How do you hire a caregiver to come in to the home for your loved one when she thinks she can't afford it?

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My mother is now needing 24/7 care for her Alzheimer's. My husband and I have been taking turns staying with her for the past 4 months because she does not want to leave her home. We have been doing it for free, of course, but it is becoming increasingly harder to not be able to go to our own home TOGETHER! We have arranged for my 23 yo daughter to begin spending 5 nights a week with her, but I feel she would need to be compensated. We have agreed that she would be paid $250 a week for 5 nights. My mother says that she can not afford this. (She can). I do have POA, so I would be able to do it, anyway, but I am uncomfortable doing it without her knowing. Also, my sister would be the first to "tell on me" if I did it anyway. Has anyone else encountered this? Any suggestions?

Answers 1 to 9 of 9
Of course you need to be home at the same time your husband is, at least sometimes!

I understand your reluctance to do something "behind your mother's back" -- and that instinct is reinforced by you sister's propensity to "tell." (Although why would your sister know?)

So, for your own peace of mind, tell your mother. But note that is tell her, not ask her. As POA you are charged with acting in her best interests, and it sounds like that is exactly what she is doing. Depending on how rational Mom can be and how much she understands, you might show her the rates from a local home care service, so she can see how reasonable your plan is. You might show her or at least reassure her that she has the money to afford this. But explanations depend on her present state of being able to understand. If she has lost the ability to reason, keep it very simple and emphasize that she can count on you to do the right things for her.

Again, this depends on her level of cognitive impairment, but my sisters and I remind our mother that her money is for her care. What is she saving it for -- her old age? Once when I had this conversation with my mother (trying to get her to buy nice sheets instead of the cheapest in the store) she said, umm ... my casket? And I said, "Mother! You know you want to be cremated and your funeral is already prepaid! You do not need to skimp on sheets to pay for your funeral!" She laughed kind of sheepishly. (She has Mild Cognitive Impairment.) I don't know why elders get so tight with their money and are reluctant to spend it on themselves. But as POA it is your responsibility to see that her money gets spent on her care. It is NOT your responsibility to see that it is saved for inheritances.

Also, start thinking ahead of what will be best for her as her dementia progresses. I can't imagine her granddaughter giving up her evenings and nights indefinitely. Five years from now (or one year from now) she may have a spouse in her life, too. What you are trying to arrange right now might be an excellent short term solution. But Alzheimer's is a long-term problem.

Good luck to all of you! And bless you for taking on the hard decisions.
My mother-in-law isn't rolling in dough, but she has enough money coming in to pay for her asst. living and won't have to get concerned for quite sometime. She used to ask me how her money was doing, since I'm POA. She has dementia also, so can't remember what I tell her, she just wants to know she's ok financially. I used to go into details early in my POAness (new word) about her finances, all the whats and wheres and who's. but soon found out that was useless information to her. And I also learned NOT to tell her how much she's spending for her asst living place. She nearly had a stroke when I first told her the amount, it was catastrophic! So since I've figured out she only wants to know that she's NOT going to run out of money, I say to her when she asks me 'how's my money doing?' "well, you can't go buying a Bentley, but probably a Ford". she laughs, and that seems to be enough. So like Jeanne said, it depends on her mental ability as to how much you tell her. If I were you though, I'd make sure that sister of yours in there when you tell your mom that your daughter is going to start staying with her, and how much she's going to be getting. Also, it wouldn't hurt to find out what the going rate for in-home care would be for a stranger to stay with mom 5 days a week. Sister may need a wake up call on that one.
Thank you both so much for your responses and helpful info! It was very helpful! Wish me luck with my mother AND my sister! :)
jeannegibbs and NancyH really have got good solutions. Hopefully you will get some rest with your daughter staying with your mother until you can figure a longterm solution. Good Luck and God Bless
Top Answer
It's a tricky situation when the parent who taught you how to do the very basic activities of daily life still even when cognitively impaired tells us what to do! We have to stay grounded and know now is our time to be the parent/caregiver in many areas of them. One of my brothers could not conceive of my mother's health issues and did not understand that she was dying. He thought she would live 2-10 more years. I had to understand where he was coming from. I was in the medical field and had taken care of her for years. I was the best judge but he could not hear me so I was just accepting of where he was. She died within 9 months of the terminal diagnosis.
Inact the POA if you have not already done this and then follow the law. Pay yourself and all others who take care of your loved one. Otherwise it will be divided up the way your mother desired. One adult child doing all the work including financial contributions in many areas will not be given any type of reimbursement later so take your fair share now. Protect yourself from your sister. People have their own truth and that is all alot of people can see. Your mother appointed you so take your role and be strong within moral and ethical values of yourself. Cause no harm is the best one I've ever found.
As far as care givers. I used a family friend who owns and runs 7 private care homes within my area. She was nice enough to give me the names of people she would hire next. So in that way they have already been interviewed to work professionally yet I only had them in my home. I think most people can be trusted. My mother would refuse and tell me outright that she did not want someone strange coming into her home. And I would gently nod my head yes I understand however I need a break and this is how its going to be.
The local alzheimers association may have a list of care providers or any day treatment providers. When we overcome our own fear of displeasing our mothers then we know what we must do to take care of us. Have several and back ups if needed. You will be able to love your mom to your fullest if you love yourself first! So don't give yourself more than you can handle!
Good luck with it all and flow with it...Donna
This is the time to be firm and let her know how it is going to be 250 dollars in not a lot of money for 10-12 hours five night a week aides get 20 or so an hour where I live and more with an agency let her know it's that or a nursing home where help is not aways available at the NH my husband was in rehab you did not get help the first 45 min. into the shift or the 45 min at the end of the shift at the biginning they were getting the report and passing out linen and at the end they were getting readyto catach the buss and at noon for an hour they were feeding residents then was thier meal time and two 10 min breaks during their shift and it cost 450 dollars a day.
If Sis has a problem with payment, then she can stay the night shift. Given that choice or paying your daughter the $250 - I imagine she will bo OK with $250. Also, show her cost for a pro to sit with Mom ($20++) in this area. You need to find someone besides family, too. I agree Mom's money is to be spent on her. Just keep records of all and pay necessary payroll taxes. At the end, you will receive no reimbursement, so take care of it now. Usually one's who do the least (or nothing) are first in line to get "their share".
Of course she doesn't want to leave her home. It's her comfort zone. She feels herself slipping out of control and wants to hold on to as much of it as she can.

I'm glad your husband is willing to do "split shifts" with you. But, you're right, it's killing your marriage. You married him "for better or worse" and he married you -- not your mother. The two of you deserve time together where you talk about something other than mom. My suggestion is "date night" twice a month.

At 23, your daughter is still wildly generous with her time. However, you want her life to expand; not contract. Be sure she is paid! And be sure she has days off that are really "off" - she needs to fill them with other things; not sit empty waiting to be filled by people who want her to do "care giver things" like going to the pharamacy or following up on doctor's suggestions for treatments.

Depending on her life experience (Great Depression, WWII, childhood poverty, childhood insecurity) your mom may have "good reasons" to be worried about how far the money will go. Reassuance without details is usually best. Look at it this way: if there really was a problem, she wouldn't be able to help. So, just keep her in comfort as best you can and keep the reassurance coming.

Don't allow yourself to be consumed by her care. It's so easy to get sucked in to doing one more thing until you're "one more thinged" right out of your mind. Take a deep breath and call a "family meeting" with your nuclear family (just you, your husband, and your daughter) in a place where you can discuss what your lives to look like AM (after Mom) and then take steps to see that you can each get there.
Since she can aford it and live in help would be very expensive it is not her choice if she wants to be at home or a NH would take all of her money right off the bat so it is her choice losing everything to be in a room with another person and not get good care or her choice of meals or do what you think is best for her-if she wants to give all her assests to a nursing home with limited visiting hours and maybe substandard care she will have to abide with that answer-a family meeting is the thing to do-there comes a time when you need to take a stand-our elders never had to deal with this because people did not live into their 90's and need care like it is at this time.

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