Has anyone tried using in-home caregivers instead of placing their parent in a facility?


I have been caring for my Mom in her home for the last 3 years. I can see that she will need more attention in the near future. Long-term care facilities really to not meet her needs...and even the best institutions do not offer customized care (even though they are charging "customized" prices.) I feel that if we hired our own caregivers we would have more control over and be able to monitor the quality of care. I know it would be expensive, but I figure that the average nursing home in our area costs $8000./mo. Seems like that would buy a lot more "personalized" care.

So I am wondering if anyone has tried using solely in-home care either in your parent's home or your own home. What are the pros and cons?

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We use in-home caregivers for my mother who is 90 and has advanced dementia. We spend a great deal of our income on having someone come in at nights to work a 10 hour shift, 7 days a week. I work and my daughter who lives here to help out, takes care of her 4 to 5 days a week during the daytime. I fill in the rest of the time.
Other pointers I'd give are -
* Be prepared to have to hire and let go of a number of people. It's hard into is finding good, reliable aides, whose personality will mesh into your household. You should look for someone who loves the elderly and understands your mother's health issues. Some people expect to just "sit" with the elder, or "sleep" while Mom sleeps. The problem is that she doesn't sleep all night or for long periods of time, and she wants to get out of bed and look around the house!
* Give them a specific set of duties from the start.
* Make sure that you are very clear about the rate of pay, date of pay, and anything that could cause their pay to be docked.
* Be sure that you have several people you can call if the aide gets sick or calls off for an emergency.
* Be prepared to lose some privacy. It was difficult for me to adjust having people in the house all the time. Never leave valuables around, or anything that you don't want others to see.

I hope that this helps some.
Helpful Answer (9)
Reply to dlevy

This topic is pertinent to my situation. From day one my brothers wanted the nursing home option, while I feel strongly that home care is best. I am a physical therapist assistant and have worked in nursing homes and rehab facilities. They are in business to make MONEY and will try to keep the person in the facility as long as possible, even if they are well enough to go home. And all of these assisted living facilities popping up, these young investors think they are going to make a lot of money off of the aging "baby boomers" and the elderly. It makes me sick.
I'll say that there are good facilities and that it is an option for those who need it, etc., but our healthcare system is kind of a racket these days.
That's my rant for this morning!
Helpful Answer (9)
Reply to sskape2

My folks live 1/2 mile away, and Dad had been caring for Mom who has dementia. Gradually her needs have expanded as his abilities have diminished, and now we have 3 caregivers. One works 8-12 Mon-fri, gets her up, feeds her breakfast, back to bed for napping, bathing, laundry, up for lunch, back to bed. She naps til 5 when caregiver #2 comes to get her up for supper, evening tv or whatever, and back to bed by 8:30. Weekends, we have another who is willing to work both shifts for both days. They communicate with each other in a book (how did she eat, was she awake, BMs, etc) We pay unemployment, social security and medicare. We needed a fed employer ID and state unemployment #. Also, be careful because if you have 4 people, you have to pay workmen's comp. We pay around $12 an hour. If you go through an agency, you don't have to worry about any of that, and you will pay more, but they (theoretically) can send a replacement if someone is sick. What we are doing works pretty well for now, since Dad is there and can be watchful in the hours between caregivers. Mom gets great care, and the aides love her. We heard about our workers through friends, always nerve-wracking to think of finding a new one. Facilities are understaffed and can compare to home care. I know I will never regret the time we were able to spend.
Helpful Answer (8)
Reply to cbuyea

Thank you everyone...that gives me a very good start. It is so hard to even imagine what a situation will be like unless you have lived it...so I appreciate that you took the time to share your experiences with me.
I recently got a little taste of what an institution would be like if Mom ever need one. She went to rehab for 2 weeks - but I found that I was going out there nearly every day for one thing or another. As others have mentioned about facilities: there is absolutely no privacy...doors are left wide open and really anyone from the outside could walk right in. They put her in adult diapers..."just in case." This was a highly rated facility and overall I thought she received good care, but I know that it would make me sad seeing her "cooped up" in one room all day, waiting for someone to come and get her - such a loss of dignity. The staff members were great for the most part, but mistakes were made and I am glad that I was over there a lot.
I began to think that in-home care offers more individualized care, even though you are paying out of pocket for the services. I realize that it takes a great deal of time and planning, but it can't be worse than running over to the rehab all the time. And I worried about her every minute she was there.
So, when the time comes, I am going to try in-home care. With everyone's help here, I hope I can figure things out. thanks again...Lilli
Helpful Answer (7)
Reply to toadballet1


I strongly suggest you do all possible to try to keep mom at home. I left my job after 22 years with AT&T to take care of my mother. Was the best three years I have had in life. I had to place her in a rehab facility for A few weeks to gain strength after a brief illness. After three weeks of being there all day, I would leave at night, and lone and behold they KILLED her one night by placing her in bed on her side at the EDGE of the bed. Really, who in their right mind would put someone to bed that way?? Staff is overworked and under paid; rushing to get to the next patient caused my mother her life! I did have home care while I was still working and the lady was awesome. She became part of the family and loved my mother as well as she took "care" of me. My one suggestion is to please take care of you! Even when I hired help or Mom was in rehab I was home and never took a break. My health suffered greatly and took a major toll after she passed. I have now taken a job in a Home Health company to fight for other seniors and help inform other care givers that there is help, and they are not alone in the care giving process.
PLEASE take care of yourself and think through decisions before making them. Hope my story helps you to make the best decision for you and your mother. Prayers and hugs coming your way. Bridget W
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Reply to BridgetW

I have been using in home caregivers. I live with my Mom and was working full time so had a caregiver about 45 hrs a week. She was great. I then tried a live 'in but at that point I got laid off from my job , so let her go. If you can afford it, I think it is a great way to go. I found my caregivers on Craigslist. Interviewed them, got references. There are a lot of qualified people wanting to work private duty instead of in a nursing home. The thing that has stressed me out is the cost. We were paying 15 per hr. Adult day was OK for a while, but Mom likes a one on one a lot better. I just went for a long walk while the caregiver gave mom her shower.
Helpful Answer (5)
Reply to sskape2

Hi! My mom has had caregivers during the day for the last 3 years and I am currently in the process of going to 24 hr care upon her discharge from the hospital. My mom was in assisted living for a while and hated it. When she was in rehab for 2 weeks she hated this also but the worst part is she received a staph infection and is back in the hospital. she will need 24 hr care when she goes home. Hopes this helps~~ :) The day "crew" was wonderful and kept my mom in her house 3 years longer than she could have stayed. I have my fingers crossed that the 24 hr care will be ok......
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Reply to kdtiller

I remember the night my mother-in-law discovered that she could no longer stand. At all. She had used pivot transfers for the previous nine years of living with us, but her neuro connections to her legs failed that night, and we just had to deal with it. I found a semi-skilled caregiver living across the street. Don't be surprised if you have one too, they're everywhere. While I was at work (at night), this caring neighbor agreed to come when called to assist with bathrooming (we had to buy a sit-to-stand lift) for ten bucks a trip. Maybe twice a night, and $20 got my wife's mom the help she needed, and I could keep working to pay bills. Get creative. Bend the rules. Ask everyone you know who they know who might be able to help. Like my old football coach used to say, "If you can't win, cheat!" Working the system will frustrate you to death first, and then bankrupt you. Good Luck. God Bless you.
Helpful Answer (5)
Reply to JonathninOregon

In home care is usually preferred, however, can be more expensive than being in a facility. Just make sure you check out several agencies. They should be bonded, trusted, you need to interview each caregiver to make sure each one is compatible with your loved one, is responsible, has a good record with others, has experience with the elderly, and understands the needs and sometimes challenging behaviors of those with dementia.
In a facility there is around the clock care, activities appropriate for those with dementia, others in similar situations and conditions, 3 full meals a day, laundry is done weekly and as needed, a nurse on-site at least 40 hours a week and on-call 24/7, and more. There are generally 2 caregivers and 1 medication aide for each shift. The number of employees working each shift can depend on the facility and if they accept Medicaide residents. All the above and more can relieve a great deal of stress for the family member caring for their loved one.
To be able to decide which situation is best for your Mom or Dad you really need to write down the pros and cons of each situation.
Helpful Answer (4)
Reply to geriatricrn44

The positive far outweighs any negative of in home care. I moved back to my hometown because my siblings had begun making plans to put the folks in a home. So 3 against 1 they tried to talk me out of coordinating care for living at home. Not sure that anyone has the desire to live in assisted living and for the most part I believe these facilities exist for those who do not have family.

Since my brother and sisters were adamant that I was being reckless and putting my parents in danger, I contacted our local VNA to find a geriatric case manager that could advise me on the safety issues and if it would be too risky to keep them home under the care of private caregivers.

Then I asked our local Aging office if they had information about how to hire in home caregivers. Fortunately they had a list of individuals who were willing to be part time or full time caregivers. Since I recruit and train volunteers at work, I applied that sense of professionalism to the process of finding the right caregiver for my folks.

In our case, we have had 2 long term caregivers that have been exceptional in every way. I made it clear to each of them that the caregiving position was as an independent contractor. In that way, they are responsible for their own taxes and we just make sure to give them their 1099 on time so they can file.

The positive side of living at home for my folks is that they still maintain some control over their own lives. I have gotten to know my parents as an adult .

I have a feeling some people feel like our parents would be safer in a home. That's just not the case --- my poor Aunt fell and sustained broken bones while living at a facility. It's not difficult to understand the research findings that conclude the elderly who live at home live longer.

Of course the downside is that caregiving sometimes swallows you up. Actually it's the people on this website that have taught me about boundaries and this support has made such a tremendous difference. I had no idea how similar many of your experiences have been to mine.
Helpful Answer (4)
Reply to Carol72156

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