I also went through an agency to provide some companion care to Dad after his stroke for a few hours a few days a week. They provided an 18 year old who read a book while he watched TV. Then they told me it might not be the same person every time and they wouldn't necessarily be able to tell me who it would be. They would just show up. (My father has dementia and would not know why a stranger is coming to his door.) They also said it was possible they might not be able to back fill an appointment. But they required 48 hours notice if we had to cancel, a minimal commitment to 2 hours/time and so many hours per week, pre-payment and they charged a hefty fee of $25/hr. That was about 5 years ago. I was lucky to hire a dependable friend and now we are looking at AL. I also worked for a client in a group home once. Staff turnover for that group home was rampant.

One factor, will the elder allow a stranger in the house to help out as a caregiver? That was a major stumbling block with my Mom who refused any help in the home, not even a cleaning crew.

Once my Mom [late 90's] was moved to long-term-care, my Dad [mid-90's] was more than happy to let the caregivers comes in. The poor man couldn't even figure out how to make a sandwich or even turn on the washing machine, those were things that only my Mom did for the 70+ years and he better not touch that washer or even mess with anything in the refrigerator !! And at his age, it's too late to cross-train.

Dad did have sticker shock regarding the caregivers cost. Since he needed 24-hour care being a fall risk, his bill was around $20k per month. Eventually Dad said he could stay the night on his own once a caregiver got him safely tucked in bed at night, so that helped save some money. I was so lucky my parents saved for those "rainy days" as it was now "storming".

Two weeks after my Mom passed, my Dad said he was ready to move to senior living as his house was just too much for him, all those stairs. You think??? Yet he didn't like the idea of paying $8k a month for rent and morning caregivers at the senior living facility, but I reminded him it was much better than $20k a month at home.

Is bed-bound care Homecare or Skilled care?

Are bed-bound diaper and sheet changes home healthcare or Homecare or both?

Home health care also has a right to report you if you cancel your relatives appointments and the relative does not cancel them. Before entering into any home health care agreement please read the privacy practices and even do a more extensive background check than the agencies themselves have done. If the nurses CNA's or APS can find a way to take belongings that are not of much worth but they can sell them and get charge of your relatives living will they will do so. If you enter into an agreement and not let them into the house they can use that as passive neglect when you are taking care of your relative. They can also try to alienate heirs in the will or POA by telling you not to speak to them on certain matters or tell you that the POA is working with APS when it is one of them working with APS. You could get called on by APS just for leaving to go to the gym up the street if there is no one in the house but your relative says that they are fine to be left along. When home health care arrives the first day safety in numbers. These people want what belongs to you your belongings and they are ruthless enough to become POA if need be to get it. So, don't sign anything until a lawyer sees it first. If there is a portfolio with records that stays in the house make sure it stays in the house. Some nurses tend to take it a bit far and say I have to take this (Portfolio) the patients record don't let them take it. Have a police officer present if they try to fling mud or accusations against you. Just whatever you do don't let them take the folder. Nurses can doctor records up to make it seem like they were not there when they were. If your relative is sick or ill the morning of their care tell them to call in not yourself you could get into trouble for that and get possibly charged or worse.

Good article, but people need to remember that Medicare and Medicaid won't pay for everything. Medicaid will pay for long term home care, but will determine the amount of home care a person will receive. It took 7 months for long term home care to kick in, and I was left taking care of my mother by myself. Since I was taking her home from a nursing home as they said my mother was unable to be weaned off her ventilator, I was trained on how to monitor her ventilator and suction her. I also had access to the company that provided the machine. Also Medicaid is very stingy with the supplies you may need in the home. As my mother is incontinent, she needs diapers, wipes and gloves. I receive 1 box of gloves a month, no wipes are provided and the diapers gave her an infection. I buy a better brand of diapers, and Target has great adult wipes for a cheap price. I also buy Balmex to avoid broken skin and infections. Medicare will pay for the hospital equipment, but it's not as user friendly as what is at the hospital or nursing home. Also, if you need physical therapy services, there is a limit on how many sessions you can receive, under Medicare and Medicaid. I work with a long term home care agency, and I have to fight for everything. It took 2 months to obtain a wheelchair for my mother. Even if you are entitled to short or long term home care, based on your parent's financial situation, it can take months for home care to kick in, so anything not covered prior to the date of coverage will be your responsibility. You will also end up paying for some supplies out of your own pocket. As I have been told several times, due to people abusing the Medicare/Medicaid system, the rules have been changed so in the end the people who really need the services are penalized.

Dad is almost 95, lives alone and for the most part does well alone. My concern and his doctor's concern was his diet and his hygiene. He doesn't drive and his diet consists of cereal, milk, a banana and coffee cake for breakfast, He takes his 4 daily pills with his breakfast. No real lunch, but he goes through Nestle Crunch bars and Pepsi like you wouldn't believe and dinner is always a deli bought container of tuna fish and sweet green relish that he puts on white bread. Throw a cookie in for dessert and that's his meal plan for the day. He does not cook, never did, and does not shower. He changes clothes every few days, but he doesn't have a washer/dryer in the house and I question how his underwear is getting washed. He tells me he washes it in the sink. Not so. I am all he has. It's me who goes to the store, the bank and pays his bills and have been taking him for a ride several days a week. I'm not young, I'll be 72 soon and have bad knees, shoulders and neck. The doctor recommended home health care which I put off until recently. I'll be moving soon, about 35 minutes away. I can come to help him 1, maybe 2 days a week. I looked into home health care and found a company owned by a local doctor and his family. Due to the name, I chose them. They came to the house to see dad, walked around and said that 3 hours a day 2 days a week would be a good start. Dad has dementia,but it's mostly his memory that is the problem. It was set up for "George" to come out. He would be a "perfect fit" for dad. So, I start telling dad George will be coming on Tuesday and Friday from 11 to 3 to help him. He will take him to the store, for a haircut, etc. Monday night I get a call that George's schedule won't permit him to come, so they were giving the case to Ryan. Ryan would be a "perfect fit" for dad. So, Monday night I tell dad Ryan will be coming tomorrow at 11 to help him. Evidently he kept telling Ryan that he could go home, he didn't need help. Then he started me asking if I'm coming to take him for a ride. No, you have Ryan there to help you. Let me speak to Ryan. Ryan offered to take him to the grocery store but dad told him that his daughter would come do it. No, I am not coming, Ryan will take you. This went on for an hour. Finally Ryan took him to the store. They come back and he tells Ryan he can go now. I have to call to tell him that Ryan will be there until 2 PM. We get through Tuesday. I talked to the agency and all in all they said it went well for the first time. Ryan was due back Friday. I get a call Thurs night that Ryan will be coming around 12;30 and it would be his last day. He didn't feel that dad wanted him there. I asked why. They told me all in all it went well the first day. Ryan got a full time job. At first they told me Ryan had a full time job and that the 6 hours spent with my dad each week was just extra money for him. Ok, now we're sending Amber on Tuesday. We think she will be a "good fit" for dad. I'm preaching Ryan to dad, how he's going to help him etc, now I have to tell him no more Ryan, now Amber. After thinking about this, I decided to terminate my association with this agency. Dad needs stability in his schedule, that's what keeps him going. Now I'm looking into another agency. Am I wrong to expect 1 caregiver for at least a few months?