Special Needs Care for Adult Children: Quality Care and Your Caregiver

How to manage and evaluate care relationships

Now that you are using the caregiving solutions that best suit your adult child's needs, how can you make sure the situation is a positive one for all involved?

Whether your child has in-home caregivers, attends a day care program, or lives in a group home or other facility, he or she should be:

  • Happy. Sounds too simple, but it's true. You best know your child's demeanor. Is she usually in a good mood, or is she more irritable and upset than usual?
  • Healthy and safe. Is your child getting sick more often? If she's bedridden or sits in a wheelchair, is she developing more pressure sores? Are accidents, cuts or bruises occurring more than usual?
  • Appropriately stimulated. Does your child tell you about fun activities or interesting places she visited? Are your child's self-help or physical skills progressing as expected? Does she have varied and positive social interactions during the day?

Assessing In-Home Caregivers

Periodically, you should reevaluate your caregivers and the working partnership you have with them by reviewing the following areas (in addition to important feedback from your adult child whenever possible):

  • Relationship with your child. Simply, does your caregiver enjoy being with your child and treat your child with respect? Does your child eagerly anticipate the caregiver's arrival? Is their time together filled with smiles, laughter and kind words?
  • Reliability, punctuality and dependability. Is your caregiver prompt? Does he frequently cancel on you? Do you feel confident placing trust in him?
  • Professionalism. How is the quality of the care? Does the caregiver bathe, dress, transfer or toilet your child efficiently and expertly?
  • Communication. Do both you and your caregiver feel comfortable bringing up issues with each other? Is your caregiver open to any questions you ask or constructive criticism you share?
  • Job satisfaction. Give your caregiver the opportunity to tell you if he's feeling burnt-out or unsatisfied in some way with the work situation. Providing special needs care can be particularly demanding, as you know from personal experience. Burn-out is common, so be sure to spend some time talking about this with your caregiver.

Evaluating Day Programs, Group Homes and Long-Term Care Facilities

Your child, if able, can provide direct feedback about her daily activities. In addition, visiting a program or facility will be very helpful in learning firsthand about your child's experiences.

On a routine basis, you may want to consider the following areas (in addition to feedback from your child):

  • Quality and attitude of staff. Are staff members helpful, respectful and upbeat? Do they know your child well and enjoy working with her? Are they competent and dependable?
  • Activities. What social and educational opportunities has your child enjoyed? What new skills has your child learned?
  • Communication. Do you receive written reports or phone calls on a regular basis? Do you have face-to-face conferences?
  • Issues. Are you informed in a timely manner when issues arise? Have the issues been resolved satisfactorily?
  • Facility. Is the space clean, bright and cheerful? Does your child enjoy spending time or living there? Do you enjoy visiting?

Giving Praise and Sharing Constructive Criticism

People like to be appreciated and commended for doing a good job! Try to praise caregivers when something impresses you, and remind them often how much you appreciate their work. Of course, if you see or hear anything that concerns you, make sure to discuss it calmly with your caregiver or the appropriate personnel immediately.

Deborah Elbaum, M.D. has three children and lives in Massachusetts. She writes about a range of family and medical issues.

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