My siblings are paying home care aides a total of $23,000 per month. Not kidding. Any advice?

CarrieSoCal, by chance do you live in Southern California as per your screen name, if yes, then you are in a large metro area like I am. My Dad [in his 90's] was paying $20k per month for 3 shifts of caregivers when he lived at home. That's pretty much the average cost in my area for experienced Agency caregivers.

The caregivers, who were supplied from a professional Agency that was licensed, insured, bonded and had workman's comp for their employees. What I liked was if one caregiver couldn't come in that day, the Agency found someone to fill in for that shift.

Then Dad asked me how could he saved money, and I told him about senior living facilities. Dad never heard of such places [I doubt many elders have], so we toured one place. As soon as I drove up the driveway to the first place Dad was ready to sign up. He chose a sunny apartment, and we had a free lunch which we really enjoyed. The place was set up like a hotel.

The cost of the IL apartment was $5k/month for basic service. Thus Dad could budget to allow him to bring with him his day time caregivers, which was great as it gave him a good routine. Later down the road Dad moved to the complex's Memory Care which cost around $7k/month and he could still bring his daytime caregivers.... they had been with him for over a year. What a lifesaver it was for me, as I was a senior and just couldn't do the work they did.

[Edit:  I didn't mind if the caregivers served TV dinners to Dad when he lived at his house, as it would be difficult for them to be in the kitchen cooking from scratch PLUS be watching Dad so that he doesn't fall.  I also didn't mind if the caregivers were on their internet hand devices, as when Dad was napping it was quiet time.  The house always looked clean so that caregivers were doing the light housekeeping plus laundry.  I got the groceries because Dad wasn't able to spend a lot of time walking.]

CarrieSoCal, thanks for providing the additional information that the funds will soon be depleted and not just for your dad's safety and comfort, but for both parents. Your POA brother may or may not be getting a kickback from the expensive caregivers or intentionally abusing your parents financially, but at the very least he is not handling your parents care and finances competently. His POA should be revoked and if dad is no longer legally competent to do that, then you'll need to terminate the POA authority through guardianship/conservatorship.

My dad is all of 150 lbs, probably less. I think he can walk with a walking frame without someone hold him up, or helping him balance. Last year he couldn’t. This was inflicted on him, and it is maddening. My sister, who is as “independent” as my brother, hired an “aging life care manager” (when she briefly had POA) to check in on my parents. Never mind that they didn’t want anyone to check on them; the live-in had started and I covered the weekends. That woman and my sister managed to get my father in skilled nursing twice, for a total of nine weeks in March and April of last year, because he had been falling a lot. Please. He emerged with atrophied muscles and stage 1 pressure ulcers in his heels.. He was kept on drugs like Ativan and Nuedexta, not allowed to get out of bed without an overworked staffer at his side...so, never. Not a lot of rehab, and a disabled and mentally changed dad is the result. This is very common, for bed rest to change an older person’s life, and I cannot believe these seedy rehabs get away with it.

And he was only falling because his doctor had just added the 6th pointless drug that causes dizziness and falls to his daily gulp; very easy to fix without submitting someone to a nightmare. No one told me...

I’d like him to have physical therapy nearly every day until he has reached maximum recovery. Also, a real food diet. Plus, outings. Under the current regime, they haven’t even left the house, except for doctor appointments, since last March. I want them to have lives.

And for my part, I’m in a very good stage of life to take this on. I and my dogsitter (and friend), who really fit the bill, covered weekends last year, until my brother freaked out and hired two guys from a referral agency and told me to stay away. I went anyway, but not at the crack of dawn. . (He didn’t pay the last invoice from my dogsitter/handyman/friend.) We were all happy with the arrangement, and I would have settled for that, but my brother just couldn’t tolerate it.

I’ve told my parents about the cost. My father yelled, “That’s Bulls—-!” I intend to revisit the topic soon.

Their banker said they will run out of savings by the end of 2019. He just hasn’t said They’ll have some income from Soc Sec and an annuity, but not enough for this malarkey.madness.

I have more questions than advice. Were your brother and sister hands-on caregivers before they hired staff? How much time were you able to devote to caregiving before the staff was hired?

I count 2 staffers, plus a night shift - of how many people in all? My first thought was also that this was REALLY out of line, but I remembered that FreqFlyer, longtime regular poster, paid a lot for care for her father while in AL and then I believe in Memory Care, to provide the level of care she felt he needed. If I remember correctly, she had 3 staffers, plus the AL staff. But a facility staff isn't available all the time, and sometimes an individual needs an extra level of care.

I think some explanations on who has done the on site caregiving and how the tasks are split up between the 3 of you, as well as more specifics about your father's medical conditions, would help put this situation in perspective

I don't know. With my dad, SNF was 10K a month, and when we looked into at home care it turned out to be quite a bit higher than that, though not over twice as much.

So, are the siblings paying it out of their own money? I highly suspect not. SO, the POA brother is paying it out of Dad's accounts. What I suspect is that these "caregivers" probably are not caregivers at all, are being paid huge amounts and then the POA is really a POS and is pocketing a kickback from the caregivers. That amount of money could pay for a WONDERFUL assisted living facility or nursing home. Oh, you need to get the caregiver information and turn them in to the IRS to make sure they pay taxes on that salary they are earning. I bet they are not through an agency and not one dime of taxes has been withheld.

How long can Dad afford $23,000/month? (Is he 97 or 72?)

If Dad wanted you to move in, why did he choose Brother as POA instead of you?

Do these caregivers come through an agency? Is it possible that your brother hired them directly and he's getting (taking) a kickback from them?

It is generally more expensive to provide round-the-clock one-on-one caregiving in a private home than care centers cost. How desperately does your dad want to stay in his home?

Having a family meeting is a fine idea. But keep in mind that as POA your brother is not obligated to carry out decisions made by family. He alone gets to make decisions.

I have an alternative way of looking at this. Your dad and mom want 1:1 caregivers so he can stay in his home 24/7/365. $23,000 per month is approximately $31.51 per hour and it includes overnight shifts. What weight and size is Dad? If it's all young men caregivers, is weight and being able to manage someone without injury a factor? If you are paying through an agency, that's about right when you calculate the payroll taxes, workman's comp insurance, overhead, etc. through the agency and the caregiver is definitely not making that amount of money. You could have moved in, but you wouldn't be able to work 24/7 including weekends without a break. Brother is not wanting to be the one providing the break - you'd have to hire someone anyway to provide respite to a family member giving care. If you put Dad into an assisted living, and he wanted 1:1 care for the ability to get help standing etc. WHEN HE WANTED IT NOT WHEN STAFF CAN COME, you'd pay more than $23,000 per month for 24/7 availability. It depends on how mobile your father is. If you've watched staff and that's all they do? Mention to brother that there's other stuff that can be done...what are you not seeing done? Or are Mom and Dad reporting that the caregivers are only doing that? According to my friend's legally blind 92 year old mother, she is living independently and needs very little help. Ah, that would be a no, person who can't drive, cook, pay her own bills, carry in groceries, walk more than 10 steps without cane and furniture surfing to restroom...

$23,000 is an impossible figure for home health care. Who agreed to this?? Are these private caregivers or do they work for an agency? Not that it matters as $23,000 is NOT the going price for even the most full-time/live-in/night shift of caregivers combined!

Another point you made, there is a lot of down time in caregiving. While it's natural for us to be on the go, attending appointments, grocery shopping, etc. it's not the same with an elderly person. They aren't on the go. They also don't want to feel as if they have to entertain the caregiver so most caregivers will sit on the sidelines until they're needed unless someone tells them they are to do differently. Most caregivers understand that a little light housekeeping is included but I stress *LIGHT* housekeeping. Simple meals are included as well. Taking the client to an appointment is also expected if necessary as is some laundry (including linens). But accomplishing all of this still leaves a lot of down time for the caregiver. It can be disarming to come into your loved one's home and see the caregiver on their phone but once all the tasks are completed and your loved one isn't in need of assistance what is the caregiver supposed to do?

CarrieSoCal, $23k/month equates to about $32 per hour, so, yes, that's on the high side, even for Southern California, I think. (In Idaho the hourly rate is in the $20 to $25 range.) But it's not at all shocking that 24/7 care in a person's home is a lot more expensive than the care provided in a facility. However, if your dad is reasonably cognizant of what he's paying and why, and he has the financial resources to continue doing that, and he has rational reasons for preferring to pay a lot more to stay in his home than he would pay at a luxurious assisted living or nursing home facility, then, no, $23k/month is not at all crazy.

That said, if it's really your POA brother who's made this decision for your dad, and your dad doesn't really understand what's happening, and your dad is in danger of running out of money and is socially isolated, then the $23k/month is not only crazy, it's also abusive.

As Midkid58 said, you need to meet with your siblings (and dad if he is cognizant) and map out your dad's care plan. If your POA brother won't do this, then it might be time to consider whether your dad would be better served if you were his POA agent, if he's legally competent to make that change, and if he isn't competent, then you have the option to seek guardianship and conservatorship.

I think so a nursing home would be 10k a month. And that is for someone who is bed bound.

This is WAAAAY out of line. Aren't you involved in the financial end of dad's life? Often, we women are considered "too fragile" to handle financial stuff. My mother would rather have a feral dog be her executor rather than one of us girls, two of us have run homes and businesses for years.

You need to get boots on the ground and see what is actually going on. This sounds almost abusive--perhaps in a financial arena, it is.

$23K will pay for the most luxurious ALF apartment you could find. Maybe it's time to meet with the sibs and talk about making that move.

For that amount "these guys" should be cleaning, prepping meals, shopping, taking dad to appointments and bathing him keeping up his PT, providing activities and mental stimulation...the list goes...
This just sounds very, very suspect and not a little sketchy. Get involved--your dad could be at the mercy of some great con artists.