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My siblings and I are considering 24-hour in-home care for our parents, however, none of us will be living with them. Is it safe to have 24-hour caregivers (2 or 3 shifts) without another family member there to watch over them? Or is it safer for them to be in a nursing home? They are mostly bed-ridden and need help getting into their wheelchairs for a few hours a day. They are also in the early stages of dementia -- but only people who know them would recognize it. They have done better in healing from their health challenges while being at home and with each other, than when they were separated and in different rooms in the nursing rehab center.

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The advantage of a care facility is that there are always multiple staff people on duty. If something happens out of the ordinary extra help is there immediately. If it becomes difficult for them to get out of bed, the care center will have equipment to assist with that. There will be activities available to watch or participate in. There will probably be regular live entertainment. Mom and Dad can be wheeled in to listen to the accordion player, for example. And there will other people their age to talk to at meals.

I can understand the desire to keep them together. Discuss the option of sharing a room in any care center you might consider.

If a care center is in their future, getting used to it now, while their dementia is in the early stage might be easier on them than waiting until their care needs really exceed what one person can be expected to handle.

You parents are very lucky that 24 hour in-home care is financially feasible for them. Whether it is the best option is a different question.

I'm not sure what you mean about "safe" -- accidents can happen anywhere. Are you thinking of theft or being taken advantage of?
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Safer in a nursing home, because there will be nurses there and an MD on the staff. Talk this over with their doctor as to whether they need a PCA, HHA or higher certification of care. Costs increase dramatically when you need CNA or LPN care.
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In addition to the nurses and doctor Pam mentioned, and the entertainment I've mentioned, it was great that so many services came to my mother in the NH. A podiatrist came around and clipped her toenails and checked her feet periodically. If there were any symptoms they checked for a uti. A couple of times physical therapy got involved to make sure her wheelchair fit her well and to go through some basic arm exercises. Mother absolutely loved the fact that the beauty parlor was right in her building complex. She didn't even have to go outside! There weren't hearing and vision doctors on staff, but they came by periodically and saw the residents that needed them.
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Why do you ask, zythrr? Medicare paid for the things they would usually pay for, and Medicaid picked up the rest. There was no cost to us or to Mother for any of her drugs.

My mother sat in front of a television set most of the time when she was home. In the NH she hardly watched it. Someone always came and said, "It is time for the sing-along now. Shall I push you down there?" and off she went with them. All of the residents were given the opportunity to participate in any activities they wanted to, but many of them declined.

At first my mother was very restless at night. They'd get her in her wheelchair and bring her down to the nurses station and ask her if she would fold some towels for them. Yes, she would. And the repetitive action of folding and smoothing the towels was soothing to her and she settled down. They had a lot of experience with most of the behaviors of dementia and some good ways of dealing with them.
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What do your parents say? I am a 72 year old taking care of my 80 year old husband with advanced Parkinsons and dementia. My preference when the time comes is to go to AL. I've always been very social and like all the activities. My husband, on the other hand, is an introvert We have friends who still visit him. I've tried taking him to day care but he hates it. He asked me to promise to let him die at home like his father before him and grandfather before him. I have an assistant 6 hours a day who is a lifesaver. She is from an agency. I've had bad experiences with outside help. I just think it's such an individual matter. There are pluses and minuses to both. Go with what makes them happiest. And, for sure, do not split them up. They have each other. That's more important than anything, even health and safety.
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Thomas, agencies vet their employees, so if you go with a good, reputable agency, you have a better chance of minimizing any exploitation.

As to advantages, some people just don't want to leave their homes, and it's too traumatic for them. Family can work with agency help to provide entertainment for their parents, and are in a good position to do so b/c they know their parents.

On the other hand, some people may prefer being around a lot of other people, even if they aren't family, and having entertainment provided for them.

So much depends on the individual person.

I think you're wise to be addressing these issues now.
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kthomas, when my Dad needed more care, I hired caregivers from a professional Agency as the Agency was licensed, bonded, insured, and had workman's comp for their employees. We had 24 hour care... the overnight person had to stay awake throughout her 11 to 7 shift. If someone was unable to come in for their shift, then the Agency will send someone else to fill in.

Now, the cost was very expensive... good grief, it was $20,000 a month, yes a month. With Agencies, they would probably charge a bit more for a caregiver to take care of two people within the same household. That's a lot of work, getting your parents up in the morning, bathed, dressed, and trying to lift them into their wheelchairs, making meals, getting them ready for night. The Agency might rotate a lot of caregivers so that those on the 3 shifts are burnt out.

My Dad use to leave money on his desk or dresser. Never was one thing out of line or taken.

Dad eventually moved into senior living and he loved it there, he wished he would have moved there sooner. The place was built to look like a hotel. The cost was half the price of staying at home with full time caregivers. It would have been less, but he wanted his morning Agency Caregiver to be there when he work up in the mornings, so we arranged for her to work 4-6 hours in the morning. It give Dad a routine.

Now, in senior living [Assisted Living or a Nursing Home], there wouldn't be anyone sitting with your parents all day, an Aide would come in to help your folks get ready in the morning, give them their baths, take them to the dining room, then back to their room, check on them during the day. Maybe physical therapy would be ordered. Most senior living facilities have a nurse on staff. Even in the evenings and on weekends.

Most Assisted Living/Memory Care facilities are locked in the evenings, so that residents won't wander out. Make sure there is a night crew available to help.
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My mom's experience at the NH is very much as Jeanne describes.

At this time, my is self pay. When her funds run out, she will be a Medicaid patient. Medicare covers the doctorrs who see her "in house" and her medications are covered, as they were at home.

My mom has a variety of activities everyday, some she goes to, some not. She mostly enjoys people watching.

I think this placement is vastly superior to being at home with hired caregivers.
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Just got another text from the care agency and the overnight sitter has cancelled - I'm already undressed for bed myself
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I agree with freqflyer. Also, the home maintenance, errands, getting supplies, etc. Endless tasks to maintain a home and none of the fun activities that a good senior living offers.

I took care of mom and dad in their home with shifts of nurses for a few years and recently placed them. Mom loves it! I was scared to move her, but she is much happier and gained weight in the first month. She was so thin and frail at home. She enjoys the menu at the "Place" as she calls it.

Dad is at a nearby Skilled Nursing Rehab and we arrange for mom to visit him there weekly. We were unable to keep them together because their needs are so different.
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