Has anyone hired an RN for home care?

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A question has been floating around in my head since my husband came home from Memory Care. I am thinking ahead so that I know what my options are. Has anyone hired an RN to care for your loved one at home? Did you go thru an agency? How much?

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You (usually) don't need an RN or an LPN/LVN for caring for someone with dementia. Caregivers have enough training to handle almost all the problems of a person with Alzheimer's (feeding, bathing, dressing, walking, etc.).

You're going to spend a lot of money if you hire a nurse (RN/LPN/LVN).

Why would you need such an advanced level of care for your husband? Does he have dressing changes, insulin shots, feeding tube, colostomy, or some other advanced medical problem?
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Be prepared to pay significantly more for an LPN and even more for an RN. I was shocked at the rates charged by an agency I planned to hire. It's getting close to my bedtime now, but tomorrow after returning from the SNF I'll look up some of the rates and post again.

I was quoted anywhere from $19 to $26/hour, but learned when I was ready to hire that that was only for nonskilled people. Medically skilled staff are billed at a higher rate. The agencies don't always tell you that!

The agency that I considered hiring had alternate rates - $x per hour, for a minimum of 3 or 4 hours (I don't remember right now), or a much higher rate for just one hour.

Perhaps the biggest surprise was that I specifically wanted someone, either an aide, CNA, LPN or RN, for pureeing food for a dysphagia diet. Although I spoke with 3 different people at different levels in the agency I was considering, and over a period of 3 -4 months, and was advised that dysphagia management wasn't a problem, when the actual interview and assessment was held, I was advised by the nurse interviewer that SHE felt dysphagia diet management was too much liability and they wouldn't participate in anything related to it. And before I was told that, I was ready to hire them.

Then the agency I did hire (a well known international franchise agency) sent someone who claimed until it came right down to the wire that she knew how to puree for a dysphagia diet. When I got out the food and food processor, she said she knew that the kitchen staff did the pureeing. She didn't know herself. Yet she represented to me when she first arrived that she know how to. I don't like liars.

So make a list of your husband's conditions and ask about each potential candidate's experience with that condition. I learned now to ask not if they knew how, but rather what kind of experience and how much of it had they had.

I also prepared a work scope with a list of activities to be performed. At the assessment with the liability conscious nurse, almost all of the proposed activities were eliminated, or kicked into a category that ran significantly higher than the mid 20's rate.
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Worriedspouse, I used a caregiving agency who had interviewed me and toured my Dad's home prior to me signing up with the agency. They would send out caregivers, usually not RN's as that would be quite expensive, but experienced caregivers. Dad was paying $30/hour for the caregivers. Cost depends on what is the going rate in your area.

Dad and I were quite pleased with the caregivers. Eventually Dad choose one that he really liked and she was helping Dad for over a year. For the weekend, Dad choose another one that he really liked, also over a year.   Kinda like handing out a "rose" :)

Matching personalities was a big help. Both caregivers had similar family background and the same sense of humor :) Gave Dad and the caregivers a lot to talk about.

Eventually my Dad needed around the clock care which I couldn't do since I was a senior myself. Having caregivers around the clock was costing Dad $20k per month, yes per month. Dad decided to move to senior care where it was around $6k per month, even Memory Care. Dad went into Memory Care at the right time where he was still able to learn the floorplan of the complex, know the Staff, etc.
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I think an RN is unwarranted. A CNA is good for feeding bathing, etc but I don't think they can give meds or shots unless a Medtech. Now u come to an LPN. In some states they are allowed to give shots and are experienced in catheters, feeding tubes, etc. They r also trained in the same responsibility an CNA is. Here in NJ anyway. RNs are not trained in the responsibility a CNA is. They are usually in Administration or head nurses. Now remember I said here in NJ. My daughter has gone thru both LPN and RN training. It may be different in other states.

So it will come down to what kind of care will he need. An CNA at $20, an LPN at $30 or an RN at $40 an hr.
Just curious, if in Memory Care why did u choose to bring him home? He will only need more and more care as time goes on.
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My niece worked as a caregiver during Nursing School. Her rate was $20/hour [suggested rate by Wife of patient] and she posted an ad on Care.com. She had a lot of experience [CNA for Cardiologist, part time caregiver for grandfather, and former teacher]. Her patient had a stroke, feeding tube, was in bed for several hours per day but with help and a hoist, could transfer to a wheel chair. She was also allowed to study/do research on laptop while he slept. It worked out great for all involved until her graduation.
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HoildayEnd - I'm curious: How much did you charge per hour? What's the going rate?
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Unless an RN is retired and dabbling in home care to fill the time or earn a little extra they are going to demand a much higher level of pay than a CNA.
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I am a retired RN and after retiring from hospital working I sat ‘caregave’ for a few people’s LOs. It was a ‘casual’ arrangement since I knew the people and they knew me.
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Oh i am not asking for now. I am asking for later when his condition gets worse.
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What level of care does she need?? Does it require an RN?
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