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Feels shady. My parents have live-in care. Both are in wheelchairs but can walk with walkers. Mom sleeps in a pull-up, Dad is catheterized. HHC agency is saying the aide is not getting enough sleep and is pushing for an additional aide at night. Our current aide is not complaining and I feel the agency is just trying to get more money out of us. My sister visits 1-2 hours daily (the aide takes that time to herself) and both parents say they rarely get up at night. They are also pleasant and grateful (our current aide says they are very nice people). Any advice on how to push back with the agency? We're NOT shelling out for a second aide.

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It will be good for you to see whether they do get up at night a lot, or whether they make noises that need to be investigated, etc.

As a 24/7 caregiver for my husband for 10 years, and a week-end caregiver for my mother, I can tell you that not getting enough sleep is unpleasant and dangerous. If your parents really do sleep through the night, then all may be well. But that would be kind of unusual in the world of people who need caregivers.

Needing breaks and needing sleep has nothing to do with how nice people are. I loved my husband (and mother) with all my heart. I was nice. He was nice. But I still needed uninterrupted sleep.

Certainly you have a duty to protect your parents' assets. I don't blame you for being cautious. See how you feel after 4 days on site. But if your parents need night care ... or when they do in the future ... it would be penny-wise and dollar-foolish not to provide them with that extra care, since they can clearly afford it.
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I am a nurse with a HHC agency and we have "resting shifts" and "non-resting" shifts. The fees for these are different.

A resting shift is where the caregiver gets at least 6 hours of uninterrupted sleep overnight.

A non-resting shift is an overnight shift where the caregiver doesn't sleep.

It's good that you'll be able to assess the situation first hand. If your parents are up and down during the night some changes might need to be made. If you're there for several nights in a row and your parents sleep through the night you'll have to have a talk with the agency. The agency isn't going to want to lose your business so I don't know why they'd be pushing this issue unless their caregiver--YOUR caregiver--has mentioned something to them. And when asked by you she may not have felt comfortable being forthcoming if there is a problem.

I see different patients all the time and the families always want to speak with me and I always compliment their loved one. Some patients may be old grouches in which case I tone down the compliment but even the grouches get a compliment. Your aide may be just being polite. If there's no problem with your parents overnight I can't understand why the agency would risk pushing you to spend more money thus risking you going somewhere else. It doesn't make sense. When we get an aide on a case and everyone gets along and the schedule works for everyone we move heaven and earth to keep that client happy.
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If you don't want to shell out for another aide I suggest you care for your parents over a weekend or more in order to assess the situation.
I think you'll find the suggestion of your HHC is not only realistic but in the best interest of your parents.A tired caregiver makes mistakes.
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Checking further, I see that in 2010 the Federal government passed laws that require an 8 hour rest period each day. New York also requires one full day off per week. Check your state for new laws regarding live-ins, overtime payments and rest periods. Things are changing rapidly and violations are sanctioned.
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I would investigate the situation. However, I had 2 aides the last year my father lived. His live in aide slept while the day time aide was there. It wasn't a perfect arrangement but I also helped with the direct care when I was not at work. 2 parents is a lot to care for even if they can walk in walkers. Supervising them, giving them baths, dressing them, toileting them, doing lots of laundry, it probably is exhausting.

Good luck.
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DCT, it is a great idea for you to spend the four days there. Also keep in mind that your parents behavior will be different with you there. Perhaps you should think about installing some sort of electronic device that will monitor and record what is actually occurring. Or maybe there is a way for you to hide so parents do not know you are there? You also might want to consider doing four days alone without assistance. In my area home care for two people is about $144,000.00 a year so $100,000.00 does not sound too out of line.
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Home care agencies vary widely in both quality of care and communication with their client families. I had a very bad experience with the private-pay agency that looked after my husband for a bit over a year. We paid them faithfully and on time and then in October of last year, the day before the day-shift 12 hour caregiver was supposed to come in, I got a notice from the principal of the agency that they were dropping us immediately for reasons she did not specify. I had to miss a day of work because of this and my ability to earn a living depends on coverage. We had an outstanding bill for the final week, so I responded, both via email and certified mail, just tell me the reason for this and I'll pay the bill. No response, so they didn't get paid. Additionally, just before all that happened, the HC aide approached me about working privately for us and I was fairly sure that this aide had been poking around on my home desk and saw an invoice citing the agency's fee for the aide's services. Yes, I should have filed that invoice away... warning to all of you out there... and it was not long after that that the agency dropped us. We are fortunate now to have better coverage through a PACE program... please look it up -- hopefully you are in a state/region that has one of these.
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California has new laws on live-ins, too regarding, among other things, overtime, rest, breaks, etc.
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Marketwatch has a blog that addresses elder care and caregiving that is worthwhile reading. Google:
"Elder-care aides stuck without wage hike"

a good place to start.
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I care for my mother who is fully ambulatory. She is a little off - senile and has visual artifacts due to macular degeneration partial blindness. She sometimes has night terrors and she wears a c-pap at night, refusing to use the potty chair beside the bed, it must be refitted each time she goes to the bathroom, usually a couple of times per night. I am sleep deprived! Your caregiver may be also.
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