duties that are to be performed are written out and that both you and the agency have a copy. Post it on the refrigerator.

Each Nurse or CNA will have a time sheet that should be signed by you at the end of each visit. DO NOT SIGN IT FOR THE WEEK, BEFORE THE END OF THE SHIFT OR BEFORE ALL DUTIES ARE DONE! Have a checklist that must be completed for each shift.

Understand that YOU, the client, set the pace of the worker. If you allow an Aid to come in and have coffee with you because you like the company, that is all that will ever get done. YOU must say "here is a list of your duties, we can visit while you work".

DO NOT get involved in the Aid's personal life or allow them to talk about their family (they are not supposed to). The next thing you know they will bring their kids to your house for you to meet (illegal as per HIPPA) then they will bring them to work with them because you liked them, you may also feel the need to give your Aid money because little Sara wont get anything for Christmas, don't fall for it.

If there is a family emergency and they have to leave early be sure to call the agency the next day to see if you can expect your worker for his/her next scheduled shift and explain why you are concerned. This way you are not tattling, just finding out if you can expect service. Some Aids will turn in time sheets documenting that they were with you for their whole scheduled shift because YOU signed the sheet before they left or had signed for the week. The agency ends up paying them for time they did not work and will not know you have not received all your services. There is no way to prove they were not there if YOU did not document it on the time sheet.

If an Aid is supposed to pick up an RX or go grocery shopping and they say they wish they could but they don't have enough gas, call the agency, most of them have already charged you for mileage to reimburse the Aid. If you wish them to do an extra errand that is not written in their list of duties simply call the agency and let them know you are paying them for gas to run that errand.

It is common for a client to give an Aid cash to go shopping for them, have the Aid sign for the money you gave them and check the receipt and change upon their return and have BOTH sign it! This also protect the employee.

Do not take an Aid's adoration of one of your possessions to mean they would like you to give it to them. The Aid CAN NOT accept gifts. If you would like to give an Aid a gift it MUST go through the agency and be documented that it is a free will gift, again this is for the employees safety so they will not be accused of theft.

I know this sounds harsh, you can be polite and friendly BUT remember this is an employee, employer relationship. YOU determine the quality of work you get. I get so frustrated when I get a call form a client saying something like...my Aid has left early every Friday for the last 6 weeks. HOW did *I* know that? Why didn't you let me know 5 weeks ago? And how did you expect me to fix it If I didn't know?

If the client sets the standards from the get go, IE ...insisting the chores are done to the proper standards and the true scheduled time is spent and documented properly you will get good service.

Don't be nice and let things "slide" you are only hurting yourself and the agency that "thinks" they are providing you with the best service. You are also teaching those with a "less than acceptable work ethic" that they get rewarded for being slackers. They only teach the next generation to do the same!

Think of the ethics YOU were taught.

Also please be sure to let an agency know when you get one of those wonderful people that goes out of their way to be sure you have the best of care. I have seen folks go WAY out of their way and volunteer time to be sure their clients have everything they need. I teach my employees to ask if there is anything else they can do before they leave, MANY have done extra services for their clients at no charge. There are WONDERFUL folks out there that are dedicated to serving, there are also some real duds. Please let your agency know of either.