Personal Assistance Services (PAS) include a variety of activities which are determined by the individual needs of the person with the disability.
Finding assistance, while not compromising independence and dignity, can be challenging. There are many issues to consider when planning for personal care needs to be met. Personal assistance services can range from assistance with grocery shopping and meal preparation to bathing, bowel and bladder care. The Personal Care Assistant (PCA) is the person who assists the individual with his or her daily living activities.
Options for Personal Assistance Services-
One of the first questions that is raised when considering who should provide personal assistance
services is whether or not a family member should take on the role of personal care assistant.
There are several factors to consider when making this decision. Oftentimes, the decision is
made based on financial considerations, without taking into account other options or thinking
about the potential toll that providing care may take on the personal relationship.
When a family member, whether it be a parent, spouse, son or daughter assumes the role of
personal care assistant, the lines between multiple roles can become blurred. Providing personal
care can put stress on any relationship, and can be particularly hard on a marriage.
Hiring a personal care assistant, someone who is, in fact, employed by you, may be the option that affords you the maximum amount of control and input into your care. The most important part of the job is to take direction and provide care in a manner that is suitable to his or her employer.
There are a couple of options for finding a hired personal care assistant, one of which is utilizing a home health agency. One of the primary benefits of hiring a PCA through an agency is convenience, as the agency presumably handles the screening and application process. Also, an agency will often provide back-up care in the event that the PCA is sick or doesn't show up for work unexpectedly. The disadvantages of hiring a PCA through an agency include higher cost in most cases, as well as a lack of control over choosing your caregiver. You will also most likely have to provide your PCA with specific training as to your needs.
Regardless of who takes on the role of personal care assistant, it is imperative to have a back-up plan in place in the event that the PCA gets sick, quits without notice or is unable to provide care for any reason. Being without a personal care assistant can be a frightening and intimidating experience that is best avoided. A well thought out plan that has been prepared before such an occasion occurs is the best way to handle the situation.
You should develop a list of people who are willing to be utilized as a back-up attendant, which could include family members, and friends. Find out the time of day and day of the week each person on the list could be available to assist you.
Prior to attempting to find a PCA, full consideration should be given to your specific needs, such as what times of the day care is needed the most, which types of caregiving activities are required, and how these could be consolidated into blocks of time.
One of the most common ways to find an attendant is through an advertisement in the
newspaper. In a larger city, it may be advisable to advertise in the local area newspaper. The first step is to create an ad that briefly states your needs and what type of person is being sought, while hopefully sparking the interest of a prospective attendant.
Another suggestion for finding an attendant is to contact the local Independent Living Center. Attendant care is one of the key services independent living centers are funded to provide. Most independent living centers keep a listing of potential attendants, that may or may not have been preliminarily screened by the staff, and some even offer classes to train the person with the disability, who may need assistance with the hiring and management process, or the prospective attendant.
Other avenues to pursue in the search for a PCA include posting an ad on a bulletin board at the local community college or university's career placement center. It may be helpful to focus on those schools that offer specific curriculum for nursing or occupational/physical/ recreational therapy. Oftentimes the students in such programs need experience in the field in order to graduate.
There are other locations that may offer places to post a job listing that may attract prospective
PCA's as well. Hospital bulletin boards may be a good source, as staff members may be looking
for extra work. Advertising in a local church bulletin, at vocational rehabilitation agencies, or at
local unemployment or social service agencies may also be worth trying. Finally, never underestimate the power of word of mouth. Get the word out by telling as many friends, family members, organizational associates and neighbors that you are looking for a PCA. A prospective attendant that has been referred by someone you know and trust may be your best bet. Also, talk to other individuals who have attendant care needs in your community to find out who they are using. Oftentimes one attendant will work for two or more people.
Screening and Interviewing A Prospective Personal Care Assistant-
In preparation for the screening and interview process, the individual with the disability should conduct a personal needs assessment to clarify those activities for which an attendant's assistance is needed. It is helpful to develop a checklist that encompasses all of the self-care, housekeeping, grocery shopping, errand running and transportation activities for which you need assistance. This checklist can be utilized in the screening and interview process. It is also helpful to clearly outline your expectations for how each task for which you require assistance will be completed.
This checklist will be a useful tool for training your PCA, and may help to address any differences in opinion regarding how a specific task should be done.
Before beginning the search for a personal care assistant, there are several things to consider
- your preference for a male or female caregiver, and whether you would like the caregiver to
live-in or just come in for several hours at a time to provide assistance. This, of course, also depends on the level of care that you require, as well as space limitations in your home and your
need/desire for privacy. If space and your personal lifestyle permits, you may consider offering a
personal care assistant room and board in exchange for personal assistant services.
It may be helpful to make a list of characteristics you would like in a caregiver. Give careful
consideration to factors such as honesty, reliability, consideration, promptness, ability to listen, willingness to learn new or different tasks, and how important each of these characteristics are to you in your PCA. What are the most important, and least important, and what are you willing to compromise on? Think about whether or not you want an attendant with shared interests, and how important issues such as having reliable transportation, smoking, drug and alcohol use, and previous driving record are to you.
It is advisable to screen a prospective attendant before expending the time and energy on
conducting a full interview on a person that may not be well suited to meet your needs. A brief
phone interview can be a helpful tool for screening individuals who may be interested in the job.
The telephone interview can provide the opportunity to find out whether or not the potential candidate has the characteristics you are looking for in a PCA, as well as chance for him or her to learn more about the job (such as the schedule, salary, and other requirements).
The Interview-
Consider conducting the interview at a location other than your home for safety reasons. If possible, have a friend or relative present or nearby during the interview.
The interview should be seen as an opportunity to get to know the prospective PCA. Discuss previous work experience, including length of employment for each position he or she has held. This is an important issue to bring up - you don't want to spend the time training a PCA to have him or her quit after a short time if you can avoid it. Inquire as to the type of work the applicant has enjoyed most and liked the least, and whether or not they have experience and are comfortable around a person with a disability.
The applicant's transportation resources should also be discussed. If driving is a requirement for
the position, talk about the applicant's driving record, and find out if he or she would be comfortable driving your vehicle should that be necessary.
The interview process is also the time to discuss your needs and exactly what the job entails
in detail. It is especially important to talk about any physical requirements of the job such as
lifting, transferring, bathing, etc. After you have described your needs and the job requirements,
ask the applicant whether or not there are any tasks he or she would not feel comfortable performing.
Also discuss compensation - whether pay will be hourly or a combination of a stipend with room and board. Let the applicant know the days and hours you need assistance and clarify which
days he/she will have off. Ask the applicant why he or she is interested in the job.
Finally, finish the interview process by giving the applicant the opportunity to ask you questions about the job requirements or your lifestyle. Discuss your timeline for making a decision and assure him or her that you will get in touch with your choice whether or not they are selected for the position.
The next step in the interview process is to contact the applicant's references. It is imperative before hiring anyone to check their references. It can sometimes be difficult to get information from previous employers for fear of a lawsuit, but explain your situation clearly, and if a reference refuses to give you information about an applicant, move onto the next reference, or ask the applicant for additional references. The feedback you receive from a
previous employer may be the deciding factor in whether or not you hire someone. During a reference check, try to obtain information on the applicant's length of employment, type of tasks performed in the course of the job, reliability, promptness, response to feedback and supervision,
ability to learn new tasks, and why the applicant left the previous job. Finally, ask the former employer whether or not the applicant would be considered for future employment.
Making A Decision-
After you have completed the interview process and obtained information from all of the applicant's references, it is time to make a decision as to who to hire for your personal care. The
primary consideration when making a final selection should be your gut reaction to a potential applicant. Regardless of qualifications, if for any reason, you do not feel completely comfortable with an applicant, do not consider him or her for the position.