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I just found this forum and I have a question for you wonderful people. I'm the only one who takes care of mom. Long story, but my brother and 3 sisters will not.
I'm thinking of getting mom some outside caregiver help. I have talked to people here and there and am not liking what I hear. I guess good help is hard to find.

Mom probably needs someone 4-6 hours daily. She is 86, had a bad hip surgery result. Walks with a walker a little. She takes eye drops , a BP pill and vitamins. She needs some grocery shopping assistance. Some doctor apt rides. She bathes herself. Some cooking and condo cleaning would be needed.

What kind of help do I need? CNA? HHA? a caregiver?
I'm not comfortable myself hiring someone off the street, or should I?

I have specific questions about homecare agencies:
1. Will they send someone to assess her to determine what type of help she needs?
2. Do the agencies send me someone already interviewed and background checked so I can hire them? Does that cost money up front like a couple of hundred dollars for their human resources part? Then I hire them for what the caregiver and I negotiate?
2. Do they only send me people where they upcharge per hour, example they charge me 20/hr, but pay the caregiver 10/hr? That's what I've read somewhere.
3. How do caregivers get paid by an agency? Are all taxes taken out or are the caregivers like independent contractors getting a 1099 form?
4. If I directly hire a caregiver, how do I pay them? I don't know how to do payroll, so I would have to pay a simple check and let them pay all the taxes ;)
5. What if they don't work out? How many will they send me? What will it cost me?
6. Who covers if they get sick?
7. Who pays if they get hurt? Homeowners ins?

Before I call any agencies, I would love your input. My mom doesn't qualify for any Medicaid, but falls just above the poverty income line.

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I moved my mom in with me cause shes almost blind shes legally blind and she s macular degative ...my question is the welfare told mecan get paid to take care of my mom since I had to quit my job...cause she was sick in the hospital from being sick and having a stroke..who do I contact with my help...
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My boss has a Caregiver six days a week, during the day, for his wife who has advanced Alzheimer's..... this Caregiver isn't with an Agency and he pays her directly as an independent contractor....

From what I heard the Caregiver is pretty good, but there are days when my boss can't come into work because the Caregiver couldn't come in due to her child being home from school....

Another issue is that the Caregiver doesn't drive, so she takes the bus over to my boss's house... thus the Caregiver can't take my boss's wife to the doctor [he would meet her there] or to the hairdresser.

So those are two extra issues to think about.
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I don't have any experience with in-home caregiving although I have explored the option a bit, so I'll share what little I know.

What concerns me are the liability issues for hiring someone directly. It's my understanding that if the caregiver were hired and paid directly by us, we'd be obligated to take payroll deductions as an employer.

I planned to but keep forgetting to contact my insurance agent, although I'm sure the answer would be that if the caregiver were injured, she/he could look to us for liability issues. That would stop me right there.

There are too many ways someone can be injured caring for an elderly person.

I've read on this forum that others have had problems with theft; obviously not all caregivers have sticky fingers, but you'd have to do a background check to be comfortable on that issue.

On the other hand, I personally know of 3 people (family and friends) who've had individual caregivers and never has a problem arisen. I don't know how they found them, but the relationships were all good.

If you do hire caregivers directly, you might want to consider someone from your mother's church (if she has a preference) for the nonmedical tasks such as cleaning and cooking.

I would think someone with medical training would be necessary for transport, especially with a walker. You would have to ask your insurance agent about any accidents (vehicular or personal) that might occur if someone is a "pay for hire" transporter. I believe that changes the liability situation for the driver.

The issue of nominal payment by an agency for a caregiver is a legitimate one. Perhaps you could consider supplementing her/his pay by periodic direct bonuses, tickets to a concert, books, or something that the caregiver might like, assuming, though, that acceptance of gifts isn't prohibited by the agency (and it may very well be).

Regardless, you should prepare a contact list for the caregiver of personal and medical people in the event an emergency arises.
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I would not have told you 2 years ago that NH would be a good thing, but my mom, 91, with CHF, post stroke, with dementia, is thriving there. She is on private pay now, will be for a couple more years (my mouth to God's ear) and if she is here 5 years or more, medicaid will take over.
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No. You do not need POA to talk to the agencies, but someone needs that over your mother, in case she is unable to speak or make decisions for herself. You are not calling the agencies to get medical info ABOUT your mom, that is when you need POA. You are just interviewing the agencies.

Respite care takes place at an AL or NH and is for a set amount of time. You would need to ask them if medicare would pay for this.

I have a wealthy acquaintance that is paying $11,000 per month to stay in her home and have 24/7 care.

You are right to be concerned over who is taking care of your mom and who she is having in her home.

I thought that a NH, especially the local one would be a nightmare - but it has saved my mother's life. She has been there 18 months and could not be happier. I NEVER would have believed it. She had no choice. She is 95 and cannot live alone.

Do not expect other family members to volunteer to help. Everyone has there own lives. Not everyone is a caretaker and everyone has their own past with mom.
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Mom is 19 months post surgery. It is what it is. It didn't heal well. That's what her dr, said. She's stubborn and wants to live on her own. Does not have the funds for ASL. She will not ever go to a NH.
She is past the doctors care where he would recommend a visiting nurse. She has all her marbles.

-Do I have to get a POA in order to talk to agencies? Is that a must because of the HIPPA laws? Please answer this one in detail.
-What is respite care for elderly?
-Do any agencies send people pre-screened so I can hire them? If so, what do they charge?

Years ago (and I didn't pay attention)someone told me that their gmother had a CNA live with her 24/7 and they just paid HER directly, not the agency, and gave her a 1099. They said that the agency sent them like 5 women before this one worked out. My thinking was that they paid the agency a FEE first, then they decided to keep the final one (CNA) and paid her directly.

I'm not crazy about paying so much and having the caregiver get so little. I would like them to get compensated fairly. I also would be happy to pay the agency for their troubles of interviewing, screening, background checking...And I'm not sure how people feel about getting a check without taking out ss and fed taxes. Will there be trouble with the IRS?

Mom needs non-medical help except for her medication which isn't tricky or anything. But in my state I think a nurse has to do it, if it's not a family member. Arrrgh. We can't afford a nurse.
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Just a comment on the cooking aspect. Inquire about Meals on Wheels. My father was resistant at first but now is very pleased. It will be one less task for the hired caregiver to do.
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First consult with her dr and see if he can order some visiting nurse, PT, etc.

Then call a few home care agencies in your area, ask some of the questions you pose, and ask for some references. Then call the references and ask the good and the bad.

In most cases, an agency should be bonded insured, have done background check. CNAs should have some training, experience. Some do some don't -ask!

Pay, you are correct, CNA gets about 50%, agency gets 50% this is pretty std unless you hire someone who is independent. Usually, you will be invoiced for hrs, expenses, etc on a weekly basis. You pay the invoice just like any bill. You claim as medical expense on taxes at the end of the yr.

Call dr office, senior center, aging center and ask for references, check on their bulletin boards, sometimes caregivers will post their availability.

If caregiver gets sick, then if you have an Agency, they will provide a substitute but if it is an independent person, then you'll have to find respite care or other means of coverage.

It sometimes takes a few trials to find a good fit that everyone trusts and feels good about. Give it a couple weeks before you make decision and spend some time getting to know the caregiver and monitoring their interaction with loved one.

There are professional caregivers on this site who can give you more insight and suggested interview questions.
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First of all, call her doctor. S/he can order an evaluation from an agency to see what her needs are. Do you have POA, HIPAA filled out? Those documents allow you to talk freely to doc and agencies about your mom's needs. Was she in rehab after hip surgery? did they discharge her home after rehab needing no care? Post back! We're here.
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