Agency Help SO Expensive

[Anonymous]

Independent of agencies we’re paying $33, some CNAs and some not but just as good. With overtime, it’s a lot. And if you need 24/7, there’s going to be a lot of overtime.

You can’t have someone there and on call but not being paid because they’re live in. That’s exploitation.

[Anonymous]

Anonymous wrote:Hi, Op here:

We tried several fall devices and she kept taking them off. The one time she fell with the device on, and it contacted someone, she told them she was fine. She didn’t want to “bother” anyone so she stayed on the floor until another relative came by.

Even though falls can still happen with someone there, they can remind her to use her walker and assess if she falls and determine if she needs medical care or just some help up.

We do pay hourly but it comes out to $6K a week. She definitely needs someone 24/hr with the meds, transportation, helping with drs appts, memory issues. She had an aunt that was a victim of elder abuse in a “home” and so she is terrified, absolutely terrified of assisted living/memory care. It literally gives her nightmares.

$6k/week is a little less than the family I know doing 24/7 care at home right now, albeit with more advanced disease. There’s also a ton of admin needed. The home is a small business, basically. The scheduling alone managing illness, vacation, people quitting periodically etc etc is a lot.

[Anonymous]

My community has a program that matches younger healthy retired people with more advanced seniors. The younger group are usually people who need to stretch their resources, but some of them just like to do it. Anyway, the younger people (50s/60s mostly) receive training similar to what a CNA does, although they aren’t intended to be a replacement for skilled nursing. It’s also focused on aging in place. More an alternative to assisted living.

So the younger group receives free rent and a stipend (depending on how much care is needed) and the older people can stay in their homes with extra help. I know several people that did this and it worked well. It was accessible through our Area Council on Aging

[Anonymous]

Yes. We paid 25k one month.

[Anonymous]

Anonymous wrote:My community has a program that matches younger healthy retired people with more advanced seniors. The younger group are usually people who need to stretch their resources, but some of them just like to do it. Anyway, the younger people (50s/60s mostly) receive training similar to what a CNA does, although they aren’t intended to be a replacement for skilled nursing. It’s also focused on aging in place. More an alternative to assisted living.

So the younger group receives free rent and a stipend (depending on how much care is needed) and the older people can stay in their homes with extra help. I know several people that did this and it worked well. It was accessible through our Area Council on Aging

Housing as compensation is very thorny and ripe for problems all around. In theory, it really shouldn’t “save” money for anyone.

That’s why these arrangements are always wedged in somehow and have a major power balance problem. Special visas, undocumented people, or retirees who it sounds like were unhoused? It’s not a good road to go down.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My community has a program that matches younger healthy retired people with more advanced seniors. The younger group are usually people who need to stretch their resources, but some of them just like to do it. Anyway, the younger people (50s/60s mostly) receive training similar to what a CNA does, although they aren’t intended to be a replacement for skilled nursing. It’s also focused on aging in place. More an alternative to assisted living.

So the younger group receives free rent and a stipend (depending on how much care is needed) and the older people can stay in their homes with extra help. I know several people that did this and it worked well. It was accessible through our Area Council on Aging

Housing as compensation is very thorny and ripe for problems all around. In theory, it really shouldn’t “save” money for anyone.

That’s why these arrangements are always wedged in somehow and have a major power balance problem. Special visas, undocumented people, or retirees who it sounds like were unhoused? It’s not a good road to go down.

This. Is it called a "stipend" so they can avoid fair employment issues. That stipend probably comes to well below minimum wage for hours worked even taking into consideration free rent. Is the person bonded and insured? Can the person get workman's compensation if injured on the job? Do they have liability insurance? Plenty of nannies gets free housing and a salary and benefits.

[Anonymous]

PP and in the last few weeks of my mother’s life, we hired 24/7 care provided in her independent living apartment within a campus style continuing care community.

The aides are not allowed to sleep while on duty and sat vigil on a sofa and kept watch - duties were to strictly monitor and assist with middle of the night toileting needs to include reminder to use the walker and to get out of bed slowly. My mom was troubled with restlessness and wandering at night. The aides left notes for each other and both gave meds, assisted with ADL, prepared meals and snacks and made certain she was getting enough water.

I did all of the above for two nights and had to return to work and realized this was not a sustainable plan so my sibling and I quickly hired aides through the CC community. It was thousands per week - I think we (actually my mom - she had a huge savings account earmarked for this) paid the service about $70/hour for the CNAs.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My community has a program that matches younger healthy retired people with more advanced seniors. The younger group are usually people who need to stretch their resources, but some of them just like to do it. Anyway, the younger people (50s/60s mostly) receive training similar to what a CNA does, although they aren’t intended to be a replacement for skilled nursing. It’s also focused on aging in place. More an alternative to assisted living.

So the younger group receives free rent and a stipend (depending on how much care is needed) and the older people can stay in their homes with extra help. I know several people that did this and it worked well. It was accessible through our Area Council on Aging

Housing as compensation is very thorny and ripe for problems all around. In theory, it really shouldn’t “save” money for anyone.

That’s why these arrangements are always wedged in somehow and have a major power balance problem. Special visas, undocumented people, or retirees who it sounds like were unhoused? It’s not a good road to go down.

This. Is it called a "stipend" so they can avoid fair employment issues. That stipend probably comes to well below minimum wage for hours worked even taking into consideration free rent. Is the person bonded and insured? Can the person get workman's compensation if injured on the job? Do they have liability insurance? Plenty of nannies gets free housing and a salary and benefits.

Not to mention, are you in a jurisdiction where you can easily evict them if you need to

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My community has a program that matches younger healthy retired people with more advanced seniors. The younger group are usually people who need to stretch their resources, but some of them just like to do it. Anyway, the younger people (50s/60s mostly) receive training similar to what a CNA does, although they aren’t intended to be a replacement for skilled nursing. It’s also focused on aging in place. More an alternative to assisted living.

So the younger group receives free rent and a stipend (depending on how much care is needed) and the older people can stay in their homes with extra help. I know several people that did this and it worked well. It was accessible through our Area Council on Aging

Housing as compensation is very thorny and ripe for problems all around. In theory, it really shouldn’t “save” money for anyone.

That’s why these arrangements are always wedged in somehow and have a major power balance problem. Special visas, undocumented people, or retirees who it sounds like were unhoused? It’s not a good road to go down.

This. Is it called a "stipend" so they can avoid fair employment issues. That stipend probably comes to well below minimum wage for hours worked even taking into consideration free rent. Is the person bonded and insured? Can the person get workman's compensation if injured on the job? Do they have liability insurance? Plenty of nannies gets free housing and a salary and benefits.

Not to mention, are you in a jurisdiction where you can easily evict them if you need to

That was my first thought too.
The younger, caregiving senior could simply refuse to work and refuse to leave. The older senior's family can't just come in and throw their stuff on the street-you have to go through a formal eviction process which could take months or even years through the court.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My community has a program that matches younger healthy retired people with more advanced seniors. The younger group are usually people who need to stretch their resources, but some of them just like to do it. Anyway, the younger people (50s/60s mostly) receive training similar to what a CNA does, although they aren’t intended to be a replacement for skilled nursing. It’s also focused on aging in place. More an alternative to assisted living.

So the younger group receives free rent and a stipend (depending on how much care is needed) and the older people can stay in their homes with extra help. I know several people that did this and it worked well. It was accessible through our Area Council on Aging

Housing as compensation is very thorny and ripe for problems all around. In theory, it really shouldn’t “save” money for anyone.

That’s why these arrangements are always wedged in somehow and have a major power balance problem. Special visas, undocumented people, or retirees who it sounds like were unhoused? It’s not a good road to go down.

IDK whether anyone was unhoused, I’d highly doubt it. It’s a program that works well in my community, and it’s not exploitative at all. It gives younger, healthy retired people a higher standard of living (annd the ability to live in the community they love which is regrettably ultra HCOL now) while it allows older seniors to stay in their homes. There are some special lease provisions to protect both parties in case of conflict, as well as a generous time for the helper-senior to move out if the elderly senior dies, but everyone is screened thoroughly going in. I love how DCUM has to sh*t on something that’s an actual solution working for people. I’m pretty involved with senior issues in our community and I have never heard of anyone having a problem.

There are no special visas or anything like that. The helper people are just younger, healthy retirees who welcome an opportunity to save some money while also getting some fulfillment from supporting an older senior. Again, this is not a replacement for skilled nursing.

[Anonymous]

Do you have the link to the program?

[Anonymous]

Anonymous wrote:Do you have the link to the program?

I’m not about to expose them to harassment from deranged DCUM posters. I know our community isn’t the only one, so of you want to google stalk good people doing good things maybe you’ll get lucky.

OP, bottom line, this isn’t the best place for advice. As far as DCUM is concerned you have four choices:
-Expensive care in assisted living (which they usually assume means good care) for as long as they can afford it
-Cheap Medicaid bed if eligible/available
-Expensive aids through an agency
-Move them in with you (usually deemed a fate worse than death)

DCUM does not want to entertain anything they deem “out of the box.”

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why not hire someone who works for hourly wage. Humans have been taking care of elderly without training for centuries. Anyone kind and helpful is good enough, doesn't have to be a certified expert.

I'm not the OP

What kind of hourly wage do you think OP would need to pay?
What will OP do if the hourly wage employee doesn't show up for the shift one day (sick, car accident, just bailed?)
How should OP find this hourly wage employee?

That is why you should hire from an agency---you need someone who will manage the "what ifs" for you. Unless you can afford to step in frequently when the help "calls out" or simply doesn't show up.

That is also why unless you are wealthy, it is more cost effective and safer to be in a skilled nursing facility.

[Anonymous]

Anonymous wrote:There are people who provide home aide services on their own rather than through an agency. A lot of them stick with one client as long as needed and then move on to the next. They often find clients by word of mouth if they’re good. I don’t know what the going rate is, but probably something above minimum wage but well less than you’re paying now. You might check Craigslist or run an ad there. That’s what one person I know did when they needed babysitters to supplement staff at a skilled nursing facility.

The fall risk business is something you have to evaluate individually. No place can prevent falls unless the person is completely restrained. How to decide whether to call an ambulance is not something that requires enormous training.

You have to be careful, but I’ve seen really great people giving really great private in home care.

I get that. But if you hire independently, what do you do if someone calls out sick? Or wants a week off? or just fails to show up? You are screwed and left scrambling. Whereas an agency will send a replacement.

[Anonymous]

Anonymous wrote:

Anonymous wrote:There are people who provide home aide services on their own rather than through an agency. A lot of them stick with one client as long as needed and then move on to the next. They often find clients by word of mouth if they’re good. I don’t know what the going rate is, but probably something above minimum wage but well less than you’re paying now. You might check Craigslist or run an ad there. That’s what one person I know did when they needed babysitters to supplement staff at a skilled nursing facility.

The fall risk business is something you have to evaluate individually. No place can prevent falls unless the person is completely restrained. How to decide whether to call an ambulance is not something that requires enormous training.

You have to be careful, but I’ve seen really great people giving really great private in home care.

I get that. But if you hire independently, what do you do if someone calls out sick? Or wants a week off? or just fails to show up? You are screwed and left scrambling. Whereas an agency will send a replacement.

You plan for that based on individual circumstances. Some agencies will take clients as backup providers. Maybe family can fill in. There are lots of ways to solve that problem. If you do hire exclusively through an agency, sometimes they fail to show up as well. Things will go wrong no matter what you choose. My grandmother’s 10k/mo assisted living gave her the wrong dose of one of her medications and also failed to check on her at bedtime. She fell and spent the night on the bathroom floor. There is no one perfect way to do things. You make the best plans for your family, plan for backups, and accept that at some point, almost without exception, something will go wrong.