Hiring 24-hour home care—Any advice?

I would imagine the around the home care would run higher than a nursing home. Having a 24 hour personal caretaker is a lot of money so I get it. You would have to get the right one, but would be worth looking into financially. If you put a lot of money into getting her house disability friendly, then you might loose that investment, and if she is refusing to go to a nursing home, then can she afford in home care 24 hours, or are you doing the paying. I would revisit nursing homes and compare costs. A lawyer for this type of thing, social worker etc might be helpful. I would NEVER post a job like this anywhere. Always go through a reputable agency, and there are many, or go to the nursing home one at a time and ask well thought out questions. Call each facility personally, don't go through agencies-they get a cut and may have that in mind when they are advising you.

When we had a live-in caregiver, we had a baby monitor and chair and bed alarms so that she could hear when my mother-in-law got up.

My mother decided for full time home care and due to her heart failure, the dr also sent daily nurses and PT. She was horrible to them, as horrible as she was to her own children. So I would say assess her "social skills", can she be coopertive?

Is there an option of 4 hours on and 2 hours off to spread out the care givers throughout the day and night ?

My mom is in CA and has Kaiser Health Insurance. They gave me a list of reasonably affordable caregiver organizations. For 24 hour care, they are usually paid by the day and not the hour.

Ultimately, I found my moms 24 hour caregiver by asking around. I managed to find a person who referred the caregiver she had hired for her mom before her mom went into a facility. I hired her and she hired her reliever.

I pay them about 85,000 per year, so comparable to a facility, but mom lives in her home. By Oct 2023, she will have run through her saving and I will have to sell her home to manage her care. I’m definitely not looking forward to moving her.

My mom is 88 years old and has stroke-related dementia. I’m very happy with her caregivers. We’ve been working together for about 2 years and I’m out-of-state.

Pay more than minimum wage.. Look at caregiver sites and word of mouth. Ask for and check references.

Bks105: Since my late elderly mother was on a poverty wage of $1,223/month, she could not afford to pay for any care. A friend of her's worked pro bono until I could arrive there from out of state to care for my mother.

I went through a trusted agency - I wouldn't hire privately. All employees were CNAs. I started with a live-in & added overnight care as it became necessary. A live-in isn't 24-hr care because the caregiver has to sleep, too - & so did I.
I compared the live-in + overnight with an hourly rate schedule (2, 12-hr shifts or 3, 8-hr shifts). It was close, but with the hourly rate schedule, there was no guarantee the day person would be the same every day. And that's a big disadvantage because with a live-in, your mom will get to know & trust the caregiver, who also will provide companionship. That's a big comfort to her. Overnight is different, but you might be able to get one same person long term. You can call it a glorified sitter, but the person is trained to handle most problems.
Yes, it's expensive, but not as expensive as nursing home care. My suggestion would be to try it. If it doesn't work out (I can't see how it can't), you can cancel. I know it's a big decision, but you can't put a price on peace of mind. Good luck!

Seconding what others have said: Don't hire someone privately unless you know them well (or someone you know well knows them well). Even then, if they get sick or need to call out for any reason, you will be the one to have to find a replacement (not to mention the insurance, tax and other considerations). And you just never know what people will do. Several years ago we hired a lovely young woman I found on Craigslist who took wonderful care of my mom for about two months and then one day just up and vanished along with all of her belongings. A few weeks later she sent me an email from Croatia, the home country to which she had permanently returned.

Im not sure about advertising for someone.

perhaps you could save money but how would you know who they are and what theyve REALLY done in the past.

hiring from a home health agency could be the same ... do they actually do background checks ??? But at least maybe theyd be safer ???

I found a very reliable woman for daytime care on care.com. I don't like the idea of advertising as many have said, we had a bad experience. I found a woman by word of mouth from a lady who worked at a nursing home. My mom can't get up alone without falling so we have a bedside commode in her bedroom. We have a baby monitor in the spare bedroom that has a camera so she can hear and see mom just in case she needs something mom can call to her. Usually, she gets mom up once a night and at 7 am. She is there from 8 pm to 7 am and we pay her 260.00/wk.
I also have a Blink camera so I can see mom's bedroom. I can speak through the camera but I never do because it freaks mom out.

I manage a small, boutique Home Healthcare Agency in South Florida so I may be a bit biased, but hopefully, I can provide some insight for you. DON'T HIRE A PRIVATE CAREGIVER!

The most frustrating calls I get are at 6 pm at night when I non-client calls and says, "My aide just called, she can't go to mom's tonight, can you find someone for me?"

Fortunately, many times I can, but my first question is always, "Did you call your agency? Were they able to cover the shift?" Half the time they answer, they just got the answering machine. The other half of the time, they say, "No, it's a private caregiver". Most of the time I win their business, but that's a different conversation.

When you hire a private aide, you hire an aide. When you work with an agency or Nurse Registry you get a scheduler, a manager, a personnel director, an insurance counselor, and a roster of other Aides who can fill in in an emergency, replace an inadequate caregiver, and make sure your mom is getting the care she requires (and you are paying for),

In my agency, we only hire full-time, professional, career Caregivers. We make sure their certifications are up-to-date, references and background checks are spotless and they typically have more than 10 years of experience working in home care (not in an AFL - big difference in the caliber and quality of care the Caregiver will provide). Then we continuously check-in, monitor, and visit the client so we can provide coaching and correction if necessary.

I know that sounds like it must be crazy expensive, right? Well actually, when I compare my hourly rates to websites like care.com, I am usually right in the middle of the price range, and oftentimes much lower than private caregivers. Plus, we take care of all the payroll issues, taxes, and liability concerns.

The moral of the story: Find a great Agency or Nurse Registry, and let them manage the logistics so you can love on your mom and sleep well at night! :-). BRAD

A bedside toilet will prevent a walk during the night...IF...she can manage that without help. A bathroom is the worst place in the house (my opinion) to fall down because usually no carpet to soften a fall and too many unforgiving hard objects.

If you can find someone in the area to stay at night yourself, you can get help much cheaper than via an agency. Around Houston, agency gets about $25 an hour with only about $14 going to the worker. Pros and cons of hiring on your own.

Any relatives that could do it? At least it's someone you know.

I don't blame her. In home care givers can be costly but so is a facility. Personally I'd find someone who can help by word of mouth and not in a business. Good, trustworthy people don't have to come by a one of those Granny Nanny businesses. They don't have to be an experienced CNA either although elder care is nice to find but a good heart is more than enough. Like I said, word of mouth from church, family or friends. Be heavily involved during the care and know what is going on. Like any family should do.

I found a wonderful caretaker by asking an especially nice clerk in our grocery store that I had known over time. I would not advertise except by word of mouth to people I trusted to be thoughtful. These include first of all neighbors or friends that have had a good caregiver. I received one rec from the SNF my MIL had been in. I hired a person from a care agency, after a wonderful recommendation, from a nurse in a medical office who had used them. They were very expensive, but the caretaker was wonderful. The agency always had her check in immediately with them when she came to work.

Our experience with my FIL was that a live-in caregiver was the best option. We found her through word of mouth. Ask your housekeeper or handyman whom you have known for a long time. They have their own networks and are careful of their own reputations. Our arrangement was that the responsibility was 7 nights and 6 days. One day each week the caregiver was free to leave after breakfast and returned at bedtime. (He spent that day at my home or my husband went there.) If the caregiver wanted other time off she was responsible to get a substitute and pay that person. We paid payroll taxes on a portion so the person was accumulating social security quarters. Stopping by every day at different times will give you a good idea what goes on and monitors you view with a smart phone will give you peace of mind.

I did this with my mom, only lasted for a few months. she has early onset dementia. the problem is, she was always roaming around. it is impossible for 1 person to manage that. the poor women barely got any sleep.. as much as I hated to I had to put her in a nursing home. she would fall in the middle of the night, take more med's than she was supposed to had to lock them up,, etc, etc.. the cost was the same for nursing home,, 10k.
these people at the nursing home are great. this is what they are trained to do.. Good Luck!!!

You could move her into your home or you move into her home and rent yours out. What about a bedside commode at night? Is there another family member that can move in with her? What about a member of her church that may need some extra cash to sleep over to assist at night might be cheaper that paid support. Don't forget these are Her golden years try to accommodate her as much as possible or you may feel extra bad once she's no longer with you. Treat her the way you would want someone to care for you if tables were turned.

In your profile, you say mom is 87 and living in Assisted Living. What changed???

What mom 'wants' and reality may be two entirely different things. I would explain to her that she has to pay X amount of dollars, whatever that number is, for CGs to be with her 24/7, after her insurance pays it's share, and that you cannot come in and pinch hit in the early morning & after dinner, sorry. If/when the costs are too high or her money runs out, she'll have no other choice but to move into Assisted Living or Skilled Nursing.

I 'want' to win the lottery and live in Hawaii but the reality is, that's not gonna happen. So I have to make do with what I have, without crucifying my children in the process. That's very important to me and to my husband as well.

Your mother is very lucky that she has insurance to pay the lion's share of her caregiver expenses, so I don't even understand what the problem is? DO NOT make ONE peep about moving her into YOUR home, that would be a huge mistake. She can shell out the $$$ to have the caregivers come into her home for as long as the money lasts and then deal with what happens next when the money runs out or if her health/mobility issues become to great for the in-home caregivers to manage.

I would not be posting ads online for caregivers! You're likely to get all sorts of crackpots showing up and who knows what kind of chaos will ensue?? Again, in order for mother to stay in her own home, certain compromises will HAVE to be made. One of them is that she agrees to spend her money on agency care; otherwise, you may wind up having HUGE messes to clean up when a nutcase is hired! My uncle insisted on hiring someone 'cheaper' from an ad years ago, and this person wound up robbing him blind. His daughter came into his house one day and found this 'caregiver' had packed up HIS suitcases with all the silver and valuables and was moving them into HER CAR! Yeah, you need to hire reputable people who come from agencies who are licensed and bonded. That's the compromise mother.

Good luck!

Bks105, I remember when my Dad had 3 shifts through a caregiver Agency. The 3rd shift person had to STAY AWAKE during that 8 hour shift. The Agency had caregivers that only worked 3rd shift, thus they were use to staying alert during the night time.

Yes, having around the clock care can take a huge bite out of one's savings. I recall my Dad was paying $20k per month, yes per month. Thankfully Dad had saved for those "rainy days".

Dad didn't like paying that much each month. I suggested moving to senior living. He was able to move to the Independent Living section, have a really nice 2 bedroom apartment.... plus weekly housekeeping/linen service, etc. It would cost him $5k per month back then [prices can vary from city to city]. Dad sold his house, so the equity helped pay for the senior facility.

I really would recommend using a caregiver Agency, as they are licensed, insured, and bonded. Putting an ad in the newspaper now a days is very iffy. Or as others had suggested, check with friends/neighbors to see if they know of anyone.

If all she needs at night is someone to supervise her going to the bathroom then you can hire for a 'Sleep Duty' aide. What they do is stay in a home and go to bed. They get up a few times in the night to take a person to the bathroom and check on them.
Sleep Duty aides do not get paid hourly. It's paid by shift time.
This is a private service that many homecare aides do on the side.
Advertise for an aide who's interested in taking a Sleep Duty case. Then list when the hours would be. Most of the ones I know work 11pm-6am then the daytime aide comes in to do the AM care. You can put the hours anyway you like.
Then negotiate the pay directly with the aide. It's not hourly so make sure when you're interviewing that the conversation doesn't start going to asking how much per hour.
The Sleep Duty aides I know get about $70 to $80 a shift depending on what's needed. If it's just bathroom duty it's not that much. If the client is a wanderer and they have to be up all night, it's more.

Do 24 hour split shift.

My Aunt did this for years and was not a trained CNA. If you just need someone to "sleep over" and help in the morning, I think $20 an hour is a little steep if just supervision is needed. But I agree to have it in writing that this is not a live-in situation. That once Mom passes or is placed, employment is done. To add to what PeggySue said, do not allow the person to start moving in personal belongings. Maybe leave her night clothes but no other clothing. Her hours are 11 to 8 or so. When her shift is over, she is to go home.

Well, you do have care in your area, so the cost would be what you are paying plus whatever hours you are adding on. You may cut cost a bit by hiring folks just to be there, assist with bathroom trips at night--not necessarily CNAs or other certified help--, but in all honesty, not a lot. Be certain not to pick up any cost yourself or you will not have money for your own care; we get here faster than can be imagined.
The truth here is that 24/7 care is not affordable for most. Even with assets over one million dollars, the assets will melt away in years. Then what of the decades left.
I understand what our parent "want". We hear that more and more. To which I say "wanting is all well and good, but it doesn't come down at this time to what we want".
You will have to take a good hard look at assets, even if housing is sold for profit, and how long it can last with in home care. I sure do wish you the very best. Hard decisions ahead.

What kind of support does she need when using the bathroom?

Does your mother agree that she needs somebody there at night?

My in laws pay 20 for their night aide, which is 120 percent of minimum wage. They found her through word of mouth.

Put in writing that this is a service contract, not a tenancy agreement. The room she gets should be seen as an caregiver office, ie where extra depends and home care supplies are placed, as opposed to an extension of her home. No mail, no personal pets and no family of hers should be allowed.