How are others managing when paying for privately for assistance at home?

Rates are location-dependent. For example, an hourly rate in Washington DC area is probably higher than in Idaho or New Mexico. It is driven by economy and demand (which is driven by density of population). But the 4-hr minimum requirement seems to be industry standard.

Some mentioned about Medicaid. It is different from state to state, but if you can be qualified for Medicaid, power to you. It really helps defray the cost!! Keep in mind though that not all care agencies accept Medicaid. This is why so many caregivers are bankrupt to finance the caring of their loved ones at home. Or quit their jobs to do so themselves.

Something is wrong for a super wealthy country in the world with a crappy health system.

I was right where you are and this is my experience.
I shopped. You gotta shop.
I shopped businesses like Visiting Angels, turns out there's a gazillion of them. Some have commercials, most don't cause it's too expensive.
I discovered the caretaker, for a fee, can solicit business thru these "middle man" orgs that give you their contact information readily on the website. Other media offers hired help and it's just shopping. SHOP
Also, if you are paying you never have to combine "companion with help bathing" or "folding with toilets?" You may go directly to "help with bathing and toilets". I was a much better companion when I didn't have to clean the bathroom. I had more mental and physical energy for the good stuff. Always hire for the tasks that you don't want to do. Be certain and be specific.
Thru my shopping I hired exactly what I wanted and it worked very, very well for me for 3 years. I started with 1 hr/week and ended with 30 hrs/week at 25.00/hr. over the 3 years. The sum cost for 3 years was about $22,000.00....with the same caretaker.
Most of these folks are professional. They work with everyone's needs and schedule.
I shopped. You gotta shop.

$40 an hour seems rather high, especially if you need to lock in for 12 hours a week.

In my state (with the highest cost of living), the place that we used was under $30/hour and it depended upon how many hours per shift and what was expected during the shift. There were 3 cost tiers: up to 4 hours per shift, 5-11 hours per shift, 12 hours or more per shift. The cost per hour decreased as the number of hours per shift increased. Minimum number of hours per shift was 3 hours with a commitment of 12 hours per week. The cost increased based upon the level of care that was expected. Nurses Aide cost less per hour than registered nurses (prescription meds). Bathing, cooking meals, driving to appointments were an add-on cost. (Housekeepers in my state make more than this per hour.) More commitment of hours per week lowered the cost per hour. Whether you are on a bus route or if they have to have a car to get to your place, made a difference too. Caregivers were not assigned to clients.

Licensed and bonded care givers cost more than unlicensed care givers. I recently looked at 2 other agencies and the cost was $34/hour (12 hours per shift 7 days a week and 2 assigned caregivers) and $35/hour.

For us, 9 hours per night, 7 days a week, plus a daytime adult care, plus food, property taxes, utilities, gas, and HOA fee (notice no mortgage), was more out-of-pocket than to put my Mom in MC. The plan is to rent her condo, which will allow us to make her money last a bit longer.

Look around. The prices vary a lot and the amenities differ considerably. Some automatically include a 21 meal plan and some had a 7 meal plan. Some included excursions, others didn't.

There are people in my Mom's MC ward, where 1/2 of the couple lives in assisted living and the other half lives in MC, in the same facility. The more able bodied of the couple visits the other, takes them out, etc.

While you are not strapped for cash, take a hard look at the out-of-pocket costs. That might help you come up with a plan for the future. If you are thinking that Medicaid will "save" you, don't count on having the same options, as many of the "desireable" places give preference to non-Medicaid, and have long waiting lists. Prior to COVID, waiting lists of 1.5-3 years was common.

Good luck to you. Its a tough, eye opening and exhausting experience.

P.S. Because caregivers cost less than housekeepers per hour, I was told of several instances where the caregivers were expected to clean the bedroom and bathrooms, do laundry, etc. as a caregiver. Those caregivers in the know, told the agency that they would rather not work, than be assigned to those places. Get a housekeeper to do dishes, clean bedrooms and bathrooms and closets, and rearrange the office and furniture. Some of them will even do your laundry. A caregiver entering the field, wants to care for people. If they really wanted to clean bathroom, bedrooms, etc, they would have gone into the housekeeping career which pays better.

I have two private sitters for my mother to give me a few hours to get out of the house. I found one by calling my mother's church and asking if there were any ladies who were interested. In addition, my mother's physical therapist recommended a retired physical therapist she use to work with. Both of them have no minimum number of hours and their rates are $17.00 and $20.00 per hour. Not cheap but better than an agency.

My mother lives with me, so I pay for these sitters with her social security. I don't ask them to do any housekeeping chores, but could probably negotiate that with them if needed.

There are also house cleaning services that you could hire to come every two weeks to relieve you of heavy house cleaning.

Also because of my mother's dementia diagnosis, medicare pays for weekly physical therapy for her.

Blessings.

We just went up to $20 an hour because of the raise in the minimum wage to $15 an hour. We hire the people and do not use an agancy. My wife needs a lot of care due to progressive dementia. We use the help 77 hours a week so we are spending roughly $80,000 a year. We use to travel and cruise at least 4X a year and our travel budget was $100,000 a year. We have one gal M-Th and the other F-Su. They cover each other when one goes on vacation or a family affair.

Good luck.

W

3) Medicaid HCBS Waivers – for Medicaid beneficiaries, HCBS (Home and Community Based Services) Waivers provide a variety of care services and non-medical support for the elderly and their caregivers. These services are specifically intended to prevent nursing home placement and allow seniors to live at home or in the homes of their caregivers.

Privately hired help might be cheaper, but you are responsible for checking backgrounds, filing and paying taxes, and finding a substitute if the expected aide cannot come. Just keep that in mind when deciding between an agency or a private hire. A four hour minimum shift is quite common.

dear judycares:
My husband is now in a local memory care facility and had been there for 2 years.
I researched @ home care and found that I couldn't afford it and I could no longer care for him myself. This really nice lady @ the adult day care where he was going for 2 days a week told me about several memory care facilities and I called each one and found out they were very expensive, with the exception of the one he is now living in. The first one was $10,000 a month ( almost fell off the couch!) the second one was the one he is now living @ $2,500 a month and includes everything. The facility is very old and not @ all updated but has everything he needs. He receives 3 meals a day, laundry taken care of, sheets, towels, depends and staff to take care of his meds, etc. I can't ask for more. I'm very happy that I can pay for his care. We both worked very hard all our lives and this money we saved is for his care, I'm glad I can pay it. Medicaid strips you of practically all you have. I also checked that out. I know that in home care thru an agency is very expensive. I wish you the best because I know how hard it is to try and figure out the budget. You also have to think about your living expenses too. It is very hard to place a loved one in a facility this I know first hand but for me it was the best and I know he is being cared for. I visit him every other day and sometimes every day. I know what you're going thru and I'm sending lots of prayers & hugs, Roofie

I've hired from the hospital registry for my dialysis assistance. I have 5 days a week and have my tech with me for 4 hours on those days. I'm wheelchair bound, but I can transfer to the toilet or bed without assistance. I have two aids who help me showering and dressing daily. One works M-Thurs and the other one F-S. I also pay my two granddaughters who come at other times for four hours at a time as needed for other help. I pay all help$15.00 per hour and withhold taxes and Social Security. I pay approximately $900.00 a week. Starting next week my long term care insurance will kick in and pay 700.00 a week. I like being at home and that's what I saved and worked for and paid long term insurance premiums for years. But when it becomes undoable at home I'll go into the nursing home.

I'm in the Los Angeles area, and I posted a notice to my neighbors on "Next Door".
I got lots of people applying, and most are happy with $20 an hour. Of course you have to do the interviewing and checking them out. You could also ask the various nurses or church members or other neighbors. Word of mouth and personal recommendations are best.