Hiring 24-hour home care—Any advice?

In your profile, you say mom is 87 and living in Assisted Living. What changed???

What mom 'wants' and reality may be two entirely different things. I would explain to her that she has to pay X amount of dollars, whatever that number is, for CGs to be with her 24/7, after her insurance pays it's share, and that you cannot come in and pinch hit in the early morning & after dinner, sorry. If/when the costs are too high or her money runs out, she'll have no other choice but to move into Assisted Living or Skilled Nursing.

I 'want' to win the lottery and live in Hawaii but the reality is, that's not gonna happen. So I have to make do with what I have, without crucifying my children in the process. That's very important to me and to my husband as well.

Your mother is very lucky that she has insurance to pay the lion's share of her caregiver expenses, so I don't even understand what the problem is? DO NOT make ONE peep about moving her into YOUR home, that would be a huge mistake. She can shell out the $$$ to have the caregivers come into her home for as long as the money lasts and then deal with what happens next when the money runs out or if her health/mobility issues become to great for the in-home caregivers to manage.

I would not be posting ads online for caregivers! You're likely to get all sorts of crackpots showing up and who knows what kind of chaos will ensue?? Again, in order for mother to stay in her own home, certain compromises will HAVE to be made. One of them is that she agrees to spend her money on agency care; otherwise, you may wind up having HUGE messes to clean up when a nutcase is hired! My uncle insisted on hiring someone 'cheaper' from an ad years ago, and this person wound up robbing him blind. His daughter came into his house one day and found this 'caregiver' had packed up HIS suitcases with all the silver and valuables and was moving them into HER CAR! Yeah, you need to hire reputable people who come from agencies who are licensed and bonded. That's the compromise mother.

Good luck!

If all she needs at night is someone to supervise her going to the bathroom then you can hire for a 'Sleep Duty' aide. What they do is stay in a home and go to bed. They get up a few times in the night to take a person to the bathroom and check on them.
Sleep Duty aides do not get paid hourly. It's paid by shift time.
This is a private service that many homecare aides do on the side.
Advertise for an aide who's interested in taking a Sleep Duty case. Then list when the hours would be. Most of the ones I know work 11pm-6am then the daytime aide comes in to do the AM care. You can put the hours anyway you like.
Then negotiate the pay directly with the aide. It's not hourly so make sure when you're interviewing that the conversation doesn't start going to asking how much per hour.
The Sleep Duty aides I know get about $70 to $80 a shift depending on what's needed. If it's just bathroom duty it's not that much. If the client is a wanderer and they have to be up all night, it's more.

I manage a small, boutique Home Healthcare Agency in South Florida so I may be a bit biased, but hopefully, I can provide some insight for you. DON'T HIRE A PRIVATE CAREGIVER!

The most frustrating calls I get are at 6 pm at night when I non-client calls and says, "My aide just called, she can't go to mom's tonight, can you find someone for me?"

Fortunately, many times I can, but my first question is always, "Did you call your agency? Were they able to cover the shift?" Half the time they answer, they just got the answering machine. The other half of the time, they say, "No, it's a private caregiver". Most of the time I win their business, but that's a different conversation.

When you hire a private aide, you hire an aide. When you work with an agency or Nurse Registry you get a scheduler, a manager, a personnel director, an insurance counselor, and a roster of other Aides who can fill in in an emergency, replace an inadequate caregiver, and make sure your mom is getting the care she requires (and you are paying for),

In my agency, we only hire full-time, professional, career Caregivers. We make sure their certifications are up-to-date, references and background checks are spotless and they typically have more than 10 years of experience working in home care (not in an AFL - big difference in the caliber and quality of care the Caregiver will provide). Then we continuously check-in, monitor, and visit the client so we can provide coaching and correction if necessary.

I know that sounds like it must be crazy expensive, right? Well actually, when I compare my hourly rates to websites like care.com, I am usually right in the middle of the price range, and oftentimes much lower than private caregivers. Plus, we take care of all the payroll issues, taxes, and liability concerns.

The moral of the story: Find a great Agency or Nurse Registry, and let them manage the logistics so you can love on your mom and sleep well at night! :-). BRAD

My in laws pay 20 for their night aide, which is 120 percent of minimum wage. They found her through word of mouth.

Put in writing that this is a service contract, not a tenancy agreement. The room she gets should be seen as an caregiver office, ie where extra depends and home care supplies are placed, as opposed to an extension of her home. No mail, no personal pets and no family of hers should be allowed.

My Aunt did this for years and was not a trained CNA. If you just need someone to "sleep over" and help in the morning, I think $20 an hour is a little steep if just supervision is needed. But I agree to have it in writing that this is not a live-in situation. That once Mom passes or is placed, employment is done. To add to what PeggySue said, do not allow the person to start moving in personal belongings. Maybe leave her night clothes but no other clothing. Her hours are 11 to 8 or so. When her shift is over, she is to go home.

Bks105, I remember when my Dad had 3 shifts through a caregiver Agency. The 3rd shift person had to STAY AWAKE during that 8 hour shift. The Agency had caregivers that only worked 3rd shift, thus they were use to staying alert during the night time.

Yes, having around the clock care can take a huge bite out of one's savings. I recall my Dad was paying $20k per month, yes per month. Thankfully Dad had saved for those "rainy days".

Dad didn't like paying that much each month. I suggested moving to senior living. He was able to move to the Independent Living section, have a really nice 2 bedroom apartment.... plus weekly housekeeping/linen service, etc. It would cost him $5k per month back then [prices can vary from city to city]. Dad sold his house, so the equity helped pay for the senior facility.

I really would recommend using a caregiver Agency, as they are licensed, insured, and bonded. Putting an ad in the newspaper now a days is very iffy. Or as others had suggested, check with friends/neighbors to see if they know of anyone.

I went through a trusted agency - I wouldn't hire privately. All employees were CNAs. I started with a live-in & added overnight care as it became necessary. A live-in isn't 24-hr care because the caregiver has to sleep, too - & so did I.
I compared the live-in + overnight with an hourly rate schedule (2, 12-hr shifts or 3, 8-hr shifts). It was close, but with the hourly rate schedule, there was no guarantee the day person would be the same every day. And that's a big disadvantage because with a live-in, your mom will get to know & trust the caregiver, who also will provide companionship. That's a big comfort to her. Overnight is different, but you might be able to get one same person long term. You can call it a glorified sitter, but the person is trained to handle most problems.
Yes, it's expensive, but not as expensive as nursing home care. My suggestion would be to try it. If it doesn't work out (I can't see how it can't), you can cancel. I know it's a big decision, but you can't put a price on peace of mind. Good luck!

Our experience with my FIL was that a live-in caregiver was the best option. We found her through word of mouth. Ask your housekeeper or handyman whom you have known for a long time. They have their own networks and are careful of their own reputations. Our arrangement was that the responsibility was 7 nights and 6 days. One day each week the caregiver was free to leave after breakfast and returned at bedtime. (He spent that day at my home or my husband went there.) If the caregiver wanted other time off she was responsible to get a substitute and pay that person. We paid payroll taxes on a portion so the person was accumulating social security quarters. Stopping by every day at different times will give you a good idea what goes on and monitors you view with a smart phone will give you peace of mind.

Seconding what others have said: Don't hire someone privately unless you know them well (or someone you know well knows them well). Even then, if they get sick or need to call out for any reason, you will be the one to have to find a replacement (not to mention the insurance, tax and other considerations). And you just never know what people will do. Several years ago we hired a lovely young woman I found on Craigslist who took wonderful care of my mom for about two months and then one day just up and vanished along with all of her belongings. A few weeks later she sent me an email from Croatia, the home country to which she had permanently returned.

I don't blame her. In home care givers can be costly but so is a facility. Personally I'd find someone who can help by word of mouth and not in a business. Good, trustworthy people don't have to come by a one of those Granny Nanny businesses. They don't have to be an experienced CNA either although elder care is nice to find but a good heart is more than enough. Like I said, word of mouth from church, family or friends. Be heavily involved during the care and know what is going on. Like any family should do.