Agency Help SO Expensive

[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.

My experience with this was that 24/7 care ended up being six-ish people. There was always scrambling on the schedule and a pretty continuous effort to find new hires but generally other people could cover for sick and vacation. It was a lot though. And the overtime really racks up.

[Anonymous]

Would she be open to a smaller group home where there are only half a dozen residents? Even if she just attended a day program that might be helpful in terms of both cost and company.

[Anonymous]

Where are some good day programs in DC? What if the elderly person gets tired? My mom couldn’t stay all day without being utterly exhausted. And she has all these doctors appointments too. But I am curious to see what they offer and price.

[Anonymous]

Anonymous wrote:Where are some good day programs in DC? What if the elderly person gets tired? My mom couldn’t stay all day without being utterly exhausted. And she has all these doctors appointments too. But I am curious to see what they offer and price.

Different poster. There were definitely people napping at the day programs(this was not in DC). They had exercise time where they worked on fall prevention, but people still fell even there because sometimes you can't avoid it. The social aspect was wonderful and they make holidays lots of fun.

That said, I would start looking into residential. They usually have transport and it just makes more sense as you plan for continued decline. I know some people on here make it sound like you are sending someone to prison, but that has not been our experience with some relatives, inlaws, etc. The key is to visit and be an active member of the care team and be very appreciative. You can also hire an advocate to go in and give you an objective idea of how it is working and that person can advocate for anything else needed.

[Anonymous]

Anonymous wrote:My parent requires FT companion care due to major fall risk and not being able to manage meds or drive. She has some memory issues, otherwise she is doing well for her age.

Full time agency help is amounting to around $6000 a week. How much would it be to hire an independent live in instead? Wheee would I go to find someone like that?

Craigslist

Our local aging department also maintains a list of local individuals for hire. They are not vetted. This is in Maryland.

[Anonymous]

I've also run ads on Indeed. I got about a 2" stack of resumes.

I did not have luck with Care.com.

[Anonymous]

Anonymous wrote:

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.

New person here. I had 10 people to cover around the clock. Several worked just 12 hours a day. There were times some worked 38-60 hours per week. All had other jobs and I had to work around that.

We paid workers comp and social security that is we paid legal. I had an accounting firm run the payroll. We paid several dollars per hour under agency rates so the women made really good money from us. We also paid vacation.

It was a lot on me. The women worked the same shifts every week and I did schedules one month in advance.

My experience with this was that 24/7 care ended up being six-ish people. There was always scrambling on the schedule and a pretty continuous effort to find new hires but generally other people could cover for sick and vacation. It was a lot though. And the overtime really racks up.

[Anonymous]

Anonymous wrote:My parent requires FT companion care due to major fall risk and not being able to manage meds or drive. She has some memory issues, otherwise she is doing well for her age.

Full time agency help is amounting to around $6000 a week. How much would it be to hire an independent live in instead? Wheee would I go to find someone like that?

Can you move her into your home and care for her? If you make less than $24K a month, it would be cheaper to do it yourself.

[Anonymous]

Anonymous wrote:

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.

NP here:

1. We paid a couple of dollars under what agencies charged. CNA's earn $18 per hour in my part of Md. We started them at $26-$28 per hour. Agencies charged me $30 per hour.

2. Call outs were very very rare. We paid top dollar and I think that helped. If someone wanted some time off in advance (I did the schedule 1 month out) then I filled her hours with someone else. Otherwise I encouraged them to find someone to fill their shift. On rare occasions I'd send a text blast out and someone would pick up the hours.

I had 10 on the payroll and virtually all had other jobs and also college classes. I think it would have been tough to fill call outs with only 6 who worked other jobs.

I also had accounts with 3 agencies and there were times I used agency personnel but it was rare.

3. Most of our workers were referrals. The referrals were our best workers by far. One young lady referred 4 people over the years. Another referred one. When I was desperate during Covid I used Indeed. I had no success with care.com. I could not even get anyone to respond back to me. One person was hired from a list from our county office of aging.

It was challenging to staff because I'd have to schedule around other jobs. The caregivers worked the same days and same shifts every week for us.

[Anonymous]

The IRS had rules and regulations on in home live in care. I'd check their regulations regarding pay.

[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?

+1
All of this.
But mostly the call-out suck or accident situation.
Agency is the way to go because of coverage (if loved one needs care full time, then you have to have a back up plan).

Also agencies are $36/hour but the worker is paid like $18-20.
You can hire someone cheaper directly if you can find them but then no liability insurance and no background check and no accountability if something goes wrong.

Placement in a care home is best especially if your loved one lives alone. They are SO vulnerable to theft or mistreatment. No oversight if they are the only ones there in the home.

[Anonymous]

Anonymous wrote:

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?

+1
All of this.
But mostly the call-out suck or accident situation.
Agency is the way to go because of coverage (if loved one needs care full time, then you have to have a back up plan).

Also agencies are $36/hour but the worker is paid like $18-20.
You can hire someone cheaper directly if you can find them but then no liability insurance and no background check and no accountability if something goes wrong.

Placement in a care home is best especially if your loved one lives alone. They are SO vulnerable to theft or mistreatment. No oversight if they are the only ones there in the home.

This, 100%. Do you really want to put cameras in every room and go searching footage every night?

[Anonymous]

My mom lives with us and the care was killing me and putting strain on my family. I finally hired an agency for three times a week. Then it went to 5. As she grew more challenging in many ways and her fall risk increased, we went to full time.

It is VERY expensive and people don’t understand why we need it and don’t do it ourselves. With both of us working and kids, it was driving me into the ground. I have guilt when people try to shame me for this and the cost. But we pay all of her housing costs and keep her safe. People make us feel like we don’t deserve to live our lives and paint us as lazy or selfish.

That’s lovely on top of the strain and stress. May they never be in this position.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

NP here:

1. We paid a couple of dollars under what agencies charged. CNA's earn $18 per hour in my part of Md. We started them at $26-$28 per hour. Agencies charged me $30 per hour.

2. Call outs were very very rare. We paid top dollar and I think that helped. If someone wanted some time off in advance (I did the schedule 1 month out) then I filled her hours with someone else. Otherwise I encouraged them to find someone to fill their shift. On rare occasions I'd send a text blast out and someone would pick up the hours.

I had 10 on the payroll and virtually all had other jobs and also college classes. I think it would have been tough to fill call outs with only 6 who worked other jobs.

I also had accounts with 3 agencies and there were times I used agency personnel but it was rare.

3. Most of our workers were referrals. The referrals were our best workers by far. One young lady referred 4 people over the years. Another referred one. When I was desperate during Covid I used Indeed. I had no success with care.com. I could not even get anyone to respond back to me. One person was hired from a list from our county office of aging.

It was challenging to staff because I'd have to schedule around other jobs. The caregivers worked the same days and same shifts every week for us.

This is great data! I’m the PP who said 6-ish and I think only half have other jobs. They are at 33/hr and I think that’s high but I also think OP’s data may be a bit older? Anyway that’s two good examples for everyone.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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?

+1
All of this.
But mostly the call-out suck or accident situation.
Agency is the way to go because of coverage (if loved one needs care full time, then you have to have a back up plan).

Also agencies are $36/hour but the worker is paid like $18-20.
You can hire someone cheaper directly if you can find them but then no liability insurance and no background check and no accountability if something goes wrong.

Placement in a care home is best especially if your loved one lives alone. They are SO vulnerable to theft or mistreatment. No oversight if they are the only ones there in the home.

This, 100%. Do you really want to put cameras in every room and go searching footage every night?

My FIL (now deceased) was able to stay in his home until the end, with assistance of two unlicensed aides, but only because MIL was generally around to oversee them and fill in when needed, and this was an LCOL area as decribed below.

It was narrow circumstances for many reasons why it could work, and only worked with MIL coordinating and overseeing. Even in the best of circumstance which I think theirs was, you risk theft/mistreatment and general flakiness which requires supervision/oversight.
-LCOL area
-They paid $30 hourly which was generous, he died just before the Pandemic. This is an LCOL area, with many fewer job opportunities than here btw (Consider, alternately these candidates could work taking care of babies/kids, at a store, etc - you are competing with those job responsibilities and schedules, benefits for the same job candidates.)
-No lifting was required. ILs already had a stairlift installed. FIL was never heavy but actually thin/frail at the end with difficulty keeping weight on.
-For most of the early times the job required being around if MIL could not be due to the fall risk, running errands. Gradually and at the end there were more toileting issues or cleanup the bathroom.
-Absolutely key: no cognitive issues for FIL or MIL (who is a number of years youger). FIL was a great guy and very pleasant and funny to be around. His personality was not to impose on people too.
-Did not hurt that their place had lovely views.

They found two wonderful ladies in their 50's/60's who lived closeby. MIL had to oversee and schedule them, and work out a couple issues, but it did work out in this specific circumstance of my ILs LCOL area with MIL supervision.