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We live in a remote rural area and we have been offered 3 hrs a week of a home health aide. We tried it before and it didn't work because dad needs a companion to socialize and to protect him from memory problems. Home health aides are more for specific medical or hygiene needs. The time spent scheduling an aide without meeting them to see if dad will be able to talk to him, the time spent isn't worth having someone who may not be any help. What is needed is someone who will come less often for a longer time. The last one we ended up helping him more than vice versa. How can we decline this while still maintaining the very real need we have for dad's caregiver to get some time off AND dad to talk to someone besides just his caregiver? I think the only option of choice is to hire someone out of pocket. We are in NJ and he needs aide and attendance I guess but don't have it yet.

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If your dad's caregiver needs time off then that is the priority in my opinion, not dad's need for a companion. Even if this aide is nothing more than a responsible presence in the home so the caregiver can get out it is well worth keeping them. Depending on your needs/schedule they can help with bathing, meal prep, light housekeeping, any little thing to make the caregiver's life easier.

Dad's need for a companion is a separate issue and should be addressed as something in addition to the aide. Is adult daycare available in your area, even once or twice a week? Some volunteer groups provide visiting companions, have you asked about that possibility? You don't say what your dad's needs are, but perhaps you should start planning for the long term and looking at his relocating to an independent living or assisted living situation where he would not be so isolated and would be able to socialize with his peers. I personally wish I had insisted that my mother make the move instead of allowing her to remain isolated on her own, I'm sure she would have been much happier and less lonely.
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Cwillie, I've read your responses here and are always dead on. I appreciate your taking the time. In this case, the caregiver doesn't want the 3 hrs of aide, it won't give him enough if s break. The break needed for him is psychological, dads physical needs are slight. Hess depressed always needs redirection from obsessive behaviors and needs to be directed towards realistic conversations about current life instead reinventing the topics he can't change (how his wife died, who is kids are that he can't remember). How to use the tv, why he can't have wine at 20 in the morning. Showers and dressing are the easy parts. Scheduling a male home aide for 3 hours and thinking of something for them to do is just one more chore he says. The other wrinkle is he's got a privacy issue (the caregiver not my dad) and doesn't like strangers in the teeny tiny house. He's visited the adult day care a half hr from here and says it's dismsl, dad would never enjoy it. I am at a loss how to deal with them living so far away from decent services. Taking him to live with me on the other coast would deprive him of two close family members. Will keep writing and thinking until we figure it out. Meantime FF miles are running out.
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Unless you are truly way back in the boonies a 3 hour break is more than enough to get out of the house and recharge. Even when I had only 2 hours and had to dash 1/2 hour away to the store for my mom it was doable and a real boon.
The fact that the caregiver is resistant to help seems to be the real problem, and one that will be hard to surmount. I expect that no matter what solution you come up with they will find fault with it. There are no perfect solutions and we have to be willing to work with what we have, if the caregiver would prefer to play the martyr it becomes very difficult.
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