Should I hire a private nurse for Mom in a nursing home?

Lena
What is the nh rated by Medicare ? Is it possible to move her elsewhere ? Unfortunately Ive seen firsthand bed ridden folks calling for help while the CNA is asleep in the hall or reading a magazine or on a cell phone
Most only get their diaper changed a couple of times a day
Do you have family friends or church members that drop by for at least a short visit each day ?

It's expensive to hire a sitter but most of us have done so

My moms first stay in rehab following a broken back resulted in renal failure from dehydration and hospitalization for a UTI requiring treatment by an infectious disease specialist and this at a five star rated facility

please help me, my mom's in a nursing home for 2years now and has had 18 UTI's. They say she is prone to them. She never had them home. I go every day and many times she is sitting In feces. She is wheelchair bound and can't use her legs. She tells me she calls and calls to go to bathroom, they say in a minute. HER DIGINITY is gone. She has slight dementia, but remembers some things very well. I have only two rooms and she requires an aide 24/7. Her SPIRIT is gone. I am not just talking about my MOM but have heard others residences BEG to go to bathroom. I am so depressed I don.t know what to do. Can anyone please give me some advice. Thank You. Lena

Hello i am a CNA HHA also and i do go into homes and nursing home and take care of love ones and trust me its a big help for the family cuz mostly nursing are very short on the wkends and with us like me come in its a big releif for the nursing home and the family ..sometimes they take her home and i go into the home i even went on a trip with them (i flew too) cuz they didnt want to leave their mother here alone..so yes by all means hire her to help out on the wkends its good thing

DulcifromDenver I applaud you and hope that maybe you can use your mothers SS or assets to pay yourself or use for her supplies and keep her with you. My husband and I also have my mom, and she has one on one daily. I hope and pray someone stays with me if I get old like this, and not put me in a NH. My adult children have watched us take care of Mom, and also helped us, and they said they would never do that to us. I prefer at at-home help, let them hire someone for me but please no nursing home, hey can oversee but not be tied down. I am here for Mom and no one will ever neglect or abuse her, we spoil her, she deserves it as she was a great Mom and would do it for me. Best of luck to you.

People need to realize that the $8000 - $9000 (private pay),or approx.$4000 - $5000 Medicaid dollars each month the nursing home collects is for room and board and 'staff' only, everything else is being charged to Medicare/Medicaid.We are talking many,many more thousands each month they are raking in from the government..Let not even talk about all the kick backs from pharma suppliers,ambulance services,medical equipment suppliers,non in house doctors on retainer,personal care, hospitals,etc.With these huge amounts of money being spent every month you would think the care would be premium.It is not.Then the family needs to spend thousands more to hire private caregivers or devote their own time because they can not do their job efficently?This is why Medicare and Medicaid are in dire straights.Nursing homes have some of the most powerful PACS and lobbies working Congress and they almost put to shame many of the other special interests working the government for dollars every day.This is the reason they don't want you to care for your loved one in the private home.

After 2 NH in one year, 2 of which both my parents were neglected and abused, I took them both out and brought them back home. My dad died within a month of being home because he was so sick with what happened in the NH. Three months later I put my mom in the 5Star best home that we'd been waiting for 3 years to get her into. I took her out in 6 months because of the lack of care in her podunk town, the abuse she got and the fact that instead of checking for UTIs, they just gave my mom pychotropic drugs that made her sleep 20 hours a day. None of the nursing homes ALLOWED me to help her to the bathroom, nor did they ALLOW anyone coming in from outside to help with her to the bathroom because of 'safety concerns'. She fell in their 'care' three times in 6 months. In my 45 years of caring for her, she fell once with me in the shower 5 years ago.
HIRE SOMEONE TO KEEP AN EYE ON HER. $20 for a one hour visit is a lot, especially if she's just a student. I only paid $10 for a girl to go in once a day.
My mom lives with me now and my husband in Denver. I can't afford to keep her but I will because I refuse to let her live her last days in a place where she is abused, neglected and ignored and drugged. DO NOT listen to the aides when they 'volunteer' themselves. Do NOT tell the administrator who is was because your mom is there alone and these people (not the admin but the workers and nurses) will retailiate against you for speaking to the admin. Just ignoring your mom will affect you so just tread lightly. Then get an ombudsman. Every state has one.
Good luck.

I retained her sitter that was with her daily in my home as a nursing home "friendly companion". She does not do any care for her because of liability issue with nursing home, but just goes there daily to check on her. The nursing home is near my home, so she divides her time between going to the home for an hour or two, then she goes to my house and cleans and does errands while my mom sleeps or is in therapy. This works well because I work long hours in a neigboring town and cannot get to the facility "at the drop of a hat". My mother loves more than anything the security of having her long time sitter with her. The nursing home treats her well, so we are very fortunate--but nothing can replace the one on one interaction. If you can afford it, I would say do it, by all means.

Thanks again for all of your replies. To clarify, Mom is in a private, family-run nursing home that (supposedly) rates high on most lists, but, as several of you mentioned, there is never enough staff on weekends or holidays. We have Hospice, but they only visit 3 times during the week.

Mom is paralyzed on her left side from her stroke last August, so she needs assistance doing almost everything. She can operate the call button, but sometimes it falls away from where her right hand can reach it. And sometimes Mom just can think straight enough to know what to call about.

To those of you who give care at home, I salute you. I don't have the patience or the knowledge to do that myself, even if I didn't live 800 miles away (I fly in about 2 times per month). I don't even know how I would get her to where I live. So she's stuck in the nursing home and I'm stuck managing her care from a distance. A few relatives that live near her do drop in occasionally, but I can't count on them to notice anything or let me know if they do. All that talk about "establishing a care network" kind of falls apart eventually. That's why I hired the student nurse to send me reports...and I specifically instructed her NOT to help the nursing home staff because I didn't want the place worried about liability issues.

Mom hates it there, I don't blame her, but I've had to tell her its the new reality. Four months ago she was living alone, going to exercise, driving her car, having a beer occasionally, and then the stroke took that all away. But she's 88 and having a hard time accepting her current limitations. I guess I am too.

Liability. I am going to get a mom sitter or something of the like, to talk with mom, entertain her advocate for her. Luckily (if that is possible) I was laid off in June 2011 so I see my mom every day twice a day...I see the short comings in the NH...mostly, i see patients being ignored...there is no or very little one on one. I would not have the person I hired to transport mom , chair to bed, wheelchiar to chair etc etc as that would be a NH liability and I don't think they would agree to that. The person could grab a cna and have the cna do it so the hired person could take mom out to the garden during the spring/summer; feed mom a snack, make sure she is toileted and more I don't suggest you have the person you hire doing transport or cna duties as theNH will likely not agree. the cna's at mom's nh do not allow their staff to work for the family privately and they certainly would not let their staff therefore, work right there in the NH for the family.

D2, That's my experience. You are right. The family need to know.

The nursing home my father is in calls me everytime he has a skin tear or is hurt in anyway. They are required to. If this is not happening where your loved one is, you should talk to the social worker.

Lizann, I also have my Mom at my home and used caregivers and daycare when I worked but I left my job now to stay home with Mom. I stil have 1-3 hours of help in the mornings to get Mom out of bed. My FIL who passed years ago was in a nursing home and we had to hire someone to go in at each mealtime. The NH told us they only have to bring the food, they dont have time to feed it, nice huh? He was dying of bone cancer but still wanted to eat, has his sharp mind still, but needed help . It was worth the money to have peace of mind he got his meals in as we were all younger and working fulltime with young kids back then. I say if you cant be there or keep them home hire someone, even if its just to visit them as those people dont have time to chat or they get in trouble, good luck.

Jeanne, I'm probably talking out of my hat, but I think the conflict of interest arises in the fact that the aide is an employee of the facility. Most certainly, workman's comp issues and the like would be muddied should the employee be injured while being paid independently. I imagine it would mess up a liability case also if a resident was injured. Under whose purvey were they employed in either scenario, especially at 'their' usual work place?

To me, the legal and insurance issues are too tangled for a facility to allow this situation.

Just my two cents and a guess. Won't even buy a cup of coffee, much less a gumball these days. :)

About the propriety of the aide offering private services. I really don't know. The facility must have a policy in place.

For those of you who see potential conflict-of-interest issues, could you give some examples?

I know that police officers often free-lance providing security during their off-hours. Does this present potential conflict-of-interest, too?

I really don't know the answers, and I'm curious what others think.

I feel very fortunate upon reading some of the experiences people have had with different facilities. My mom is in a private pay AL, and there is no way we could afford to pay an additional person on top of the AL bill. No other relatives live near her so I visit every other day. On holidays, she spends the days with us.

Mom's AL is well-staffed except for the occasional day when one too many calls in sick. They're pretty quick to call in replacements. My mom is still fairly sharp and has developed some caring, special relationships with the 'girls' as she calls them. They're like her own girls, but instead of her taking care of them, they take care of her. She is a good listener for quite a few of them though, and they pour out their hearts to her about boyfriend break-ups, problems at home and such. So I guess in a way she supports them too! Win-win. Sure, there are a couple of people she doesn't care much for and probably likewise for them, but it's the way life works.

Mom's a little clumsy and bruises badly. Any little thing, (once she hit her hand on the vanity and got a small cut), they are on the phone calling me.

Overall, the experience has been pretty positive so I will count my blessings!

There's two questions here:

1. "Should I hire a private nurse/nurse's aid/sitter."
2. "Should I hire *this* nurse's aid."

With respect to #1, if you *can afford it*, and don't have any severe restrictions to what professional aid/sitter/etc. could do, and especially if your mom is incapacitated, by all means, do it! My experience with a nursing home as a regular visitor is that the nurses and aids may be well-intentioned but there simply isn't enough workers to deliver the quality of care one would hope for. What your hired help is allowed to do depends upon the policies of the nursing home.

As far as (#2) hiring *this* nurse's aid , well, she might be well intentioned, but I'd have to wonder about how exactly she would be able to help. (The aid could certainly be a "he" but to avoid awkward English let's just assume "she".)

I have the same concerns: How can she go *private* at the same facility she works regular hours? Wouldn't there be potential work ethics issues? I'm sure the administration would have the same concerns. It smells fishy. The situation with the private hiring could lead to some very unpleasant accusations toward the aid due to apparent conflict of interest unless some special guidelines have been set previously, and I doubt that there's a nursing home in this world that would even agree to the terms that would allow this without very extenuating circumstances. I'm not sure the aid has thought this proposal through.

I am surprised that the nursing home administration hadn't immediately gotten back to you about hiring private help, but maybe it was just the way you asked. Besides inquiring with the nursing home about *external* agencies or people you might be able to hire, consider also directly asking some home health providers in your area if they might work with your mom's nursing home. I'm sure arrangements can be made.

Friends hired a companion for their father in dementia care, for 40 hours a week. They were not so concerned about the level of care at the facility they selected for him, but they wanted to give him stimulation and companionship during the day when they could not visit. This worked out very well for all of them.

I can see value in having a companion or a personal care attendant for certain periods in the NH, but I don't know why this would have to be a nurse. If medical attention were needed surely the aid could summon it from the regular staff.

onlychild5, were you considering bringing in extra help before this aide approached you?

Luckily I did not have to place my parents in a nursing home. I cared from them in their home with the help of home health aides. However, hospitals, Nursing homes and ALF are generally understaffed and over holidays it is really bad. If you can afford to have a good home health aide there for some part of the day during the upcoming holiday it may be money well spent. Often when staffing is short "accidents" happen when the elderly try to walk without assistance because nobody responds when they push their call button. Use your own judgment. I did have my dad in 2 rehab facilities and I all but lived there to make sure he was well cared for during his stays.

Face it nobody wants their loved one in a nursing home.
Elizabeth

sound so much like how my mom was---
love and hugs---
we need them...
love
k

I am a nurse and have specialized in Geriatric care. I worked in several nursing homes and have NEVER heard of hiring extra help. you are already paying a LOT of money to receive the care she needs. If they are not meeting those needs, I would talk to the administrator and if they can't do what you feel needs to be done, then I would look into another nursing home. Private nursing homes are MUCH more accommodating than corporate ones, from my experience. The corporate ones have too many "hands" wanting money on a higher levels to care about the individual needs of a resident. My grandma was at a private nursing home and they ALWAYS had ample staff to be able to sit with her daily, etc. Just saying! If people start paying for private staff, then what is the point of the nursing home?? Might as well move her home and have the private care, it would be cheaper in the long run, I am sure!!

While it can be nice to have someone familiar with your mother and the nursing home she's in, in many/most businesses it would be considered a conflict of interest for an employee of the facility to hire out for private care of patients in the same facility. Employees are not supposed to have personal gain from a situation that came up only as a result of contacts through their regular job. This would be considered a boundary violation. It can really place the employee in an awkward position, too. If there's a conflict related to patient care, will the employee's loyalty be to the facility or to the patient that is paying them privately? That might be why the facility wanted to know who the employee was that offered to provide private care. So, if you decide to hire someone privately for your mother, I would support those who suggest hiring someone from outside the facility.

Hello Onlychild and others. Please talk to the social worker at the nursing home. Ask her for referrals for a private duty person. I would only get someone from an agency. Have you considered having HOSPICE for her? They have been wonderful for me and my husband. Medicare pays for them. They will not stay full time, but will visit, shower her, change her, help the aides. Do NOT hire someone from the nursing home. And don't ask friends. It's a huge job and friends may call off. Best of luck and love. As time goes on and mom sleeps more and more, the extra person won't be needed. Let the administrators know they need more people on the weekend. Also, keep your ear listening for a better place. God bless you. Sending hugs for you and Mom. Corinne

It is all very sad because this generation were the ones who worked very hard,lived by the rules,cared for their families,paid their whole lives for good care when they needed it and now are being used as nothing more than a money pump for some corporation and stockholders.The eldercare system in this country really needs to be taken behind the shed for a good whipping.Government officials talk a good game but in reality everything is getting worse for the middle class and poor.

You guys hit a nerve for me. I feel the same way. I can't be at the NH 24/7 but I know my mom feels and acts so much better when someone she knows is with her. I'm think what I'm going to do is talk to a few of my friends to see if they would be willing to visit with her and be paid. Even if they are not qualified to get her up to the potty, they at least can be her advocate to call for help. That's my mom's biggest fear, that she gets them mad at her. She is able to walk with her walker, but only with assistance. So she has the alarm attached to her when she is sitting in the wheel chair. Sometimes she waits so long for someone to come she just has to get up or she'll pee in her pants. Then the alarm goes off & they "yell" at her (this is what she says).. I can see the benefit of having someone with her. Thanks for the suggestions!

I Think its a very good idea.My Mom and Dad both are in a nursing home and sometimes i have seen things not being done that should.Sometimes when I go to visit my parents smell.I dont get to go often as I am disabled.A personal nurse would be a big help and a blessing

i think if u can do, you should.
it could provide u with some peace of mind-and an opportunity to know what goes on when u arent there-
we know nh are short handed-and sometimes the staff cannot give as much time and attention to everyone.
besides seeing how issues are dealt with, when family visitors are not around,
would make me feel less worried and anxious about mom being in a nh-
i hate to hear from the staff- oh she is doing fine- when i ask how she is-
beause i dont know what that means? i know they dont look forward to speaking with me, since i always have so many questions- i dont try to sound mean , i am just very concerned since i cannot be there and i know they cant spend too much time with one person.
besides, if mom feels comfortable with this person, why not let her have that secure feeling -she is going thru a scary time, a traumatic change in her life,
if u can finance it, why not?
i know my mom spends too much time alone-in the nh-even though they say she isnt-they say she goes to activities,,
activities? like what?
she cannot do activities!
so what do they mean?
-for example i was told she enjoys cooking, what? cooking? how is that possible? she is weak, cant really hold anything, has aphasia,dementia, and alz, and is on mucho meds- when i asked what does she do there- the answer was a real eye opener-
oh, we put on a rubber glove, and she holds a spoon-sometimes-
please- give me a break- cant they be honest instead of giving those annoying generic answers?
so lets be real- a companion would help
a great deal-
frustrated and stressed out-
k

Yes,nursing homes are severly understaffed most of the time especially weekends,night shift,during severe weather,and holidays.Burned out staff turnover is another big problem.It is really pathetic if you end up on Medicaid because the care level takes another huge step down.Believe me profit or non profit they are still making tons of money,one of the reasons Medicare/Medicaid are in big trouble.Nursing homes and assisted living are some of the most profitable businesses in the country (why there is one on almost every corner these days).Don't blame the aids or nurses because their wages are at the low end of the medical field stratum!It is all about profit.I kept my mom at home until it was impossible with the help of private caregivers .When she went to the hospital or rehabs we followed the same routine (private caregivers and I full time) because they are just as shortstaffed.When my mom finally had to go to a nursing home full time it became a nightmare because of the above situation and we covered her 24/7.BTW : This place was 'rated' five star.It was not a pleasant experience for my mom,private caregivers or I.Many other families also resorted to the same routine or gave up their life in order to be a watchdog for their loved one.If your loved one has dementia you need to be there a lot and you will be shocked at what is going on in regards to the so called care level of these people.Once again it is all about money/profit.Many nursing homes resent overprotective loved ones and private caregivers because they get to witness the darkside of life in the facility.It sure put the fear of God into me.I never attempted a private nurse because I don't believe any facility would go for that because of the liability.The only way this situation will ever improve is if the Medicare/Medicaid departments really make a serious effort to investigate where all the billions of dollars are going because it sure is not going into the care of the residents.Sorry if I sound bitter but I am because I spent 40 - 60 hrs every week in those places for over six years with my mom.It is bad now and it is hard to imagine what it will be like in the future when the government cuts more money out of the care of our loved ones and eventually us.The only solution will be accountability of whose pockets where all these billions of dollars are going into every day.A typical routine for a nursing home is to dump a resident off on a hospital during a holiday period for four or five days (usually something like a UTI/dehydration) ,government pays 10 - 20 thousand dollars,then on return the nursing home collects 10 - 21 days of skilled nursing care.It is a huge round robin and everyone makes tons of money because the government keeps paying it out until they (us) are broke.See,guys (NH,ASL,Hospitals) who are reading this I know exactly how it works and that is the tip of the iceberg.................And yes these places will always continue to 'win' because there is a infinite supply of customers in the pipeline waiting to get in.

I think if you can afford it, yes, have a sitter with your mom. So much is going on in this crazy world. If you work and get there everyday to see about heer, It would be a good idea to have someone there to take care of her. The set up you have with the student sounds good, as long as someone makes their present at diff times of the day, your mom should be ok.

Thanks for your replies. I asked the nursing home admin about the offer by one of their aides to work weekends for Mom...they wanted to know "which aide?" I didn't give them a name and I'm still waiting to hear what their policy is.
I guess my concern is that this aide works for the nursing home right now, so how can she go in there as a "private" nurse on the weekends?
But what I did do about a month ago, was hire a nursing student to stop in and check on Mom up to 5 times each week. I'm paying her $20 per visit to stay for one hour, assess the situation, and email me a report on what's going on. This is how I found out, for example, that Mom had tried to get out of her wheelchair last night and cut her leg. I'm not sure the nursing home would ever tell me that.

Hello, well my 85 year old mom has been in a nurseing home for 2 months now,they have kept her alive,clean,fed but food is POOR,give meds OK,the rooms clean,gets to beauty shop 1 x week, and have activities she does,she is wheelchair bound, has Alshiemers..But either Myself,Brother or her hired Companion who stays 6am -2pm covers am care and 2 meals,helps some takeing her to bathroom setting up tray and really a watchdog for me about what's really going on there,with mom and whole staff.Plus I am an RN and they know it.They listen what I ask and say to recommend things in a nice way for mom.The companion sitter helps when I can't be there at all mostly when I work my 12 hr shifts 2 days a week,she has helped mom alot they play cards and go around the place.This companion was just for her to adjust but mom says she needs her and well going to keep trying to keep her as long as me and brother can pay her...Really if you can get a good one they are worth it because patients wait a long time sometimes for care,I have seen and someone has to be there visiting and seeing about their loved one or??things can get really lax..blessings Upon You I know this is so hard to put them in a Home but the stress is mostly off me now andt he care although WATCHED is fairly good...