It is slowly becoming a reality that my mother will need some care at home. This is a concern because she is digging her heels in and stating that if she needs 24 hr care at home, she wants to remain in the home with round the clock care. She has some money, but paying for full time care will quickly deplete her funds.
I am not able to do any of her physical care due to health problems. I am able to take her to the doctor now and also do her grocery shopping.
What is the reality of round the clock care? Has anyone ever done this?
In certain states your able to take your mom to the doctor. They in turn make the decision that she needs Homecare. Then once a Homecare is set to come in there is certain things your mom my need to do to qualify for help. Meaning if she has money certain states don’t allow people with a lot of assets to quality for help. That being said she may have to pay until she cannot pay anymore or have her assets transferred to someone else in order for her to qualify for help. Once this is done she will have someone come into her home take a bunch of information then they take it back to the office and determine the amount of hours she’s allotted for. If she has money and doesn’t want to transfer it into someone else name she may have to pay for a private duty aide. They are going to be very expensive and depending on how much money your mom has it’s gone to go fast.
You need to talk to your mom about this. It’s difficult to do but if your mom is asking for someone you really need to get her the help she needs. She will probably feel much better knowing someone is there for her. She may have some underlying problems that you are unaware of.
First start with the doctor find out if she qualifies for Homecare hours. If she does then you will have to have the talk with her about her financial situation. Go from there.
I had to do this with my mom. It was exactly the same thing. I don’t know where you live. Sometimes it can be hard to get things going. Once she’s in the system though it works really well.
Good luck.Be patient get your mom’s affaires in order then the help should start with her. It takes a few steps but it’s really worth it once it’s done. I had Homecare for my mom. I had to do exactly what I told you with her affairs first. Actually this is what we where told to do by the someone ( a friend) that knew how to get help. I just did what he said and it worked. My mom had the help she needed until the end.
Good luck.
Caregivers in the home are employees if not working for an agency. Take that a step further, an agency does not tell caregivers how to change a diaper, they train them, then they are on their own and still employees of the agency.
Hopefully private in home caregivers are provided some level of training.
https://www.irs.gov/taxtopics/tc756
"Household employees include housekeepers, maids, babysitters, gardeners, and others who work in or around your private residence as your employee. Repairmen, plumbers, contractors, and other business people who provide their services as independent contractors, are not your employees. Household workers are your employees if you can control not only the work they do but also how they do it."
Were they deductible? All of them? Some of them?
If (when) we need to add a nightshift, that would be $1800 a week and $93,600 a year before taxes.
My FIL lives in independent living and his rent covers big expenses such as meals, all utilities, and housekeeping. Indy living already costs a fortune and the additional cost of his aides is burning through his savings at an eye-watering pace.
The other reality of having full time care in the home is when one of the aides cannot be there for any reason. Things come up. People have lives. People get sick. People have family emergencies. Someone has to scramble and find someone to fill the gap or take the day off work and do it.
Please know what you are doing and what is required when you are making the decision on how to pay the caregivers. It will save you serious headaches.
If they aren't employees then they are occasional workers. Thus they should be covered by the renters or homeowners policy for occasional workers. Other examples of that type of worker is a baby sitter or a gardener.
That's the way I understand it.
My first husband died last June with his last couple of months in a private room in an excellent nursing home. They provided round the clock physical care, and family visited extensively, including all night at the end of life. It worked well.
My suggestion would be to do a lot of detailed research about who would do what and how much it would cost. Write out pros and cons for each option, including facilities, separately, and talk them through with your mother. Most people would prefer to stay at home, but ‘it takes a village’ and hiring a village to care for one person is rarely workable. Good luck.
Speaking to the cost. Caregivers are paid just above the minimum wage from the companies they work for with very little training. I was trained by DHS which has continuing education and required certifications. While the caregiver is making above minimum wage, you will be paying the company providing the caregiver $30-$45.00 per hour. In addition your loved one will not receive the same caregiver and turn-over is high. Thus the consistency of care will change and if there are problems in the home it is difficult to nail down who or how when you have 2-4 different caregivers in your home. Training is basically watching YouTube videos which I experiences in the two of the companies I worked for. Which then signed off on "trained professionals".
I highly suggest you find a private care individual who can commit to the kind of individualized care your mother will need. Sometimes it takes having a few different people before you find the right one. Having employed house help and in home child care for my children, I see this as no different. Respectfully you are putting the trust of a loved one in the care of a stranger.
Those clients whom I have either worked with, worked for or helped find care have had the same individuals for many years. Although I have been working formerly in the elderly care industry for only two years, it has been my passion for many years in volunteering, and assisting with families to find the kind of help needed.
Work alongside your mom with the kind of schedule she would keep with a caregiver, the specific needs ( personal care, house help, errands) and then help her make a service plan, schedule, and cost break down before your first interview. You will also get better serivce and more of what your mother will need with private care as agencies who provide care givers will outline services, write out a care plan and the cost will be based on need. Be assured if you go the route of an agency and your mother needs help with incidentals outside of the written plan by an agency, there will be added costs.
With private care, those incidentals become part of the care and statements in a contract allow for the incidentals that come up. Here is an example...
Let's say your mother has spilled the milk in the frig. If "cleaning a refrigerator" is not listed on the care-plan from an agency most caregivers will not clean it up. I worked in a home briefly where I actually got in trouble for emptying the garbage. The client called the agency to thank them for sending me. She also said that she was grateful I had emptied her garbage. My job was to just "sit with her" while she healed from back surgery to see that she did not fall. The house had a foul smell and I tracked it down to the garbage, which she was not able to empty, thus I did it for her.
All to say that you can go on craiglist and look at the job qualifiations for caregivers. There are 100's of positions listed by a number of agencies. Most will say, "no experience necessary. "
My five children now promise to never place me in a facility or hire a caregiver when that time comes for me. I now work in a private home, and still maintain assisting with clients on an as needed basis. I hope this helps a little.
"If you or a family member needs home health care, and you live in California, plan on it costing about $22 per hour. That's the average cost in the state for a Health Aide, according to a survey published by the MetLife Mature Market Institute*. The yearly cost of $22,880 is based on an estimate of 4 hours per day, 5 days per week."
Has anyone ever done this (24/7 care)?
Yes, I was a caregiver for an elderly man for over a year, (along with other c/g's). His wife paid over $100,000 for his 24/7 care. He wanted to stay at home too and, since they had the funds, he got what he wanted. This is a very expensive way to go. In the end, he was unable to stand or walk on his own and, at the very end, he could no longer reposition himself in the bed. I went off on back strain 3 times, until I had to quit the job altogether. He died 2 weeks later.
It worked because they had a single level home and, at times, they were also doing hospice (no nursing care). We gave him bed baths, he used a urinal and we would assist him up to the bedside commode. We transferred him into a wheelchair and rolled him out to the kitchen for breakfast and lunch.
The problem is when a caregiver is sick (or any other reason to call out sick). Often the home care agency can't find a replacement (no guarantee is offered for care). It then reverts back to the family. Are you prepared for that? If you are not physically able, is there another family member that can do a shift with your mom? It is not a RELIABLE mode of care for her. I was only out when I threw my back out but the other c/g's would call off for lame reasons and there's nothing you can do.
I'd say, if you're going that route with your mom, definitely have a few people as backup.
If your mother needs someone to come into the home and help with medication management, meal prep and housework due to her vision problems, then in home care is probably manageable. Please contact your Area Counsel on Aging and find out what programs are available that may assist your mother - some of them may be free.
Ive mentioned to her about bringing in someone to help her for some things, but she is the one who jumped into the subject of staying in her home should she ever need full time care. It must be on her mind. A neighbor recently went into a nursing home because she fell and broke her pelvis. So, I suppose my mother is letting me know ahead of time that she won’t go into a NH.
I hope it never gets to that point, but there just isn’t enough of me to go around. I know the rich and famous have full time care at home - but wasn’t sure of the reality of home care like that for regular people like us. 😊
Two considerations that arose immediately in our decision making were the suitability of the home settings and the reliability of the caregivers available.
One of the homes was a ranch ranch with two easily accessible, adaptable baths.
Two of the other homes were bungalows with no first floor bath. One of those had a complex stairway arrangement and single bath.
When reality hit, the house with the tricky bathroom proved unsuitable (at different times) for both family members. One entered a residential hospice and the other is now in AL.
The relative in the ranch was able to remain at home for several months, with an excellent caregiver who worked with a second excellent caregiver who was a personal friend. Over the course of time during their service, there were no lapses in care coverage.
The care arrangements for the house with the the upstairs bathroom were much more haphazard because the agency was often unable to provide coverage for the full time aide’s time off. That meant that for a period of several months, it was family who were on call 24/7.
We came to the conclusion that it was a good idea to develop a selection of options for care, then when possible offer trial runs. Not by any means a perfect solution, but the “perfect solution” when dealing with elder care became the exception and not the rule in dealing with our family experiences.