I live in a diff. State as my parents (1 hour away) my brother is local but currently stays there at night and prepares their meals. He is a Veterinarian and has busy work schedule. I feel guilty when no one can cover so it falls on me. I have middle school age children with a busy schedule so it’s hard to change things at a moments notice.
It’s a common issue to have a shortage of help in caregiving. It’s a tough job, with low pay, so there is always a high turnover of employees.
There may be an independent caregiver that would be available to help. You could even check with a nursing school. Students always need extra money. It would depend on their school schedule and if they are doing online or campus classes.
I was in a similar situation, kids old enough to get home alone (just) but working part-time & I lived 15 mins away. Not ONE HOUR!!
Ask yourself now: is this working for you?
It's not selfish to try to make it work for everyone. It's common sense.
What if you were the Vet? Or a man? I'm not dissing your brother, but I was asked this kind of thing. I was asked what if I was a man? Maybe a truck driver? Would there be the same expectations on me? This led me to thinking... How much pressure is coming from family & how much did I signed myself up for?
I think you are on the *slope* right now... by slope I mean slippery slope. I think it's wonderful that siblings band together to help their folks stay in their home as long as possible. It's a gift. But it's a gift that keeps on giving! It's not a static thing - the needs keep increasing until you find your own life slipping away & you are living your folks life All.The.Time. Suddenly you don't know your kid got in trouble at school, less & less meals are home cooked, chores at home not done, marriage stress.
My advice would be to have a family meeting. Not to get your brother to do more (I just re-read & saw he is staying o/night & doing meals) but to both LOOK at the situation.
Is it still working for you all?
Sounds like you are both at your capacity?
That day was always going to come... So time to plot the next course.
Can you change agencies to one that will send a substitute? Is there a neighbor or other caregiver who can pinch hit once in a while?
Depends on the level
of need - how OK they are without the service?
1. Miss a shopping day but have enough supplies until tomorrow? Inconvenient.
2. Miss a doctor's appointment? Frustrating.
3. Be left wet, dirty, unwashed, undressed? Very poor.
4. Left in bed, unable to reach meds, food & water? Crucial.
My relative has had years of home care, many different providers, usually with good regular service but stuff happens occasionally :
no shows/late/unknown fill-ins etc. My relative has functional decline & now at the level 4 I listed. Even at 3 I felt this tipped the balance in favour of residential care.
Sj, when you say it falls on you, do you mean to start calling around for replacements? So you must always be available? Ready to drop everything? Must be exhausting!
I see from your profile that your mother has dementia, and I'm assuming that your father is her primary caregiver, with your brother acting as primary caregiver for them as a couple, and a regular agency acting as the lead service provider. Is that roughly correct?
What irks me about the situation, assuming it is as outlined, is the flawed thinking about whose responsibility it is to solve this problem. If your father is not affected by dementia and remains the primary decision maker for himself and your mother, then this is for him to figure out. Of course you will still want to contribute when it's sensible, I'm not suggesting you should refuse to be involved, or anything unkind, but he has to plan ahead AND plan for contingencies - i.e. he needs to sort out his own back-up strategy.
And if the agency regularly lets him down then he needs to find another agency or two.
My rellie continues to accept that risk as part of living alone.
Wonder if Dad can phone for backup aide? Language barrier? Hearing issue? Phone tree system to navigate? Just easier to call family & ask them to do it or come over?
If they can not find a replacement you might want to contact another agency and ask what they do in such a situation.
In your profile you mention mom with dementia. Is dad fully able to care for her if there is no one else there? If so it does not seem to be a safety issue. It would just mean that things get left undone for a day. That is IF dad can manage by himself. Have a few frozen meals in the freezer for him so he does not have to worry about lunch and dinner. BUT if dad has any problems caring for mom then that is negligent on the part of the agency to leave them alone for the time they are supposed to be providing care.
Is it possible that the agency is taking advantage of the fact that you can "jump in" and take care of them if they have a scheduling conflict? If they are depending on the fact that you can take a shift maybe you should ask them to pay you...😉
I had caregivers through an agency for my parents 7 hours a day, 7 days a week. The agency took no responsibility for making sure the caregiver was in the home. We had numerous "no shows," which the agency wouldn't know about, or care about, unless I called them and yelled.
If they had a caregiver cancel, the agency would supposedly try to find a replacement, and sometimes they would. The agency was famous for telling me they were "looking" and then never getting back to me to say they didn't find anyone.
I finally got fed up one holiday weekend after yet another "no show." I called the agency and demanded to talk to the owner.
The owner actually told me that they don't guarantee to send someone. Yes, those were his words. I then told him that they should be very upfront with this fact in their ads, and when they initially come to your home to sell you the service.
I was all new to this at the time I hired this agency. I specifically went with an agency rather than the cheaper option of hiring an independent caregiver, because I knew I'd have problems when the caregiver needed a day off. I assumed an agency would provide the service they were hired to do. I didn't ask how they handle no shows and caregiver cancelations.
The owner also told me that he thought his agency was doing well in providing coverage, because they covered a little over 90% of the shifts. He then said that 90% is top-notch service in the caregiving industry and better than the other agencies are providing.
Ninety percent is good in some things -- like amount of words spelled correctly on a spelling test, or games won in baseball -- but NOT caregiving. Would people find it acceptable to say that their infant was watched and fed 90% of time?
When I'm driving, if I pass 90% of cars safely and smash into the other 10%, do I have a good driving record?
Plus, the agency skewed the statistics. If at any point I told them to call off the search for a replacement because it was already well into the shift and I have to make arrangements to take the day off from work, the agency marked that down as "canceled by client."
At one point I asked the owner if they report themselves to the Aging Office when they neglect to send a caregiver to an elder person's home. The owner then said that it sounds like my parents need medical care. I told him that my parents don't need medical care, but they do need to eat and go to the bathroom several times a day -- all services which the agency says they provide.
I ended up pretty jaded by the whole "hire a caregiver and age at home" experience. I recently fired the caregiving agency and moved my parents to memory care. It broke my heart to do that, but they need dependable care.
We had some good caregivers through the agency, but the overall performance of the agency, especially for what we were paying them, was poor. This particular agency might be good if you only need them for a few flexible (for them) hours per week, and if your loved one is pretty self sufficient, but not for daily necessary care.
My advice for anyone thinking about hiring daily in-home care: Ask the agency right up front about how they handle caregiver no shows and cancelations, because this will be one of your top headaches. Ask what their statistics are for no shows. Keep in mind that statistics can be skewed. And, will having 90% of your shifts covered be good enough for your loved one and you?
That is why the government only pays for nursing homes (Medicaid) because they are frankly a LOT cheaper than around the clock home health. The average nursing home patient costs about $80,000 to $90,000 a year. A private sitter (who does NO hands-on care) would cost $175,000 a year. You still need to hire someone for feeding, cleaning, bathing...so it would probably go up to a quarter of a million dollars a year (seriously).
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