Provide Trained attendants for dementia home care
This page is part of the section Resources for volunteers. Use the menu option on top, or the right sidebar, to see the other pages in this section.
Introduction
Almost all dementia care happens at home, and trained attendants are critical for such care because without their help, family members are unable to continue with any other work or responsibilities, sometimes unable to even leave home to buy vegetables. Also, care for a dependent person can be physically taxing, especially for elderly caregivers, and caregivers start facing health problems themselves. Families therefore often look for reliable trained attendants to help them in dementia home care.
Many families that write asking for help and information want to know where reliable and trained help can be obtained, but currently home help is unavailable, unreliable, and untrained. This page discusses how concerned persons who want to do something can contribute to reducing this problem about availability of reliable trained attendants.
The requirement from trained attendants sent by an agency, explained
See the resources and references section below for extensive discussions on this.
What a trained attendant agency does
Some key points (not intended to be a complete list)
- On an ongoing basis, acquires a base of competent, reliable attendants and ensure they are verified (such as police verification) and that all education/ work-experience documents and contact details are collected and verified. (Necessary)
- Trains staff members for home care support, including typical elder care, home nursing skills, and dementia care skills (Necessary)
- Coordinates with families to understand their requirement and identify a suitable attendant (Necessary)
- Ensures the contract is clear about scope of work and the payment (Necessary)
- Handle all statutory requirements, legal obligations, and accounting.(Necessary)
- Maintain records as required.(Necessary)
- Periodically assesses the work and provides any re-training/ counseling indicated (highly desirable)
- Ensures attendants doing care work remain safe and respected, and are treated fairly by the family they are assigned to (highly desirable)
- Has premises to operate from, and place where the attendants can stay or report if not assigned to a family (in-between assignments) (highly desirable)
- Briefs the attendant and the family to ensure that the work scope is understood mutually, and that there is compatibility (highly desirable)
- Resolves conflicts and complaints (by family, or by attendant)
- Provides alternate attendant to family when currently assigned attendant is not available.
Ways concerned persons can help
Persons with an entrepreneural mindset and enough resources can consider setting up such an agency. They will need to create a business model, gather resources, build a team, get the required permissions, set up the agency and run it. They will need to create all the required processes and training, and put into place the management they need for running the agency. They have to manage the day-to-day actions of the agency, as described above.
You can also contribute so as to encourage/ empower others setting up such agencies, even if you don’t want to set up an agency yourself. You can make it easier for them to run these agencies better. Some ways to contribute are:
- Create material or courses and other things that can be used to set up an agency that provides trained attendants. This could be for any aspect that is important for setting up support systems, collect and structure the information into documents or training material/ videos that others can use.
- Conduct training for existing agencies to sensitize and train their staff for helping persons with dementia.
- Counsel families on how they can best handle attendants.
- Share your experiences of training attendants or setting up agencies so that others can undertake similar projects.
- Help persons with viable project proposals to set up such agencies through funds/ partnership.
- Design criteria and maybe a rating for judging the quality and reliability of such agencies.
- Create systems that get agency ratings from families that used them and make them available (like any online rating system)
(A general discussion on how potential contributors can select projects and contribute can be seen at: Action Areas to Contribute to, and Possible Approaches )
Additional note for some India-specific aspects
- In India, families often do not know what work they can ask a trained attendant to do, and what they should not ask the attendant to do. They may treat trained attendants like any normal household help. In addition to any contractual clause that specifies this, there is often need to sensitize the families about this. Attendants, too, need to be told how to handle such situations. Sensitization and training should include examples of what the attendant can be asked to do and what not.
- Verification of attendants is particularly important as many of them are from distant villages and may not give correct data.
- There is a severe shortage of trained attendants. Concerned persons who cannot set up agencies can help families train their existing household help for dementia. They can also help by ensuring availability of material (booklets, videos, etc.) that families can use to understand dementia care for themselves and to explain to their household help.
Resources and references
Some links to understand the current situation and how caregivers cope:
- Using Trained Attendants for Dementia Home Care: This web page is intended for family caregivers and discusses the various aspects about using attendants for dementia care, listing problems and giving suggestions. It can also be used to get an idea of the types of problems faced, and to think of ways to reduce these problems.
- Trained attendants and respite care for dementia: Observations from India: This is a blog entry discussing caregiver experiences and difficulties related to trained attendants and respite care.
- Trained attendants and respite care for dementia: Sharing suggestions for volunteers from India. This discusses more on how to contribute.
- Experiences across divergent caregiving situations: This is the report of a two-week long e-group discussion (focus: home care staff) that I facilitated, and lists the problems caregivers shared in this discussion. It can give an idea of the situation and challenges for which solutions are needed.
One document by the Kerala Govt which provides their statistics and observations of home nursing agencies in Kerala may be useful to get some overall idea of how such agencies work, and what their expenses and infrastructure may involve. This is not a model, and is not dementia-specific either. See Report on Home Nursing Institutions in Kerala 2015-2016.
Pages in this section:
Resources: If you want to help caregivers/ spread dementia awareness
- Understand dementia and care in the Indian context
- Action Areas to Contribute to, and Possible Approaches
- Community-level work: A Dementia-Friendly India
- Focus: Improve Dementia Awareness
- Focus: Create Dementia Services and Products, Facilitate Support Forums
- Project ideas for students, artists, and others
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Youtube channel of Dementia Care Notes 
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