In-Home Health Care: Has Your Folks’ In-Home Caregiver Had Formal Training?

Jacqueline Marcell Health Guide
  • A fascinating new caregiver survey by "The Caregiving Project for Older Americans" says all kinds of in-home caregivers have not had much training, because there is no national training requirement for in-home caregivers for older adults. And since 78 percent of those surveyed (who had hired caregivers) had the misperception that they did have training, the problem is heading for a crisis with the enormity of the advancing aging population.

    I experienced this problem myself when I took care of my parents for a year–the whole time trying to find caregivers to help me–from agencies and independents. I was so dismayed because most didn’t speak English very well, had limited education, were shy and sensitive, didn’t have a car and were being driven by a relative, and had their own children and elders with all kinds of family and health problems, which I heard about–every day.

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    And then, since my father was so challenging, I had a rough time getting anyone to stay very long. Who needs to be yelled at over the silliest thing, called nasty names, and have fruit thrown at them? And those that did stay for a few days or weeks had very spotty training–at best.

    Then I realized that it really takes a person with a very special heart to want to continually give so much of their self to a sick elderly person who isn’t even their own loved one–and to continue to bathe, diaper, dress, feed, entertain, and manage all the daily challenges that arise–and do it day after day, year after year. There are just too many other opportunities these days–that require a lot less emotional involvement.

    With each passing day and nightmare with my parents, I learned so much on my own that since I had taught college in my first life, I took on the task of training the caregivers myself, who’d of course quit on me right after I got them trained because of their own crisis or a better job in another industry. Finally, with the help of "Amazing Ariana" (a young gal with no eldercare experience and only one year of high school), I figured everything out and had it all managed so well I could have run a national caregiver training program myself!

    The heart-wrenching experience compelled me to write my first book, Elder Rage, and commit my life to eldercare awareness and reform. And, because she was so deserving, I committed to mentoring "Amazing Ariana" until she was able to get her GED high school equivalency, even though she was so terrified of taking tests.

    The great news on the horizon is that the many doctors and professionals involved with "The Caregiving Project for Older Americans" are starting to develop a national core-curriculum to standardize in-home caregiver training (for elders) in the U.S.! I just hope that some of them have actually been caregivers for their own elderly loved ones, as it is one thing to study caregiving and work with people doing it, and it is quite another to really do it.

    I base that statement on this: As I lecture around the country, it is always so interesting as I poll my audience before I begin. "How many of you are healthcare professionals?  OK… and how many are or have been hands-on caregivers for a loved one?  OK… and now how many have been both?" The number of hands waving at me has always been high and noticeably rising over the past five years–to now being the vast majority.

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    Then I always ask, "Professionals, I know you always had a heart for healthcare or you wouldn’t have picked your career, but now that you have done caregiving personally for your own loved one, would you say you have a much greater understanding and compassion for what families and caregivers go through?" They all nod emphatically and answer yes. Then I ask, "Would you say that caregiving is the hardest thing you have ever done?" I always get an immediate, unanimous and resounding, "YES!"

    So, the newly formed, "Jacqueline Marcell Informal Caregiving Survey" wants to very respectfully suggest to the many professionals designing the new caregiver training (which will affect multi-millions), to please include people on your advisory board who have been both healthcare professionals and family caregivers. I think that will help ensure a realistic user-friendly result that doesn’t get so overdone that those rare individuals who do have a heart for caregiving decide not to apply or drop out, simply because they feel intimidated, uneducated, shy, or afraid they will have to take a test. It would be such a shame if families miss out on the extraordinary care and loving ways of those "Amazing Arianas" out there.

    Learn more about the Caregiving Project for Older Americans:

    You can learn more about Jacqueline and find information about her book at

Published On: April 30, 2007