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

Carol, I couldnt agree more and I do the same thing here. I even have a contract for them to sign as independent contractors. Moms spoiled and gets one on one 24/7. Cheers to you for what you did, I've been at this over 3 years now! There is nothing like being at home and I couldnt ever imagine my Mom not being here with family and watched and waited on. I feel its her her turn now she deserves every bit of it. Mom doesnt even know me most of the time and is extremely difficult with the extreme difficulty of walking and incontinence but I still wouldnt change a thing, only the best for her, as she was to me.

In home care is more isolating for the parent and for the care givers. We kind of flipped the equation.
When mom lost her license and stopped driving, we rented her house out and did about half the estate sale nonsense and moved her to a little house across the street from the daughter in the coolest location. She played house, gardened and lived independent, while all the neighbors kept an eye on her. As she escalated and needed someone to watch her wandering, no longer able to to the math to buy her own groceries, we moved her to an assisted living. She had her own apartment and ate in the dining hall, swam in the pool with her friends. The center was across the street from the kids school, so they often went by for ice cream and a swim on the way home from school. The center cleaned her studio apartment, could have done her laundry and gave her her medications. We were able to afford this because her house was generating income, she had no more transportation and food costs, she had long term care insurance and it was an affordable facility.
When she could no longer handle this, we evicted our tenants, remodeled the house (walk in tub, widened door ways) and moved one daughter and her kids into the big house. This was a great gift to this family to live rent free for a while. When the daughter went back to work, mom attended day care and we hired a granny nanny from 2-6 pm.
Now mom is escalating to higher care. We are beginning with 24 hour care two nights a week, so the family in the house can have more independence. She will soon be kicked out of day care, as she is starting to poop her pants more. When we need more 24 hour care the family and house will be ready for it. And hopefully we will be in a trusting relationship with an agency.
I agree with everyone that you need a network of caregivers as it is hard when it is on one person whether that person is an employee or family.
The tax paper work for the granny nanny was a pain and that is why we have shifted to working with an agency.

Lindags, daycare deals with incontinence all the time so please dont let that make you think they wont want her. The daycare we had was mostly dementia patients and most all had bathroom issues or incontinence. If she gets moody , a couple of weeks on a medication (my mom takes depakote) and those go away also. We gve a 1099 at the end of the year. You need to keep all the tax info and what you pay for daycare, etc all recorded regardless of wether or not you use an agency. I found better people out of an agency on care.com who were older and had no small children, etc to make them unreliable, and they have background checks Good luck.

You can't "sign a independent contractor agreement" and rely upon that. Whether or not someone is an independent contractor and not an employee depends upon the facts and circumstances. In almost all cases, in-home caregivers will be found to be employees of either the client/client family OR the company or organization who sent the contractors.

My experience is this. For a year we dealt with "Grandpa" by taking him shopping, doctor's appointments, and to the pharmacy. I was elected to get all the pertainent information for his insurance etc. Once or twice a week I would eat with him, usually he wanted to go "out" to eat. But eventually, that got to be too much running around, and because I have physical limitations, and can't carry his groceries in the house very well anymore my husband decided we should move in with him. BAD DECISION!!! At first I thought well, this is going to just take time adjusting to for me, but it got worse than that. "Grandpa" thought it was just fine to take a shower once a week!! I think not!!! He would want to go shopping, but from the rear, he smelled so bad I was embarassed and thought others in public might think it was me if they walked by. It took so long for us to get him to shower daily.
Grandpa is usually grateful for anything I do for him, always says please and thank you, but between his daily hygiene problems (I never see him wash his hands, except AFTER he eats his food, never before, and never after using the bathroom. There are so many personality conflicts moving in with an elderly person. They want everything their way all the time, they hate change even when it's obviously for their own good. EX: Grandpa had a hissyfit when I removed all his MANY throw rugs that were all over the house. (and he uses a walker) and he is also not accepting the fact that he needs a railing down the basement stairs, or in the bathroom, or that he needs to use wipes to clean himself after a bowel movement instead of a rag that he washes out and hangs on a towel rack on the side of the bathroom sink. (We are all going to die of some awful disease at the rate we are going here)
I try to keep him company and watch TV with him, but it'is so loud I am afraid I will go deaf. He eats junk food all the time, candy, cakes, etc. but he is a type II diabetic and just laughs when the doc asks how he is doing with his diet.
Instead of going on and on, I'll just say this has been the worst 19 months of my life, I feel like I need Psychiatrist before I go insane from stress.
Think it over carefully. It is no picnic.

:-( Cara

I am taking care of my husband here at home......he was 3 month in a very expensive rehab center, but the difference in his health, mental and physically, is amazing. They did take good care, but I feel the home surroundings and peacefullness is very important and the continuation of daily rutines also seems
to play in. I have help Monday's and Friday's of a wonderful young woman, who grew up in a large family were everyone took care of each other, this gives me fredoom to run errands. The helper I found through friends, that is important, there might be a time when we need to go on from here, but as long
as the person, my husband, has many good hours and only mornings and nights are confusing for him.....the best place is at home.

I have also always felt the best place is at home. Prior to my Dad's death a year ago my Dad sheltered and protected my Mom from his illness. When he died her whole world fell apart. I had previously (two years before my Dad got worse) promised my Mom I would stay in this (their) house with her (I have been here since 2004). However with that being said, I have been here for years living my own life. I worked, went to school, socialized...now without my Dad my Mom has different expectations of me. I still go to school and yes it is lovely to be around those peers but all other activities revolve around Mom. I do NOT regret my decision, I am just saying I am more aware of what really goes into this "job" if you will than I envisioned.
I still go to school full time, next semester maybe part time. I still have a high GPA and am in honor societies but the stress is manifesting in anxiety and some sleepless nights and my grades may not be as high as they could be. I try to study but am distracted with this question and that.
There is a caregiver from church (cash, no taxes, that's between him and my mom) and he comes once a week. He was so concerned about my mom one week he called me then the following week he called to tell me the difference in how she was (my brother had visited and mom was fearful he would put her in NH ~ actually she was constipated and once THAT issue was resolved she seemed fine). I am thinking of adding another night with a female caregiver. We are in a small town and everyone knows everyone so no interview was needed as I already knew these people. The tax issue is on them. When I was a caregiver for a friend's mom last summer I declared the income but that's my issue and not everyone always agrees with me.
I now manage and monitor Mom's meds and get breakfast ready. Recently she added help getting dressed. As time goes on there will be other things that she adds that she has forgotten how to do. It is mostly me and in time she WILL have to get assistance (which she hates to admit she needs help) but one person cannot do this without losing themselves in the process.
Every situation is different and also we make decisions based on info and emotion. Sometimes it takes many people to express what they feel about your situation ... and in the same breath, you have helped me realize what I need to do in mine.
Thanks for the thread.
Peg in San Diego

There are several significant concerns that families take when hiring privately. Full disclosure here: I own a non-medical, in-home caregiving service.

1. Taxes - not only those which should be withheld from the caregiver and remitted to the government, such as the employee's income taxes, social security and medicare taxes, but also those which the EMPLOYER must pay, which include social security and medicare taxes equal to the employee's share or more, plus Federal and State Unemployment taxes. Yes, that's right, the employer must pay those, not the employee. If you privately hire a caregiver and then later let them go, they can file for unemployment benefits and then the state government will come calling to ask for back taxes for not only your employer taxes but also the ones that your should have been withholding and paying on behalf of the employee as well. Then, it's your responsibility to try to recover the employee's share of that back tax mess - which will be just about impossible.

There are other significant financial and operational risks besides taxes:
No home care company to sue for negligence if the caregiver causes harm or steals.
No home care company to be accountable if the caregiver claims, or fakes, an on-the job work injury. In California, at least, if the employee claims that they were hurt on the job, it is virtually impossible to rebut that claim, regardless of whether there were any witnesses, etc.
No home care company to hold accountable to provide a replacement fill-in, qualified and insured, caregiver when the regular caregiver can't work due to sickness, car problems, etc.
No home care company to hold accountable for any other problems, losses or damages caused by the caregiver.

It may be tempting to "save money" by hiring privately but those "savings" can turn into family finance-crippling costs when there is a problem that arises like a genuine or fake work injury. In California, work injuries that cost more than $100,000 in medical expenses and lifetime partial disability awards are VERY commonplace. It takes a whole lot of hours with "savings" of a few dollars per hour to make it worth taking those risks.

The other issue is if you have not made your home safe for your loved one to age in, often an agency will not allow their employee to work in your home. That is why we did the several steps to graduate mom into full time in home care. We needed time to clear out a downstairs bedroom, widen a door way, remodel a bath room, add a ramp to a driveway porch. It has been very easy to find employees willing to work in an appropriate setting. If we did not have the extra money to do these home alterations, it would have been much more practical to keep her in the assisted living facility. These are not normal house enhancing remodels and the patient probably does not need each long enough to merit the expense.

My widowed mom (90) with med-stage dementia stays in her own home, and I have friends, family, plus me and my husband that help her 24/7. She doesn't need nursing care yet, can still do much on her own, but needs companionship, meal prep, and meds. I have everything laid out the night before. I do her shower & hair. She can't afford to pay professional aides, so for now this is working okay. I know things will change one day, and we'll cross that bridge when we have to. She gets lonely for ladies her age, but there aren't any around where she lives. She hated adult daycare, and prob can't do most activities at a regular senior center...and we'd have to stay with her there. Taking it day by day, and a lot of prayer gets us through!

I have been careing for my mom for the last year and a half 24/7 at home instead of putting her in a nursing home or Assisted living because here in Rhode Island the costs of a nursing home is over 3,000..ooa month and she doesn't make that much in her Social Security and I'd rather care for her myself because I 've seen how moms sister who is in a nursing facility is beening cared for and I think it's a disgrace how she looks when we go to visit her.I will care for mom at home until she passes away this way I know the quality of care that she'll be receving. If she were to be in a Facility they would take our home then I would be out on the street. Thank You for letting me give my answer to the Question Dayle Riggs from RI

I am finding this discussion most helpful. My thanks to all who have contributed their responses.

My 83yr old mom recently had shoulder surgery and was hallucinating in the hospital and afterwards b/c of the pain meds. Scary. B/c she was unable to walk after the surgery (too weak), the nurses recommended rehab. Due to already being so disoriented and very confused (meds,anesthesia,short-term memory loss?)), I didn't want her going to another facility. We got an agency to send 2 women to cover 24 hr care, with her husband also there (but unable to physically support her). A PT from the agency also comes 3x/wk to help w/mobility, which is improving. While she Hates having people in the house, we know she is safe while walking, they have meals covered, and her husband can sleep at night while the caregiver gets up 3-6x to assist her walk to the bathroom. Expensive, but hopefully partly covered by long-term insurance. Don't know what the future holds, but this beats nursing homes by 100 times.

That is great that this is working out for your mom. It seems common that that age group hates people in their home and/or assistance. I think it is great she is with her husband! That's so comforting. You are fortunate to have full time help. Peg

we have been using live-in caregivers from an agency for 3 yrs. In the beginning, it was for my Dad and Mom, Dad passed 2 years ago. My mother at 92 is a very demanding person and we have used at least 10 people. She is mentally fine but expects constant attention, but then gets mad if they give it to her. My sister is involved also, and we think she gets tired of the same person and she contributes to my mother's disatisfaction. She has had some good caregivers, some so-so. Many come from Ghana or Africa and do not speak or read English, many don't know how to cook. She has a really good one now and hope she will stay, but as with the others, if she is on the phone or sits outside or does anything, my Mother gets upset. We are not sure what she expects them to do, in between making sure she is cared for. But, it has worked out but costs $195.00 per day for this service.

I am sorry for the loss of your Dad two years ago. Mine passed last Fall, 2010, and I wonder sometimes how I live life without him. For now I care for my Mom.
$195/day for a caregiver seems high to me but I am "free" caregiver for now for my Mom...wish I got THAT amount! But I do get free room and board and I do have many moments/day to myself and am able to go to school full time. How many hours is the caregiver in the home? And actively working?
I think that is the "work, work, work" generation and talking on the phone (just invented in their time) is a "luxury" and therefore in direct conflict of work, work, work. You know, the sweat shops did NOT allow breaks thus the laws that were passed many years ago.
I agree that maybe she does get used to the same person and new blood is good but 10 in 3 years? Wow. Not speaking or reading English would irritate my Mom as she had to learn English after coming from a Portuguese home AND learned French in her academy. The expectations are so different now from then. I have numerous conversations about the contrasts in generations' work ethics (and culture ones as well).
More laws will give the next generation more privileges and we just might be complaining about those rights in years to come.
I am very happy this group is here. I gain so much from it.
Thank you!
Peg

I used in home care for my mother for four years. It is very expensive in less you have LTC. My mom had no insurance or medicare. I had to spend down to get her on Medicaid. It kept her in her home until a week before she died. Don't make the mistake I made if you live in a different state. Mom's very valuable wedding rings disappeared. By the time I checked, they were gone. She did have dementia and could have lost them. I will never know. So, before you get help in the home, get the valuables out.

Lilbuddy: I agree. I am not saying there are thieves in every profession but it is wise to take these precautions. Good idea. Peg

I have nothing but praise for in Northwest Connecticut than the McLean Home Hospice or Amy's Angels. all of the wonderful folks at McLeans and all of Amy Marandinos Angels Made my Mom'...peaceally at home.s last weeks exactly what she wanted them to be.......peaceably, at home.....with her family.....Gail, Tommy, Diana and my husband and myself and all her wonderful caregivers...(Amy and one of her very special caregivers Who gave heeer the dignigty she she deserved. Val, thank you.

It's always a good idea to put away, or move to another home altogether, things which are small, valuable and easily misplaced.

Outside caregivers often are accused, implicitly or explicitly, when a Senior claims that something has gone missing, but there are almost always other people who are in and out all the time who are equally likely to have been the culprit. Also, sometimes Seniors simply forget where they put things, or become mischievous and make accusations with no foundation. I know of one case where the local police won't take theft reports from an elderly resident any more because she is a serial theft report filer who often files subsequent reports about the "culprit" breaking back in at night to put the things back. :)

You can go onto care.com and put in your zip code and fine caregivers in your area. We have done it going on 4 years now and its worked out well. You do have to weed out the inexperienced ones but there are good ones out there. You can also get a grammy-cam if you want to make sure. Good luck, Home is best, its what we all would want !
luvmom

I agree home is where I want my mom to be. I also know that I can't do this alone and will definitely be considering many of the ideas you, my friends, put here. Thank you, Peg

After many years of my caring for my mother on my own in my home through thick and thin, I have decided that its more then past time that I hire someone to come in to help. Shes made it clear that she doesnt like the idea, but its just gotten to be way too much for me to care for her by myself anymore. I'm keeping my fingers crossed that her attitude changes, but either way I know that I'm in great need of some "me time". I dont mean to sound harsh but her constant wants, needs and reasons to have my attention 24/7 are way too much for me to handle anymore. During the past 2 years I've never felt so drained in all my life. I am really keeping my fingers crossed that this works out because I really think its in the best interest of both of us that it does.

I have been caring for my mom for the past two years instead of her going into the nursing home. Mom's sister isin a nursing home and we don't like the care that she is getting,she has Parkisins deseasand a little Dementure mom hasboth Dementure and Alzhimers and we are in a shared living program here in RI where I look after all o her needs,take her to her Doctors appointments, I'm also involved in a program care living and the nurses come out once a month and check on her well being . I have the house all set up with a raised toilet seat,shower chair wheel chair,walker, a wlking bar installed on the wall in the hallway so she can hold on to that while she is walking down the hall. I purchased her a Contour bed to be able to lift her head&legs up it has a 2 type massage unit on the bed and it helps her to relax and she goes right off to sleep. I'll do anything for my mom she is my Best Friend. Dayle from RI

Having help is a lifesaver! I have help now as I mentioned and I have my life and my mom now. Its not easy having someone in your house. get a lock on your bedroom door and put all your personals in there. We bought a keypad doorknob lock so we dont need a key. There are alot on care.com if you put in your zip code. Al ot just want money and do the basics, but then there are those who love helping and do a fantasstic job, they are the best! If you get the right one, your Mom will get to know her, or her voice, and love it, takes time. explain to your Mom you dont want to get sick, you need help. good luck

Thank You All for your most welcomed coments I appreciate all the comments and it helpps me to cope with what I'm going through with my mom I'm her soul caregiver but i've ask my neice to care for her while I go into the hospital in February to have my total knee reolacement and she said yes and I'll see if she can care for her for two to three weeks. mrjess5 Dayle Riggs

My mother has dementia. I haven't tried too hard with the in-home care but I did try for a CNA to come to give mom a shower....mom said no...the CNA said she couldn't force her. What the heck, you have to force my mother into the shower, there is not two ways about it. It doesn't take that much force...just walk her in and sit her down. I need someone who will get the job done. I do have my mother on a waiting list at a nearby facility. I am having the usual guilt feelings, doubts, etc. about putting her there. After 8 years of having my mother here in my home, I recognize that it has become toxic for the rest of my family (kids and husband) If I were to have in home care, I would be coordinating and watching over the helpers and that to me is just more stress. Also, I think that it intrudes upon the privacy of my other family members. There comes a point where it has to be over. My mother screams at me and tells me I have ruined her life. She says I ruined her teeth and her hair (yet she won't let me brush either). I know it is the dementia talking but I do not want to hear it anymore, nor do I want my kids to hear it anymore...they don't even like having friends over. In my situation or any situation that involves a growing family, a facility has to be the best way. If you can have your loved one at home with you and it not affect others' lives, that is different; you have to consider your children and husband.

Absolutely choose what is best for you, your family, your family member and others and no one will ever judge you for it. 8 years!!! I applaud you for that. I have been with my Mom just one year and am constantly fluctuating about options. I congratulate you for what you have done, support you in your decision making, and applaud you for putting your own family including children first. Their childhood is important and having friends over is vital to social growth. I am with you!!!

My name is Reggie ,I have a Twin Brother that has Squamous cell carcinoma of the left ar.
My Twin brother live with me , I go off and work 21 days strait and off for 7 to 10 days.
We live in a smill town in Texas, the clooses large town is 30ml away from me.
I'm not able to get the right kind of help he need at home while I'm off working.
I hate leaving Twin alone, I do have home care service,a lady come over for 2hr a day 6 days week.Twin is needing 24/7 care while I'm gone.
My question is I would like to take care of my Twin brother at home, how do I go about geting paid for taking care of my Twin brother at home. Twin is on disability, I make up the diffrence with my income. Doe's the state of Texas have a number that I could call and talk to some one that can help me!

Many here have posted about in home care givers that focus on the elderly person. i have another thought. We had a house keeper at different times in our home. for those who are with relatively sane elders. This can be your best bet. A housekeeper would never dream of sitting on your sofa, napping or eating up your ice cream. They stay engaged and productive. Ours takes mom outside to help her with the yard sweeping and recycling. They like each others company.

For my dad he just needed a human in the house so that if he fell or wandered off we would know within in hours not days. A house keeper can do this and prepare meals. We also found an adult who road his bike up to the house with the gallon of paint on the handle bars to paint our house inside and out. It took him 9 months. That was nine more months we did not have to begin this process of putting dad in a supervised facility.