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My mother in law lives alone, until now she was doing everything her self, but now its going down the hill. so we need to do some struction in her life. I could do everything but medical, and she needs some activity.

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I have caregiver service thru an agency ... They charge $19-22 per hour and require a minimum of three hours per visit. There are several franchise agencies...i.e., ComfortKeepers, Helping Hands, etc. google for your area.
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If she needs structure in her life, perhaps sending her to adult day care would be one possibility . Contact you local area agency on aging to find out what options exist in your area.
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You can often get meals on wheels to deliver 1 meal per day and some counties provide a service of sending someone in. Check with the county in which you live. She may be able to get help she needs free. If she's on Medicare, have her doctor send in a request for nursing. It is not every day and it doesn't last forever, but it's a start.
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I have no idea what question about services you are asking. Please clarify.
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Talk to her doctor and tell the MD what losses in functioning you see. Go with her to the MD, have him assess and recommend assistance in front of you, maybe even telling you to get the help which makes the MD the "bad guy". Then if it is in home help, it is about finding the right person. We had some very "energetic" helpers that were exhausting to be around. Now we have people who work hard, but seem calm, quiet, and flexible. Good Luck.
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In our area St Paul MN the Home Instead rate for 2013 was about $29/hr for 2hrs and slightly less per hr if you did 3 hrs. We learned that the franchise got most of that, the aide got about 10/hr. There were some issues we could not resolve and with it being really expensive, and not liking the aide, we now have 3 different private persons for $20-22/hr and this is much better.
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Reverse Roles, I also got burned by an agency "background checked" caregiver that they charged me $18 per hour for her to come out & sit on her butt. I got a lovely lady from website care and she has a slight disability. She can only earn so much. She is lovely. She lives in our home now, has been here 6 months. She is so professional and like our family. She worked with the public in retail etc for most of her work career. She understands that I'm tired from my job and tries to make my life easier AND takes great care of my mother. Good luck with your search. My lady was the FIRST person that I met from care.com. I had the opportunity to do a background check and I hired her on the spot.
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Oh, and the agency one stole my coat, a lamp, some plants and gawd knows what else along with throwing my mother's sweat pants in the trash.
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I use care.com to find caregivers, interview via email, phone and then if they get that far, my home. I pay for 3 months on care(dot) com to find the right person. They provide a background check included with your payment of all the caregivers. I went thru many many many but found a few great ones! The cost is $79 for 3 months and then when you leave they offer you 6 months for $50 lol. I pay caregivers $12-$15 an hour depending on their experience. If its 3-4 hours I pay $15 an hour but if its a whole day I usually pay $12 an hour and never had a complaint in years. Good Luck
PS agency caregivers are not as good as finding your own, they are usually high school drop outs, or cannot do anything else. I dont mean all of them but most of them are because a friend of mine had medicaid for her mom and gets them free. She has sent some to me and they were horrible, uncaring, and want to be on their cellphone .
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Wow, I feel for you all! Maybe we got lucky... but we love our gal! However, I will say we used a small local agency.. maybe they have more reason to be accountable?
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