Patient care @ home

Patient care at home- This word often is confused with regular nurses in the hospital and aayas. In hospitals there are two kinds of care available-One are the nurses who are responsible for taking care of patients as per the doctor advice, giving medicines or food on time and checking vital stats. The second are “Aayas” who are responsible for activities like giving sponge bath to patients, helping them with bed pan and other cleaning related jobs. Nurses are well educated while on the other hand an aaya could be little or un- educated. 

Sometimes we need the same kind of care at home.  While hiring a helping hand at home, what should one do? The first thing we have to keep in our mind is the requirement of the patient. For example if the patient needs regular injections or constant monitoring and medicines depend on vital body functions, then one must hire a nurse. Nurses are required for bed ridden patients, those suffering with serious conditions or old patients living alone. Aaya is also required in these kinds of cases because most of the nurses would refuse the cleaning jobs. In case of predefined medicines and food an “aaya” would be perfect. Aayas are good with those patients who are bed ridden and where the only work is to feed and clean them. An example is my mother who fractured her leg after slipping in the bathroom. 

In some cases help is required for half a day but that’s depends on the patient condition. In general an aaya is required only for helping the patient with those daily activities which they are not able to do by themselves.

Now the question arises that from where to hire them. Nurses are mostly available from the hospital directly and it is the most preferred method too. However, they are very expensive and also no one wants to take a chance because they are meant for a critical job. The same way aaya can also be hired from hospital but the problem is hospital charge a huge amount for this unskilled work. It is better to hire an aaya from an independent agency.

With growing needs, there are new agencies mushrooming everywhere and all of them promise you with the best staff they have. In reality, most of them are bogus and have no experience. The reason they are into this business is quick and tax free money. They work on two ways-One is you pay only to the agency and in turn they will pay the employee. In other words it’s an outsourced profile. The second way is you pay some amount initially to the agency and a fixed salary to the maid every month.

The problem is there is no guarantee of the employee. Even these maids are unskilled but they must have prior experience of patient care. Most of the agencies give you wrong information. The best way to be on the safe side is to ask for references and then wait for their answer. Almost 90% will never give you any reference because of two reasons- One they have never worked with patients, and two- they have never worked at all. 

I have come across maids who were involved in house cleaning and the agency people lure them for these kind of jobs because the pay is high. My present maid (aaya) even told me that once her agency owner got a road side lady beggar and took her for a job in patient care after teaching all kind of lies! That’s alarming!

So how to handle grave situations at home in presence of maids/aaya-

1.       Install a CCTV by which you can monitor the daily activity at home. This is also important because the maid always have the fear that someone is watching.

2.       Take a small interview of the maid in front of the agency person. For example where they have all worked previously, for how long they have been working, what was the nature of their last assignment and so on.

3.       Take two or three references from the nurse and the agency owner as well.

4.       Ask for a police verification before you hire them and also check their original documents. Keep a copy of all the documents with some photographs.

5.       Explain the nature of work in detail to avoid last minute surprises. Try to tell them they have to do everything for the patient, even cooking and washing clothes, massage or therapy patient’s body. Also don’t miss telling them the most important thing- In case the patient needs anything at night, then the same has to done.

6.       I will also suggest restricting their access in the house for example eating habits. Please understand, most of them come from a very poor family and never had access to luxury. My intensions are not to be inhuman but at least they must know their limits.

7.       Don’t let the maid knows about the places where you keep cash or jewellery. Try to lock the room in case you are leaving and the patient is all alone at home with the maid. In case you are planning for few days out of station then please let few neighbour know. Their frequent or surprise visit will keep the maid under control.

8.       Try to keep an eye for the initial few days and take a feedback from the patient himself.

9.       Last and most important is the compensation. Be clear on the terms and conditions from the beginning itself.

I am no expert in this field but this is my experience and hope it will help. These agencies charge a lot of amount, so don’t let them fool you.