I have been caring for my Mom in her home for the last 3 years. I can see that she will need more attention in the near future. Long-term care facilities really to not meet her needs...and even the best institutions do not offer customized care (even though they are charging "customized" prices.) I feel that if we hired our own caregivers we would have more control over and be able to monitor the quality of care. I know it would be expensive, but I figure that the average nursing home in our area costs $8000./mo. Seems like that would buy a lot more "personalized" care.
So I am wondering if anyone has tried using solely in-home care either in your parent's home or your own home. What are the pros and cons?
Other pointers I'd give are -
* Be prepared to have to hire and let go of a number of people. It's hard into is finding good, reliable aides, whose personality will mesh into your household. You should look for someone who loves the elderly and understands your mother's health issues. Some people expect to just "sit" with the elder, or "sleep" while Mom sleeps. The problem is that she doesn't sleep all night or for long periods of time, and she wants to get out of bed and look around the house!
* Give them a specific set of duties from the start.
* Make sure that you are very clear about the rate of pay, date of pay, and anything that could cause their pay to be docked.
* Be sure that you have several people you can call if the aide gets sick or calls off for an emergency.
* Be prepared to lose some privacy. It was difficult for me to adjust having people in the house all the time. Never leave valuables around, or anything that you don't want others to see.
I hope that this helps some.
I recently got a little taste of what an institution would be like if Mom ever need one. She went to rehab for 2 weeks - but I found that I was going out there nearly every day for one thing or another. As others have mentioned about facilities: there is absolutely no privacy...doors are left wide open and really anyone from the outside could walk right in. They put her in adult diapers..."just in case." This was a highly rated facility and overall I thought she received good care, but I know that it would make me sad seeing her "cooped up" in one room all day, waiting for someone to come and get her - such a loss of dignity. The staff members were great for the most part, but mistakes were made and I am glad that I was over there a lot.
I began to think that in-home care offers more individualized care, even though you are paying out of pocket for the services. I realize that it takes a great deal of time and planning, but it can't be worse than running over to the rehab all the time. And I worried about her every minute she was there.
So, when the time comes, I am going to try in-home care. With everyone's help here, I hope I can figure things out. thanks again...Lilli
In a facility there is around the clock care, activities appropriate for those with dementia, others in similar situations and conditions, 3 full meals a day, laundry is done weekly and as needed, a nurse on-site at least 40 hours a week and on-call 24/7, and more. There are generally 2 caregivers and 1 medication aide for each shift. The number of employees working each shift can depend on the facility and if they accept Medicaide residents. All the above and more can relieve a great deal of stress for the family member caring for their loved one.
To be able to decide which situation is best for your Mom or Dad you really need to write down the pros and cons of each situation.
Thanks for posting the link about care facilities.
I was dumbfounded by the lack of "advertised care" where my father lived. He was OK since I was nearby ~ yet their advertising indicated much more "care" than other residents received.
Of course it is all the individual patients & employees, some were great - others dropped the ball big time.
The scary thing is that corporate didn't seem concerned about the low paid employees who didn't provide decent care.
After too many incidents with others as well as my father, I moved him home with me. I know he is safe & cared for here.
Much loved too!
Looking into visiting care givers now so I can have a break now & then.
You raise a good question about insurance. I spoke with an agency which "trains" their people & does back ground checks. I should have asked about insurance, but early on I realized we couldn't afford the fee.
I look forward to learning more from this thread!
I'll say that there are good facilities and that it is an option for those who need it, etc., but our healthcare system is kind of a racket these days.
That's my rant for this morning!
195Austin: Nanny cam is an excellent idea...I saw them in a magazine and it looks like you can monitor activity on your computer. If Mom ever needs round the clock care, that will be my first investment.
rip: All these places look good on paper...or even when you visit them. But it would break my heart of Mom was injured, neglected, or abused in one of these facilities. And I agree, there will be tremedous profit in the future as the entire baby boomer population needs care. I also think that the boomers (of which I am a latter member) were responsible for ushering in this philosophy of "not me" when it came to caring for our parents. Now, what they sow they will reap.
Sskape: what is it with the guys. Recently, I have had two male cousins place their parents in nursing homes who were no where near ready for one. These were once vibrant members of the Greatest Generation. Now, they are wasting away in NHs. One cousin claimed his father had Alz. and the doc gladly obliged with a diagnosis. (everyone who visits him says that his mind is as sharp as a tack.) The other cousin claimed dementia too - come to find out that his Mom is being sedated and was hallucinating. When she got to the NH she quietly stopped taking the meds and is now just fine. But their fate is sealed while their darling children fight over their properties. Breaks my heart in a million ways. Out of my huge extended family of many cousins I and one other cousin are the only ones who have cared for their parents directly. We were not raised this way. My grandparents were all cared for at home...but I have to admit they did not have severe ailments...just died peacefully in their sleep...a blessing.
I had good luck with an agency called Visiting Angels. I found it by asking the hospital's social worker. It is a franchise, so I am sure it is only as good as its local management. The owner came out to meet Mom, assess her needs, and actually brought the caregiver over to meet Mom. They call me once and awhile to see how things are going. If the customer has 24/7 care...they come out to evaluate the caregivers on a bi-weekly basis. Also, Mom had a great Medicare caregiver. So after her time was up, we hired her privately. Nice to have two.
Again, thank you all for the info. This forum is the only place where I can not only find answers, but peace of mind......Lilli
Two of my aunts were kept at home and hand round the clock health care givers in their home. It worked very well. It may take you some time to find the right person but it was the best situation for my aunts.
Good luck.
Good luck on your journey into caregiving~
Hap
I have interviewed over 25 women and called probably 100 over the years and learned interesting things. Most are shocked thats it only ONE person to get ready, which they love. They tell me in the nursing homes they had 8-14 people to get up, washed and to breakfast between 5-7am ! You need to make a list of exactly what the home caretaker is to do, dishes, laundry, read to your Mom, have her roll up yarn, etc...... depending on your moms health. I have girls who unload dishes, fold laundry and sweep if Moms still asleep. I also had one that sat and text'd her friends and did nothing. The woman you have work on their own, you pay them with a check, and then they pay their own taxes on it, you dont have to do anything legal as far as I know, as they work for themselves. I tell them up front, clean background check, drivers liscense, proof of care insurance if driving your Mom, aclean driving record , and pay your own taxes, never had a problem.
Best of luck, write if you have any more questions.
I strongly suggest you do all possible to try to keep mom at home. I left my job after 22 years with AT&T to take care of my mother. Was the best three years I have had in life. I had to place her in a rehab facility for A few weeks to gain strength after a brief illness. After three weeks of being there all day, I would leave at night, and lone and behold they KILLED her one night by placing her in bed on her side at the EDGE of the bed. Really, who in their right mind would put someone to bed that way?? Staff is overworked and under paid; rushing to get to the next patient caused my mother her life! I did have home care while I was still working and the lady was awesome. She became part of the family and loved my mother as well as she took "care" of me. My one suggestion is to please take care of you! Even when I hired help or Mom was in rehab I was home and never took a break. My health suffered greatly and took a major toll after she passed. I have now taken a job in a Home Health company to fight for other seniors and help inform other care givers that there is help, and they are not alone in the care giving process.
PLEASE take care of yourself and think through decisions before making them. Hope my story helps you to make the best decision for you and your mother. Prayers and hugs coming your way. Bridget W
The paid caregivers were much better and more reliable. Mom tends to like older female caregivers and they have been lovely with her. They do not come too often, so I do not have to keep watch over them. I do, however, keep all her valuables at my home as to keep temptation away...ya' just never know. The hardest thing is to remind Mom that these people are there to help her...they are not family or friends. I keep telling her to not share personal family or financial information with them. You do need to be vigilent. When Mom was still living in her home state, she had someone just walk right into her apt. claiming to be an aide sent from Medicare. She went into my Mom's bedroom then asked to use the bathroom...of course, she was looking for drugs. Apparently, these creeps follow the cars and vans of the real medical workers and PTs so they can see which seniors are getting care...then they pretend to work for those companies. That's when I moved her to be near us.
Thanks again for all the very useful advice and encouragement. I know that it some cases loved ones need ALFs or NHs, but, in my heart, I just can't see my Mom in one. I just pray for the wisdom and knowledge to help her through this stage in her life. This forum has been a Godsend for me....Lilli
What happened was that mom started having panic/anxiety attacks at the thought of being alone.. We were spending $4,000+ per month for aides (they cost more on weekends)and I still spent a lot of time and emotions taking care of her---with minimal help from my sibs.
The ALF she is now in costs $7,000+ per month (her RX'S are extra as well as hair apppointments, DEPENDS, and other toiletry items). The ALF has agreed to keep mom when her money runs out. She can afford to self-pay for 2-3 years and then she is guaranteed to be allowed to move into the nursing home facility when the time comes and they will help us apply for Medicaid. The advantage of doing this is that we don't have to worry about mom running out of money and trying to find a nursing home facility that is really nice. I shudder at the stories about homes with bed sores, un-needed restraints, etc.
and I was afraid that might happen if we didn't have enough money to get her into a well respected facility. I felt that we weren't "building equity" toward her future care by relying on home aides. I am able to stop by and visit her 3-4 times a week b/c I work only 5 minutes away but she has plenty of support whenI'm not there---BINGO, music, "field trips," movies, etc. as well as 3 meals and snacks a day.
Anyway, this is just my take on home-care vs an ALF or nursing home . (I prefer the term "nursing center!).
Good luck on whatever you decide is best for your circumstances. Mom's dementia is in the early stages but I am already stressed out some days and the ALF gives me a respite.
Three times. The 1st woman who came was very good ... at gossip. She sucked at caregiving, but my mother adored her. What's that saying? "Birds of a feather ..."
The 2nd had a forever-drunken, jealous husband she never told us about. She had to go.
The 3rd, an openly-gay young man of about 26 she met while working at St. Barnabas Hosp., referred to himself as a too fierce, finger-snapping, fabulous for just one man. He's the one who gave my mother that Hooker Barbie outfit that makes her so alluring. The downside of it all was that obsessive compulsive need to to keep the house antiseptic. I told him many times he only had to service my mother, but next thing I knew he was doing my laundry, ironing my underwear and then folding it neatly. My boys adored the guy because he made them laugh and kept them well fed at all times, plus he was on call in case "my mother" needed anything. ... Like some Marylin Monroe pictures I found on my walls, followed by a huge antique dresser "for her bedroom." I picked the lock and found his clothes and a small suitcase containing a travel kit, iron, colognes, a couple of Blue Boy mags, and a pair of stiletto heels. A mix between Donna Reed and Betty Crocker, he cooked up a storm and my kids were well fed all the time. I asked him once if he was planning to move in, and suddenly he started talking about where "our" relationship was headed. To make a long story short, he had to leave. My mother was so overwrought, she barked at me and said he was the best "girlfriend" she ever had. From what I still hear, they still keep in touch and watch novelas together at his apartment two blocks away from hers. ... Whatever makes her happy.
This is my experience with in-home caregivers. You know what? I recommend it. But check those references!
That was a funny story about your Mom's caregiver who dressed her up like a hooker barbie. We had one for my Mom who loved getting her all done up, hair jewlry, nails, etc.She always wore high heels and I couldn't fathom how she didn't break her neck while showering my mom. Not a guy though. At least you had an admirer!
Since my brother and sisters were adamant that I was being reckless and putting my parents in danger, I contacted our local VNA to find a geriatric case manager that could advise me on the safety issues and if it would be too risky to keep them home under the care of private caregivers.
Then I asked our local Aging office if they had information about how to hire in home caregivers. Fortunately they had a list of individuals who were willing to be part time or full time caregivers. Since I recruit and train volunteers at work, I applied that sense of professionalism to the process of finding the right caregiver for my folks.
In our case, we have had 2 long term caregivers that have been exceptional in every way. I made it clear to each of them that the caregiving position was as an independent contractor. In that way, they are responsible for their own taxes and we just make sure to give them their 1099 on time so they can file.
The positive side of living at home for my folks is that they still maintain some control over their own lives. I have gotten to know my parents as an adult .
I have a feeling some people feel like our parents would be safer in a home. That's just not the case --- my poor Aunt fell and sustained broken bones while living at a facility. It's not difficult to understand the research findings that conclude the elderly who live at home live longer.
Of course the downside is that caregiving sometimes swallows you up. Actually it's the people on this website that have taught me about boundaries and this support has made such a tremendous difference. I had no idea how similar many of your experiences have been to mine.