I spent years considering how a paid caregiver spends her day in a client’s home. They carefully follows our agency’s care plan: preparing and serving meals, assisting with a bath and dressing, accompanying the client out for a walk or shopping or going to an appointment, doing laundry, keeping the environment clean and neat, reminding the client to take her medications as the doctor ordered. The day goes by accomplishing these basic and very important tasks. But I felt that something was missing – a richer, more meaningful interaction between the caregiver and the client – something beyond accomplishing the tasks in the care plan.