I work for a non-profit company that specializes in supporting individuals and families with disabilities. I specifically work with people that hire support workers, either for themselves or for a family member. While we talk with many families that use support workers, it is very rare that we find a family that has created house policies on their own.
When meeting with a family for the first time, we always ask if they have used caregivers before. If they have, we ask about what went well and what areas they would like to improve on. Most complaints we hear from families usually stem from the fact that they do not have clearly defined expectations and boundaries for their staff in the form of house policies and a dress code.
My program manager once met with a family who lived in an immaculate home. One of those homes that you see in decorator magazines. While she was talking with Mom, Dad, and the medically fragile child, the support worker walked in. She was carrying a lamb and started to bottle feed it. She repeated this process twice. Really?? Bringing your livestock to work, bottle-feeding them in the living room of an immaculate home, right next to the medically fragile child is a good idea?? In what world is that acceptable? If you wouldn’t do it in an office building, why should it be okay in someone’s home?
Sorry – rant over!
Unless you want lambs in your house, I strongly suggest taking the time to create, in writing, house policies. It’s best to do this before you ever have support workers, but as Confucius said, “The next best time is now”.
When support workers arrive to start their shift
Most people are so relieved that they have found a support worker who can help them with their care that they are not always willing to set boundaries.
It is important to set boundaries from the beginning so that the support worker understands their role in your family and knows your expectations.
The first item to think about is where a caregiver needs to park. If you live in a home this may not be a big deal but if you live in an apartment, it is.
Some things that may be helpful to set boundaries around, include how you want a support worker to enter your home and what is the first thing you want them to do. For example, do you want them to leave their shoes by the front door? Where should they hang their coat and put their purse or backpack?
Do you want to have any COVID-19 protocols in place? When entering your home, should they use hand sanitizer and take their temperature? Are they mandated by the government to wear a mask while on shift, or would you like them to do that per your request?
Cell phone Policy
If you do nothing else, create, then print out in really big letters, what you want your support workers to do with their cell phones while they are on shift. It is permissible for you to require them to lock their phones in their car or power them down for the duration of their shift.
Support workers are not permitted to use their cell phones for personal reasons while on the clock. They are not allowed to text, call, check emails, or use social media while they are working. If they need to use their phone for work purposes, they need to get permission from you first.
Per Medicaid rules, a support worker does not get paid for any time they are not working. So unless they are using their phone for work, they need to be clocked out.
If you have your caregivers work 5+ hours, they are probably going to want to bring food with them. You can decide whether or not you want to permit them to store food in your refrigerator, but they need to be sure to take their leftovers home with them when leaving. Support workers need to be aware that they need to check with you first before taking a meal break to make sure it is a convenient time. If it is, then they need to clock out.
Another thing to consider about food is if they swing by McDonald’s or Subway, is do they need to put their food into a non-descript package or container before bringing it into your home. Sometimes, for our loved ones, certain logos can cause a meltdown or them to perseverate, so if that is the case for your family, be sure to tell the workers to repackage their food.
If you hired a smoker, can they take smoke breaks while they are on shift? If they are, be sure to let them know where they can go to smoke, that they need to wash their hands when they are done and let them know that they can not take additional breaks from their normal breaks to smoke.
Many times, people will carry over-the-counter medication with them. Can they bring those medications into the home with them? There is no set policy on this, but if them bringing those items into your home could pose a danger to your loved one, tell them to keep them locked up in their car. This could also be true of any prescribed medication they may be one.
It’s always a good idea to print out a copy of the drug-free policy and post it in a place the worker can see or access it easily. In states that have made marijuana legal, this can be very important. To find most states’ official drug-free policy, just Google ‘(your state) drug-free policy’ and it should pop up.
HIPAA standards and social media
As the saying goes, ‘what happens in Vegas, stays in Vegas’ and that is true for your home too! When support workers leave work, they can not go home and talk about anything that happened in our home. Sharing this type of information can jeopardize their employment and could have some serious consequences for them.
Another area that you need to talk to them about is social media and picture taking. I am hearing more frequently about caregivers taking pictures of the person they are supporting and posting them on social media without the family’s permission. That is a big no-no!
Discuss with your new employees how and when to notify you if they need to call in sick or to schedule time off.
How much time do you need to approve their timesheets before they have to be submitted? Some people can do this right away but others need more time due to their own demanding schedules.
Lastly, go over any emergency plans you may have in place. Let the workers know how to evacuate your home and where to meet up. How much support does the person they are taking care of need in an emergency? Be sure to post all information they might need if they had to call 911, such as your address, your loved one’s diagnosis, preferred hospital, and primary doctor.
General house policies
We want to give gifts to people who are important to us during the holiday season. However, giving gifts to our support workers is discouraged. Check with your state’s specific rules but here in Oregon, it is actually written in rule that caregivers can not accept or request gifts, or loans, of cash or property. We can say thank you, write a thank you card, or a letter of reference but that is all.
We do not have to provide them with food or drinks while they are on the job. If they want food or drink, that is COB, their cost of doing business. If they want it, they have to provide it themselves, just like in a normal office setting.
The same goes for gas money. If transportation is a covered service, you should not be giving them gas money because they are already getting mileage.
Make it clear from the start that they can not bring guests or pets to work with them. If they wouldn’t do it in an office, they shouldn’t do it in your home. What you allow once, will continue to happen, so it’s better to just say no.
I worked with a woman who was in her thirties at the time. She was very capable and independent but she let her support worker bring her two-year-old to work with her. Everything that they did, revolved around what the two-year-old wanted to do, not what a 30-year-old woman wanted to do.
I keep saying it and it is true, just because someone’s job is in your home, does not mean that normal workplace rules don’t apply. If they wouldn’t do it in an office at a normal 9-5 job, they shouldn’t be doing it in your home!
If a support worker needs to use electronics to provide support to your loved one, they need to ask you for permission. They can not use any type of electronics; TV, stereo, phones, or tablets for personal use. They can research local events, fun activities, or even recipes for the person they are supporting, as long as it is work related.
Do your support workers need to keep all doors that lead to an outside area locked at all times? This can be important for 2 reasons; 1. it can be a safety concern and 2. the person they support may be a runner.
Let your caregivers know that they need to follow all protocols, procedures, and responsibilities that you have outlined as part of their job. Don’t be afraid to put any and everything into writing. People tend to take things more seriously when they are in writing than if you just tell them how and when to do something. If it is in writing, they can also refer to it any time they have questions without having to bother you.
Have your house policies clearly defined for your new support worker. Even with support workers in place, don’t be afraid to write your expectations down and put them in place. If you feel awkward about it, blame it on me. You attended a training and discovered you had to do this. It won’t hurt my feelings!
If you have items in your house policies that I didn’t cover here, add them below in the comments. I am always looking for new ideas to add to my house policies!
Also, check out the other articles in this series:
36 Questions to Ask before Using Caregivers
Momma Bear’s Guide: When Planning To Use Caregivers
Momma Bear’s Guide: Help Wanted Ads For Caregivers
Momma Bear’s Guide: Interviewing Caregivers
Momma Bear’s Guide: Dress Code for Caregivers