How do I hire in home help for an overnight shift?

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This is my first post. I found the site by accident and it has really enlightened me reading so many posts and knowing I am not alone. My grandfather is 94 years old, and lives with myself, my husband and my two teenage sons. Five years ago, he moved in with us when my grandmother passed away. The first four years were great he was almost self-sufficient. Six months ago, he began rapidly becoming confused. He drove off in his car and was lost for a day, he walked out the back door of our house fell and hit his head on the brick wall and began to become extremely confused. He was hospitalized and we found out he has Alzheimer’s and dementia. We have gone thru in patient rehab; home therapy and hospital stays since then. We have hired a full-time care taker for days 9-5 while we are at work and school. This helps a lot but he has rapidly declined in health and now cannot even stand up without assistance. Allot of times it is dead weight. Nights have become the worst now. Every 1/2 hour he is calling for someone to help him up. He cannot sleep, his neck hurts or he must go to the bathroom. Myself and my family are burnt out completely. No one is sleeping and this is only been a month of this happening. We are already spending 3400 month for daytime help and I don’t think we can afford to pay that for nights also. Has anyone had to deal with a loved one not sleeping and constant movement at night? How did you solve the problem? I don’t have an extra bedroom for a live-in care taker. So, I am lost at what to do. Not to mention we are all burnt out. It is even harder because the next day he does not remember what happened overnight. His short-term memory is shot. I am 49 years old and I can no longer get him up alone, I must wake up someone to help me. He is like dead weight at night. I don’t want to put him in a nursing home I feel like he does not have much longer to live based on the rapid progression of his health. But at the same time, we have no life anymore. After work is all dedicated to his care now and bedtime has become crazy. Just looking for some insight to how other people have handled this type of problem -- Alzheimer’s -- Dementia -- No mobility –
When my grandmother passed away she asked me to care for him, I now know she knew he had Alzheimer’s and never told us. His doctor told me six months ago, that he was diagnosed ten years ago, with early onset of the disease. Now I feel responsible to care for him and I want to make sure he is cared for but I need a life also. What is the best way to handle this? What is it like to have a live-in care taker? Do I divide the day to more shifts? Is there anywhere to get help financially to pay for services?


I am sorry for all the questions but as I said in the beginning this is my first time reaching out to others for guidance or help. Thanks, in advance for reading or replying. Hope you all have a wonderful day!

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The sleeping pill scenario would not have worked for my mother, who had an extremely odd sleep cycle and was up at all hours of the night. No sleeping pill ever worked on her. They would give them to her, she would sleep 2-3 hours and pop back up like a jack in the box. Medicare nor Medicaid would pay for any overnight help, not even with a Medicaid waiver that was meant to pay for services to keep her out of a nursing home and in her own home. The only option was to pay for the services myself (not possible) or get up with her myself all night long. That was part of the decision that led to her being in a NH - she started falling more often and at her size, I couldn't lift her on my own. And I had to sleep at some point. She was on 24/7 oxygen too, so tripping over the hose was a real risk.
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Fall risks definitely increase with many traditional sleep meds and is a reason I often see mentioned on the forum that docs and caregivers to refuse them. It takes a doctor skilled in weighing the pros and cons of various meds and in dementia care to prescribe something that may work without causing too many unwanted side effects.
Mirtazapine (remeron), is not a sleep aid at all, it is an anti depressant that has bonus side effects. For my mom it helped her anxiety and seemed to help her feel more her old self during the day and also helped her to sleep through the night. It also is said to increase appetite, which is a bonus side effect for us.
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For cwillie and suggestion of sleeping medication -- that sounds like a good idea but how do you balance the risk of trying to get up and falling OR for an elderly person that walks, are there safety concerns about them getting up and falling if medicated or sedated?
If my mother (96) with early dementia gets into her worry mode she walks the hall and creeps around all night. I have a motion sensor installed and last night she walked up and down the hall 15 times based on the recording of motion. My sister suggested sleeping meds but I am concerned about fall risk. Also she navigates the stairs OK alone but as she sleeps upstairs, concerned re: falling.
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The cheapest, easiest option is medication to help him sleep at night. My mom was greatly helped by mirtazapine, it also made her more herself when she was awake. Of course what works for one may not work for another, the docs may need to experiment a little to determine what works best for him.
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Was he a WWII veteran? If so and he has few assets and his income won't be enough to pay caregivers, apply for Aid and Attendance from the VA.
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Rinky, my Dad needed around the clock caregivers as he was living alone and was a major fall risk. So I hired a licensed Agency to schedule all 3 shifts for which Dad paid. With this Agency, the over-night caregiver has to remain awake the whole time, she/he didn't need to be in the same room with Dad, but close enough to hear him getting up. It worked out quit well.

Then my Dad decided he wanted to sell his house and move to senior living. He was there almost a year, mostly in Independent Living but once his dementia started to show more and he was falling more, he was moved to Assisted Living/Memory Care. The cost was much less than having around the clock caregivers. Memory Care was around $6k-7k per month.

At Memory Care, an Aide could get Dad up in the morning, shower, dressed, and point him to the direction of the dining room. The Aide would check on Dad around once an hour, and help him with bathroom issues. He really felt so safe there, plus being around other fellows of his generation.

As for finance help, none unless your Grandfather can apply and be accepted by Medicaid. Medicaid would pay for continuing care at a facility. Medicaid would use Grandfather's social security and any pension he might have. If Grandfather is a Veteran, check on benefits.
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