Marissa Sandler is the co-founder of Careseekers, an online platform that connects people who need care workers with care workers. Marissa is passionate about helping people live with autonomy and dignity, and we recently spoke with her about how caregivers are an important part of achieving that goal.
Tell us about your background. Why did you become so passionate about helping caregivers?
So many pieces of my professional and personal life came together for me to co-found Careseekers.
My background is a human rights lawyer. I am passionate about social justice and assisting people to positively participate in their communities to the best of their ability. I worked in different areas of human rights law for 15 years, including gender and disability. When I was doing disability work, I saw the difference that good caregivers made to people's lives, particularly those caregivers with whom the person with the disability got along well. These caregivers helped to assist the person in leading an independent, productive, and happier life. Also, my work on gender issues made me aware of women's economic instability and their concentration in poorly-paid work, including paid caregiving.
On a personal level, my co-founder (who is actually my sister) and I had experiences trying to keep grandparents at home as they aged. We saw the incredible job our parents, aunts, and uncles did to keep our grandparents at home. It was really challenging to find affordable in-home caregivers who were willing to assist at times that suited our grandparents and were a good personality match for them.
I saw Careseekers as a way of bringing together these passions and solving a problem that families with aging relatives or family members can have. It was also an opportunity to help caregivers gain some economic stability by finding more work at higher pay rates.
How does Careseekers help seniors and their loved ones?
Careseekers helps seniors stay at home as they age by connecting them and their families with in-home caregivers. Often, finding the right in-home caregiver can be a huge hurdle to assisting someone to stay at home as they age. Careseekers also helps families find in-home care workers for relatives with disabilities.
We have a large and growing database of caregivers who feel passionately about helping people age at home. Seniors and their families can connect with these caregivers either through our online platform or through our Concierge Service, which appeals to people who are time-poor or not tech savvy.
Caregivers' services are:
• Affordable - care workers set their own rates and we don't take a cut. As a result, we provide a much cheaper service than care agencies.
• Flexible - there are no minimum hourly requirements. Caregivers can be engaged for as little as one hour or for 24/7 care.
• Tailored - the person needing care chooses which caregiver will deliver their care, so they can find someone who is a good personality match for them.
What are some of the hardest tasks that in-home caregivers must carry out for sick or elderly patients?
The tasks, which are not often that challenging, can be quite varied: social companionship, light cleaning, cooking, personal care, and assistance with showering and toileting. Sometimes, a job can be physically tiring; for example, if the person needs a lot of assistance being lifted in and out of a wheelchair or with mobility.
The most challenging thing for a caregiver can be dealing the attitude of the person requiring the care. Obviously, this is not all situations; but the care recipient may be very resistant to having a caregiver in their life, and is doing it purely because their family (usually their adult children) insisted. The children are often doing this out of care and fear for the person's safety living alone. An ultimatum (in-home care or a nursing home) is usually made after the person falls or is found wandering the streets at night disoriented on a few occasions.
In addition, the care recipient may be depressed about aging or their reduced capacity, and take out their frustration on the caregiver. Caregivers may have to put up with the care recipient being rude, insulting, ignoring them, and letting them know that they aren't wanted in their home! One caregiver I know spent her days driving the care recipient around to different doctors to find one that would say the care recipient was fine to live on her own. (She had a caregiver at her son's insistence.)
When I ask caregivers how they deal with these situations, they usually say the same thing: they don't take it personally, and they understand that it is the person feeling frustrated at the situation they have found themselves in. They ignore a lot of the comments and don't take the bait.
What are some of the signs that indicate a senior citizen needs a caregiver in his or her home?
- Increased falls and being unable to get up from falls, or finding themselves "stuck" in situations that they can't get out of until help arrives (e.g. not being able to get out of the bath)
- Increased wandering out of the house and disorientation, particularly during the night (relevant to dementia sufferers)
- Experiencing fear or a loss of confidence in their own ability to be alone in their house
- Finding everyday tasks very difficult or impossible to do (e.g. getting out of bed, getting dressed, showering, toileting)
- Safety issues (e.g. forgetting to turn off the gas stove at night)
How does a caregiver know when it's time for a senior citizen living at home to enter a senior care facility?
With the right setup, it may never be necessary for a senior citizen living at home to enter an aged care facility.
If it is feasible for a home to have all the necessary modifications made to it (like the introduction of hand rails or inclinators where there are stairs), and the right caregivers and medical equipment can be put into place, there is no reason why someone would ever need to move out of their home.
This may be an ever-changing situation; but today, full nursing and palliative care services can be provided in the home. Most medical equipment can be set up in homes, and care can be provided around the clock. Research shows that people's preference increasingly is to die at home in a familiar environment, hopefully surrounded by loved ones.
The only impediment may be cost, since it can become expensive to put in place very high levels of care. It also requires time and input to get the right setup.
For those wishing to hire an in-home health care professional, what should they look for in an applicant or service provider?
Placing an in-home caregiver in your home or that of a loved one is a big step. Ensuring the individual is trustworthy, of good character, and highly experienced is crucial. It is also important to make sure the caregiver respects the dignity, autonomy, beliefs, and culture of the person they are caring for.
We are always asking families about what was important to them when looking for a caregiver, especially with regard to how they made the relationship work between the person being cared for and the caregiver. Based on these conversations, we suggest that you:
- Look for a caregiver who demonstrates sensitivity to the cultural practices and beliefs of your family member. Select someone who is prepared to build and maintain new and established rituals - the little things make all the difference!
- Use the caregiver's time well, perhaps taking the time to do a load of washing while your loved one has a nap in the afternoon.
- Confirm what hours are required, and set firm pricing on your hourly rates, overnight charges, or any additional expenses. Shifting goal posts can make it hard to budget.
- Consider how far your caregiver will have to travel each day. This is particularly important if you'd like the caregiver to be available for unplanned events.
Try choosing a caregiver who can speak the same language (even if only a few important words) as the care recipient. Language assists with building rapport and trust, which in turn provides the family with peace of mind. Language is particularly important in caring for dementia sufferers who may revert to first languages.
Do you have any tips for helping elderly individuals embrace the idea of an in-home care professional?
1. Start off by hiring the potential caregiver to help with duties around the house that aren't too personal or that make the individual feel like they are losing their independence. Getting someone in to iron shirts or clean the bathroom may be tolerated or even appreciated, and the individual will get used to having someone in the house helping them out.
2. Get to know the caregiver and make sure the individual receiving the care does too. Sit down and have a cup of tea with the caregiver, and also talk fondly about the caregiver to the care recipient when the caregiver isn't around so that the care recipient starts to feel comfortable with having someone new in their home.
3. If you are forever running errands for the care recipient, ask the caregiver to start doing them instead so that the care recipient begins to rely on the caregiver to do things that you used to do.
4. Slowly increase the hours and duties of the caregiver week after week until they are working the maximum amount of hours you envisaged they would be.
5. In time, this caregiver may be a great option if you need to transition to a live-in caregiver; and if this is the end goal, make sure you choose a caregiver that could possibly live with the care recipient in the future.
6. If possible, involve the individual in choosing the caregiver, such as presenting them options through an online site (like Careseekers) and having them present at the interviews.
The most important thing to remember is that most individuals will resist a caregiver; it's a normal reaction. It can often be a huge blow to the person's confidence, and they see it as losing their independence. But you should persist because in the long term, it may actually mean they maintain their home life for longer and are able to keep their routine intact.
What does the future look like for the home health care industry?
BIG! As many populations around the world age, including those in the USA and Australia, we will see an increased demand for aged care services, especially home aged care services. This reflects people's personal desire to remain at home as they age, but also government policy and initiatives to keep people at home.
Technology will have a huge role to play in the future of home health care, which will make it easier and safer to age at home. It's not about robots replacing caregivers, but rather technologies that ensure peace of mind and offer quick access to medical help, while minimizing trips to the emergency room or hospital. Technological advancements include telehealth, apps, wearable sensor devices to monitor and report daily activity, and online services to help people age at home (like pill subscription services and GPS trackers for dementia sufferers).
Already, people are coming up with innovative and sustainable ways to age in their homes and communities. Interestingly, all of the best solutions rely on togetherness and creating a sense of community. Examples include house sharing with a number of couples/individuals at the same stage of life; constructing multigenerational communities in one housing estate and sharing resources; and homeshare programs that match elderly people with spare rooms and who need extra help with young people who need a place to live and have spare time to provide support.
mmLearn.org provides over 300 free online videos for caregivers of older adults. This quality training is done by professionals in the field of aging to help support and educate the caregiver. For more information on finding or being a caregiver, access our free online videos today!
