hiring a live-in caretaker?

[Anonymous]

Got a question...anybody been through this process and what to do?
Background:
Wife and I are only children. 3 kids of our own.
Father in law was dx with ALS, last June. But had started showing symptoms in 2020. Very gradual decline.
Just last week, finally lost his ability to ambulate. Leg weakness became enough he can't anymore. Arms work fine.
We modified a downstairs room, he has bed, bathroom area, etc etc. Really nice setup for him.
We're a close family, and I've helped a lot. My own parents are in rather decent health so I'm lucky.
He is a veteran. I got him set up with VA benefits and A&A funds. Rather, PVA did all the work and I fed them all the needed info. VA sends him north of $9000 monthly. Thats a huge help. This crap can bankrupt someone .
He has a caretaker who helps now 12 hours daily for 7 days....the VA pays for 40 hours per week and he covers the other 48 out of his benefits, leaving still quite a bit left. So at least money isnt an issue.
They live in Germantown MD, neocolonial mid-80s style house.

But...he kind of needs someone who can be there 24 hours. As in, live-in and available. The early morning routine, help on and off during the day, but not hands-on 24 hour care. This person will have a lot of downtime and could even have another remote-work style job even if they wanted, and certainly evenings out after bedtime for Gampa.

How does one go about hiring someone like this? Writing a position description? How are they paid? By the "day" ? Presumably room and board is part of their pay, or at least an added benefit. Or is it better to just keep working via the agency being used now, and just expanding the hours they come. You're basically hiring a family member, so it has to be just the right fit.

Anyone who has been here and has advice, I'm all ears....

[Anonymous]

Anonymous wrote:Got a question...anybody been through this process and what to do?
Background:
Wife and I are only children. 3 kids of our own.
Father in law was dx with ALS, last June. But had started showing symptoms in 2020. Very gradual decline.
Just last week, finally lost his ability to ambulate. Leg weakness became enough he can't anymore. Arms work fine.
We modified a downstairs room, he has bed, bathroom area, etc etc. Really nice setup for him.
We're a close family, and I've helped a lot. My own parents are in rather decent health so I'm lucky.
He is a veteran. I got him set up with VA benefits and A&A funds. Rather, PVA did all the work and I fed them all the needed info. VA sends him north of $9000 monthly. Thats a huge help. This crap can bankrupt someone .
He has a caretaker who helps now 12 hours daily for 7 days....the VA pays for 40 hours per week and he covers the other 48 out of his benefits, leaving still quite a bit left. So at least money isnt an issue.
They live in Germantown MD, neocolonial mid-80s style house.

But...he kind of needs someone who can be there 24 hours. As in, live-in and available. The early morning routine, help on and off during the day, but not hands-on 24 hour care. This person will have a lot of downtime and could even have another remote-work style job even if they wanted, and certainly evenings out after bedtime for Gampa.

How does one go about hiring someone like this? Writing a position description? How are they paid? By the "day" ? Presumably room and board is part of their pay, or at least an added benefit. Or is it better to just keep working via the agency being used now, and just expanding the hours they come. You're basically hiring a family member, so it has to be just the right fit.

Anyone who has been here and has advice, I'm all ears....

$9000 monthly? To cover what? The other 48 hours of care? I have never heard of a veteran getting that much through the VA--and every male in my family is/was a veteran, maybe of them retired career officers.

[Anonymous]

^many of them, not "maybe" sorry

[Anonymous]

Anonymous wrote:

Anonymous wrote:Got a question...anybody been through this process and what to do?
Background:
Wife and I are only children. 3 kids of our own.
Father in law was dx with ALS, last June. But had started showing symptoms in 2020. Very gradual decline.
Just last week, finally lost his ability to ambulate. Leg weakness became enough he can't anymore. Arms work fine.
We modified a downstairs room, he has bed, bathroom area, etc etc. Really nice setup for him.
We're a close family, and I've helped a lot. My own parents are in rather decent health so I'm lucky.
He is a veteran. I got him set up with VA benefits and A&A funds. Rather, PVA did all the work and I fed them all the needed info. VA sends him north of $9000 monthly. Thats a huge help. This crap can bankrupt someone .
He has a caretaker who helps now 12 hours daily for 7 days....the VA pays for 40 hours per week and he covers the other 48 out of his benefits, leaving still quite a bit left. So at least money isnt an issue.
They live in Germantown MD, neocolonial mid-80s style house.

But...he kind of needs someone who can be there 24 hours. As in, live-in and available. The early morning routine, help on and off during the day, but not hands-on 24 hour care. This person will have a lot of downtime and could even have another remote-work style job even if they wanted, and certainly evenings out after bedtime for Gampa.

How does one go about hiring someone like this? Writing a position description? How are they paid? By the "day" ? Presumably room and board is part of their pay, or at least an added benefit. Or is it better to just keep working via the agency being used now, and just expanding the hours they come. You're basically hiring a family member, so it has to be just the right fit.

Anyone who has been here and has advice, I'm all ears....

$9000 monthly? To cover what? The other 48 hours of care? I have never heard of a veteran getting that much through the VA--and every male in my family is/was a veteran, maybe of them retired career officers.

Then you just haven't known anyone rated 100% disabled, and also getting SMC in the R1 and R2 levels! Plus they sent him an electric wheelchair that costs what a car used to cost. about 22 grand. The VA has been a godsend. As an american I'm honored to see how well they have taken care of him. The VA is really 3 agencies. VBA provides the benefits, VA Health handles the equipment and health visits.

[Anonymous]

If he has at least 70% disability the VA will pay a small amount to live in caregivers. You just have to apply for this. Also consider home based primary care or VA nursing home facility. Call the VA he goes to and ask to speak with a patient advocate, they can help you navigate.

[Anonymous]

Anonymous wrote:If he has at least 70% disability the VA will pay a small amount to live in caregivers. You just have to apply for this. Also consider home based primary care or VA nursing home facility. Call the VA he goes to and ask to speak with a patient advocate, they can help you navigate.

It’s part of a family caregiver assistance program, or something along that name. You can be family or not but they have to live in the home with the veteran. I’d consider finding a nursing student in college or something along that line and provide free room and board unless you have family willing to step in.

[Anonymous]

It's usually not one person because that could end up violating labor laws as his needs increase. It's shifts. Gets messy if people no show. Also, it's messy when people steal things and deny. A friend of ours had a live in person-not sure how that worked with labor regulations, but the person drank a lot and it was a problem.

I would look at residential options. Yes, things still go missing and they can be understaffed, but more peer interaction and social ACTIVITIES and stimulation.

[Anonymous]

Keep in mind his needs are going to continue to increase. Does he have a feeding tube yet? Lack of mobility will speed his decline(sorry). How did you find the current care giver? Can they provide the additional hours?

[Anonymous]

Anonymous wrote:Keep in mind his needs are going to continue to increase. Does he have a feeding tube yet? Lack of mobility will speed his decline(sorry). How did you find the current care giver? Can they provide the additional hours?

He is not doing a feeding tube and has no interest in one. Which I totally understand.

Good point on staffing and labor rules and noshows. I think working via the agency remains the best way, and let them earn their due by solving those issues. He's basically got coverage 7 days x 12 hours daily. Really needs someone a little earlier, so 14 hours daily is all he needs.

Ever see "Tuesday's with Morrie" ? Well, he ain't no Morrie. Doesn't like to read, doesn't have hardly any visitors. Watches TV all day basically. Pleasant enough fellow, and I'm fond of him, and he's my dear wife's dad so I do all I can to ease his burden. But he's rather boring to talk to. And it pains me to say it. Its not like he did all that much when he could walk. Like Grandpa Simpson's line "I was a night watchman at a cranberry silo for 30 years".

We'll navigate through. Its just the flow of how life goes.

[Anonymous]

This post does seem odd as I've also never heard of the VA paying that much. Was he a general or something? No one is going to provide 24/7 care non-stop. You need multiple care givers.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Keep in mind his needs are going to continue to increase. Does he have a feeding tube yet? Lack of mobility will speed his decline(sorry). How did you find the current care giver? Can they provide the additional hours?

He is not doing a feeding tube and has no interest in one. Which I totally understand.

Good point on staffing and labor rules and noshows. I think working via the agency remains the best way, and let them earn their due by solving those issues. He's basically got coverage 7 days x 12 hours daily. Really needs someone a little earlier, so 14 hours daily is all he needs.

Ever see "Tuesday's with Morrie" ? Well, he ain't no Morrie. Doesn't like to read, doesn't have hardly any visitors. Watches TV all day basically. Pleasant enough fellow, and I'm fond of him, and he's my dear wife's dad so I do all I can to ease his burden. But he's rather boring to talk to. And it pains me to say it. Its not like he did all that much when he could walk. Like Grandpa Simpson's line "I was a night watchman at a cranberry silo for 30 years".

We'll navigate through. Its just the flow of how life goes.

Learn about what will happen without a feeding tube. I understand it is a choice to make. Just know so you can be prepared to keep him confortable when he can no longer swallow. Does he want to continue fluids? All choices to discuss now. Also learn about aspiration dangers.

[Anonymous]

Anonymous wrote:This post does seem odd as I've also never heard of the VA paying that much. Was he a general or something? No one is going to provide 24/7 care non-stop. You need multiple care givers.

Just because you’ve never heard of it doesn’t mean it doesn’t happen. ALS is always service connected at 100 percent. Special monthly compensation applies as you lose functionality, and ALS is a horrible, devastating disease. It is truly THE worst diagnosis you could possibly have. You lose the ability to talk, to swallow, to use your limbs and ultimately to breathe. Special monthly compensation through the VA goes past $10k a month. It has absolutely nothing to do with rank, or even when or where you served, or where in world you live now. You could have served 50 years ago and you are still entitled to compensation.

Not only do they pay monthly compensation and provide health care, but veterans with ALS are also automatically eligible for an auto grant (about $22k plus the cost of adapting the car to wheelchair use), and a home renovation grant to help accommodate their disabilities that is about $110k. They also get their claims fast tracked and often resolved in a matter of a few weeks.

[Anonymous]

OP this has some helpful info.

You need to be on the right side of the law and not focus on things like “they could have a remote job too.” That doesn’t affect your responsibilities as an employer.

https://thearcofnova.org/wp-content/uploads/sites/6/2018/04/Live-In-Care-Attendant-Guide-for-Attendants-Second-Edition-5.19.21.pdf

[Anonymous]

I'm not sure why you would think you could have a slave living with you, but, no, that's not legal. You'd need at least 3 or 4 people doing shift work to cover 24 hours a day.