Do any of you have a live in caregiver in your parent's home?

My mom has been in memory care since spring, but I'm contemplating hiring a close friend who has been a caregiver for many years to live in my mom's home to take care of her. My mom is moderate severe in her dementia. She is able to feed herself, walk, and is still sociable. She is incontinent and is beginning to fall though. She fell in the spring and again this month. She was very sore, but no broken bones.

I'm not sure if this is a good idea because I know mom's dementia will get worse, but my sibling would prefer for her to be at home. My mother is doing a lot better physically and socially than her counterparts at memory care. It bothers me a little because she doesn't have anyone to talk with, but it doesn't seem to bother her. She keeps herself busy.

It also bothers me a little that the caregivers have too many people to take care of, the ratio is 1 to 6. It seems like they have to hurry to keep up with all the residents, and sometimes don't have time to change mom or get her teeth in. I have to go ahead of time to get her ready before any friends come to visit because she might not have her teeth in.

I wonder sometimes what my mom would have wanted for herself, and know she wouldn't want my sibling and I to be stressing. We both have young families. I'm afraid moving mom home might be more stressful to deal with bills, taxes, insurance, paperwork, moving, and what if it doesn't work and have to move her back to memory care again.

What do you think? Have you ever had to make the decision between selling your parents home, and moving to memory care, or keeping them at home and hiring a live in caregiver? If you have hired a private live in caregiver, who do you go to to do the paperwork? Or, would it be best to keep mom where she is in memory care so everything is already taken care of especially for when she progresses?

Thank you for any advice!

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Is the house she would be returning to set up properly?
* No stairs
* Large bathroom for a wheelchair or other equipment? NO lip on the shower that she would have to step over or that you could not roll a shower chair into?
* No carpeting?
*No thresholds to get over going between rooms?
* Wide halls and wide doorways?
Just a few things to consider there are plenty others.

Are you ready to loose a friend?
How long will she work?
Who will care for your Mom when she is off? You can not expect someone to work 24/7/365 with no break.
You do not say how old your Mom is nor any other physical problems but this could go on for 5, 8, 10 years is your friend ready to commit to that? And are you willing to maintain the house for that length of time as well.
You will still have property taxes as well as all the household expenses (include added insurance for your friend in case she is injured, because she will get injured).

Personally I would leave her in Memory Care. She is with staff that is trained, she is in a facility that is set up for proper care.
If your friend wants to do something for you, and get paid, have her run all the errands you would have to do, bring Mom to the Dr, get any shopping done that she needs stop in for a visit on a few days you can't make it in.
Helpful Answer (21)
cherokeegrrl54 Jul 14, 2019
Excellent advice!!
Since it sounds like mom is doing very well where she is, leave her be. Every move for those with dementia causes further decline.

Live-in would become mom's employee. Taxes, Medicare, disability, all deductions would need to be paid for caregiver by mom. You would need a caregiver agreement prepared by an elder law attorney. You would need an accountant or payroll service to take care of salary. There is also consideration needed to labor law. Will caregiver be 24/7 or will there be three shifts of caregivers to provide breaks for the live-in?

If you were to use an agency, that would require three shifts of caregivers, 40 hours a week times three, 120 hours at $20.00 an hour or more. $2,400.00 a week plus expense of being in home with utilities, etc? Excess of $12,000.00 a month, easily.

Then a friendship that could be lost. Never hire a friend. She will not, necessarily, do things the way you want, then what? Or mom, with dementia, could decide she hates this woman. Leave mom where she is. 6:1 ratio is very good.
Helpful Answer (15)
kdcm1011 Jul 15, 2019
Great response! Outlines all the practical requirements necessary for this situation.
You say she can't socialize at the MC, but who would she be socializing with when living at home? At least in a facility she can watch the comings and goings, interact with the staff, and I'm sure there must be entertainment of some kind.

You also have the benefit of the burden of care being spread out among many caregivers, in a good facility that means they are policing each other and picking up the slack when someone else is having a bad day or is ill, with a live in caregiver you place everything into a single pair of hands.

Then there is the whole headache of finding and keeping a good person, setting up contracts, withholding taxes, arranging alternate care for the caregiver's days off, vacations and sick days, as well as managing all the medical appointments, home maintenance, grocery shopping etc etc.

I guess you can already tell which would be my choice, leaving her where she is and working to improve any deficits you've identified would be a far better use of your time and resources.
Helpful Answer (15)

The idea is to make the best decision for your mother, not to be concerned what your siblings think. If she is doing well where she is at, then, leave her there, her needs will continue to increase and eventually she will have to go back to MC anyway. As for hiring a friend, I think that is a very very bad idea, your friendship will be under too much pressure and most likely be broken. If the worst thing that is happening where she is, not having her teeth in, I would say they are doing a pretty good job, 6 to 1, is a good ratio, and if she cannot even put her teeth in by herself, that might be a sign that she needs to stay where she is.
Helpful Answer (14)

Everyone has given excellent advice and I concur. Mom will continue to decline and it would be more labor intensive and emotionally draining on your mom to take her out of memory care and try to return her if the situation did not work out. Ask the friend to drop by to see mom more often, and other friends and family should drop in more often, trying to do little things to help your mom. Being in a facility is sometimes the best for everyone involved, and it will help the family members to be more loving if no one is burdened and burned out by full time care in the home.
Helpful Answer (14)

Leave her where she is. It sounds like you have been very blessed with this facility.

Please do not project your issues onto mom, nor your siblings preferences. This is about mom and her wellbeing, which sounds like she is being taken care of pretty good.

I would find out how her skin is doing if you believe they are leaving her in wet briefs. That can't be denied, our skin speaks for itself. Could it be a situation that she has gone after they changed her? Ask the DON to help you understand what the process is for dealing with wet ones.
Helpful Answer (12)

I'd recommend leaving her in MC. Her needs will only increase over time and one caregiver in the home will not be sufficient since they cannot work 24 hrs a day. They will need days off and vacation and will get sick. This is too much of a burden, and hiring the 2-3 people needed will likely be too costly. Your mom sounds like she is doing fine right where she is. Not sure why you'd want to move her.
Helpful Answer (11)

Have you discussed this with your friend who would be doing the caregiving? Is she very experienced in caring for people with dementia? Since Mom is also a fall risk, your friend would need to be extra vigilant. Would she be on 24/7 duty or would you also need an aide during the night, since many dementia patients wander and can leave their home. Your friend has experience, yes, but even professional caregivers with lots of experience can get burned out. If Mom can be difficult, this would increase the possibility.

To be honest, since Mom is doing so well at the facility, I would hesitate to uproot her. Even though the care ratio is 1-6 ( which truthfully isn’t that bad), there is staff on duty all the time. Moving from place to place, even back to a familiar home, can be confusing and upsetting.
Helpful Answer (10)

I'm with the other responders.....since she is doing well there I wouldn't rock the boat. I have been after my parents for years to consider IL.....and now that mom has dementia (exact stage to be determined soon), AL would be preferable. Mom is extremely stubborn, difficult and demanding (always has been) and my dad is beginning to show signs of burnout. I wish she would be more cooperative for both their sake.
Moving your mom back home is an unknown.....and to depend on 24/7 permanent private care is precarious at best. Also, with dementia being progressive, you would most probably need to move her back at some point. As MsMadge suggested.....hire a companion to visit with her a few days a week to ease whatever loneliness you think she might be experiencing. If that doesn't work, then nothing is lost....whereas a move would be an upheaval and could impact her dementia. Decisions concerning our LO's is not for the faint of of luck with this one.
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Roseformom, I also vote for keeping your Mom at Memory Care. She has had time to learn the new faces of the Staff.... learned about the food.... learned the routine.... and she is able to keep herself busy.

There comes a time when it will take a village to care for a person, and with memory issues, that time will come quicker than you know it. Keep Mom where she is comfortable.

My Dad had around the clock caregivers, 3-full time shifts each day, that way each caregiver could have a good rest until her next day shift. But the cost was expensive, as in my area it was costing my Dad $20k per month. Eventually it was his decision to move to senior living and he was happy as a clam being there :)
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