Caregiver Matchmaking: Choosing a Caregiver
Choosing a caregiver for a loved one with memory loss should be about creating a relationship between the two, one that is built not just on skills but ideally will involve creativity, flexibility and mutual interests.
“What’s most challenging is finding people who really have a genuine passion for the work,” says Joe Fisher, founder and CEO of Renewal Memory Partners who has 15 years of experience matching caregivers and receivers. “Many people are just looking for a paycheck. You want to find people who view this work as a calling. That brings a totally different energy to the work that is felt by the clients.”
Choosing a caregiver who is a good communicator is crucial, he said.
“Most communication is nonverbal with people with dementia who are still good at picking up on nonverbal cues.”
Corey Bliss, Renewal’s senior care director, advises looking for someone with experience caring for memory loss individuals or who has had a “lived connection,” such as a family member with the issue. “That’s the best teacher.”
Both Fisher and Bliss say the connection between caregiver and receiver should be based on a solid relationship. “The relationship part is not all that different than it is with any two people,” Bliss said. “It’s about being a good listener, being patient and meeting people where they are. A relationship works best when two likeminded individuals come together and have shared experiences. The care provider is learning from the client and the client is learning from the care provider. This is what makes the best mutual relationship.”
What causes relationships to fail, she said, is personal preferences, such as when a talkative person is paired with someone who is reserved and prefers to be quiet.
The pairing process takes time, she says, explaining that the caregiver needs to take their cues from the person with memory loss. “You start with observing what the client is attuned to.”
Fisher says the caregiver must attune to the person with memory loss to see how they react to the volume at which you speak, whether they need more time to process the information they are receiving and how the complexity of a task can be broken down into parts.
“In general, care providers who are successful are attuning constantly. Let the [care receiver] be the star of the show. For every minute of talking have three minutes of listening.”
Out of respect for their person, Bliss said family members should look for a caregiver who will allow the care receiver to have as much independence as possible, especially in the early stages of cognitive change.
Fisher elaborated, “Do things with the client rather than for the client rather than for the client. This is not intuitive to everybody. Some work hard to do everything. They are well-intentioned but they could be taking away things that are important to a person’s self-esteem. This preserves independence and self-worth.”
He describes his agency’s process as “part art and part science.” The science part involves matching care receivers with someone who shares their interests, such as a love of history, architecture or opera. The art part is based on intuition in observing when the two meet.
“You have gut feelings these two people are going to enjoy each other’s company. It’s the intangible part of the process and taps into emotional intelligence.”
Families looking for a caregiver should take time with this exploration.
“A mindful introductory process leads to a lot of success,” Bliss says.
Keep safety in mind when choosing a caregiver
Another part of success involves the safety of the care receiver. Family members want to know their loved one will not be abused or neglected. They also want to know the provider is dependable, especially if they work and need to count on that person showing up on time. For these reasons Fisher says it’s important to work with a licensed agency that will have screened the potential caregiver thoroughly.
One measure of judging the success of the relationship, he says, is to look for the “halo effect.” The family should observe whether the person “remains upbeat, talkative and engaged for the remainder of the day. That’s a good sign the visit was a success, and the client had a high level of cognitive engagement. If the visit didn’t have a lot of engagement, you’re not going to see that effect.”
Caregivers wanting to have a good relationship with someone with memory loss should find out as much as they can about who that person has been in terms of career and interests, as well as their scheduling needs, what their symptoms of cognitive change are and how much insight into the condition they have.
“It’s really getting to know who this person is as a person,” Fisher says. “It’s not defining them as their disease but as a person with the illness. Consider the level of insight the person has into their disease. If they are in denial, they’re not going to want anything involved with the word ‘care.’ Knowing the level of resistance enables you to recalibrate the work with the family to use terminology that resonates with the person. If they are a retired executive, you can use ‘executive assistant.’ If they were an artist, you can use ‘studio assistant.’ Language matters.”
Some of the best caregivers are people from the performing arts world and other creative fields, Bliss said, because “they will be constantly recalibrating during the day what’s going to work for their client. They instinctively know how to pivot.”