In home care - what's reasonable?

[Anonymous]

Anonymous wrote:

Anonymous wrote:My MIL's people will do anything asked. Make meals, clean, chat, dress, shower. I think they are happy to be occupied. Can't imagine someone making a meal for one person and leaving the spouse on their own.

If the spouse doesn't need a care provider and are home they should be making the meal, not the in-home care aide.

My inlaws are both 91. She qualified for in home care for dementia. The aids make food for both. They get paid for their time. No one is keeping track of who eats the food. He may not qualify for in home care but that does not mean he is able to cook a decent meal. Aide droves them to the grocery store. They both go.

[Anonymous]

I think this varies by the caregiver. One of my mom's caregivers was great. She loved to be busy and would do the laundry, make meals (often she would make the food at home and just bring it over to bake at my mom's so it was a more elaborate meal), water the plants, do light housekeeping. The other caregiver did the minimum - meals consisted of a cold sandwich or canned soup- and she never did any housework. She also spent a lot of time on her phone and interacted with my mom minimally. Obviously, my mom adored the first caregiver and tolerated the second.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My father had 2 aides - 24/7 for his last several years. We chose to always have 2 aides - to make it easier on them and also we just felt it was a safety net to have two people. My Dad was mostly unable to communicate the last year.

We never expected anything beyond care for my father. But they did all kinds of things - laundry, cooking, baking - decorating for holidays -- seemed like they did stuff to help with the boredom.

I agree with the PP -- be grateful if your parent likes them and if they seem to like your parent. Treat them with respect.

Wow. 7 days a week of 24 hours so that is 168 hours. Using two people is 336 hours that need covering a week. Assuming a person worked 40 hours a week that would take slightly over 8 people to cover.

How much did that cost?! Did you or an agency really use 8 people?

We used a small agency - run by a woman that also managed my mother's care several years earlier. This is in a small New England town. Her parents went to high school with my parents. There were probably 12-15 people that rotated out through the week. There were 5-6 that never changed and then several that came and went. There were times during COVID that the agency owner stayed overnight with my Dad. She billed as a care manager at 80.00/hr. The caregivers billed at 25.00/hr. It was all expensive but worth it. The more I hear about other people struggling with eldercare -- the more I realize how lucky we were. Another advantage of small town life -- the care manager seemed to know everyone and or be related to them. So during COVID my Dad had to be in the hospital (for a non COVID thing) and because our care manager's cousin was head of the Council of the Aging and another was an admin at the hospital -- they made an exception for my father to have a caregiver with him at all times. When I think back (my dad died summer of 23) I don't think I really appreciated how lucky we were to have such great care.

Yes, being in a small enough town/city can make a huge difference. My mom's sister/BiL were in a facility where the BiL (my uncle) was in a locked memory care unit (he was a major flight risk) and sister (my aunt) was in a small AL. They had communal meals in AL and my aunt's meal mates/fellow residents included a first cousin, second cousin, two HS classmates, and a former nursing colleague. My mom, who lived an hour away, loved to visit as she knew everyone!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My father had 2 aides - 24/7 for his last several years. We chose to always have 2 aides - to make it easier on them and also we just felt it was a safety net to have two people. My Dad was mostly unable to communicate the last year.

We never expected anything beyond care for my father. But they did all kinds of things - laundry, cooking, baking - decorating for holidays -- seemed like they did stuff to help with the boredom.

I agree with the PP -- be grateful if your parent likes them and if they seem to like your parent. Treat them with respect.

Wow. 7 days a week of 24 hours so that is 168 hours. Using two people is 336 hours that need covering a week. Assuming a person worked 40 hours a week that would take slightly over 8 people to cover.

How much did that cost?! Did you or an agency really use 8 people?

We used a small agency - run by a woman that also managed my mother's care several years earlier. This is in a small New England town. Her parents went to high school with my parents. There were probably 12-15 people that rotated out through the week. There were 5-6 that never changed and then several that came and went. There were times during COVID that the agency owner stayed overnight with my Dad. She billed as a care manager at 80.00/hr. The caregivers billed at 25.00/hr. It was all expensive but worth it. The more I hear about other people struggling with eldercare -- the more I realize how lucky we were. Another advantage of small town life -- the care manager seemed to know everyone and or be related to them. So during COVID my Dad had to be in the hospital (for a non COVID thing) and because our care manager's cousin was head of the Council of the Aging and another was an admin at the hospital -- they made an exception for my father to have a caregiver with him at all times. When I think back (my dad died summer of 23) I don't think I really appreciated how lucky we were to have such great care.

Even with small town, most could not afford that. At $25/hour with 2 aides, you are spending $1200/day or $36K per month or about $440K/year. In a more urban area, you would be paying $35-40/hour ($1920/day and $58K/month or almost $700K/year). It would be much more cost effective to put them in memory care or assisted living at $12-14K/month and hire an extra aid for 6-8 hours per day.

[Anonymous]

Is it a pleasant elder? Someone very difficult? If the person is very difficult/moody/hostile, be extra grateful for anyone just willing to show up and be polite and professional and be generous with tips! Otherwise, you may be dealing with a lot of turnover.

[Anonymous]

Anonymous wrote:to expect the aide to during a 4 hour shift, 3 days per week in terms of laundry, meal prep, tidying up? Or does it just vary contract to contract?

Hey have you already got a quote for this? I need the same for my mom. Wondering the price range.

[Anonymous]

Generally, it's like with a nanny, who should do children's laundry, tidy children's bedroom and play area; and prepare and clean up after children's meals.

I have an aide for my disabled husband. She does his laundry, prepares his breakfast and lunch and cleans up those dishes used. Changes the sheets on his bed. Leaves me a list of groceries he is running low on. for his meals. Sweeps and cleans his bedroom, the bathroom he uses, and the dining room and living room areas he sits in.

Occasionally she'll empty the trash as well or run the dishwasher, help out if I left some dishes out the night before, move a load of laundry over. Especially if he's feeling low and just sleeping all day.

[Anonymous]

^ very unusual. She's a gem. np here. I think what's much more common is: in home care folks would only care for MIL and her immediate needs. As another poster said, "That did include cooking simple meals for MIL and cleaning up after she ate. Nothing else. No general tidying, no food for my FIL, no dishes other than the ones my MIL used when they were there. No laundry. They were very strict about it."

[Anonymous]

We paid well over 20k a month for 24/7 in hole care.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My MIL's people will do anything asked. Make meals, clean, chat, dress, shower. I think they are happy to be occupied. Can't imagine someone making a meal for one person and leaving the spouse on their own.

If the spouse doesn't need a care provider and are home they should be making the meal, not the in-home care aide.

My inlaws are both 91. She qualified for in home care for dementia. The aids make food for both. They get paid for their time. No one is keeping track of who eats the food. He may not qualify for in home care but that does not mean he is able to cook a decent meal. Aide droves them to the grocery store. They both go.

What does this mean, exactly?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sounds like you need a housekeeper OP, not an aide.

for just asking the question? thanks for the input

Ask better questions if you want better answers- the tasks you listed are housekeeper duties.

So an aide hired to care after my mother shouldn't be expected to change sheets?

I wouln't hire an aide that didn't do the patient's laundry or meal making.

Reminds me of a nanny our neighbors had some years back. Nanny worked from 7-5, M-F with twin toddlers that still napped 2 hours a day. When we asked them what the nanny did during those two hours they said they didn't know. Others with nannys explained that theirs did all the kid laundry, cleaned the kid room, emptied diaper pale and prepped the next day's lunch they looked at us with huge eyes. Theirs did none of that and was getting $5000 a month cash.

She got fired about a month later after they found a replacement.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sounds like you need a housekeeper OP, not an aide.

for just asking the question? thanks for the input

Ask better questions if you want better answers- the tasks you listed are housekeeper duties.

So an aide hired to care after my mother shouldn't be expected to change sheets?

I wouln't hire an aide that didn't do the patient's laundry or meal making.

Reminds me of a nanny our neighbors had some years back. Nanny worked from 7-5, M-F with twin toddlers that still napped 2 hours a day. When we asked them what the nanny did during those two hours they said they didn't know. Others with nannys explained that theirs did all the kid laundry, cleaned the kid room, emptied diaper pale and prepped the next day's lunch they looked at us with huge eyes. Theirs did none of that and was getting $5000 a month cash.

She got fired about a month later after they found a replacement.

7-5 is ten hours! With twin toddlers! The nanny deserved a mid-day break to eat lunch and decompress

[Anonymous]

Anonymous wrote:Generally, it's like with a nanny, who should do children's laundry, tidy children's bedroom and play area; and prepare and clean up after children's meals.

I have an aide for my disabled husband. She does his laundry, prepares his breakfast and lunch and cleans up those dishes used. Changes the sheets on his bed. Leaves me a list of groceries he is running low on. for his meals. Sweeps and cleans his bedroom, the bathroom he uses, and the dining room and living room areas he sits in.

Occasionally she'll empty the trash as well or run the dishwasher, help out if I left some dishes out the night before, move a load of laundry over. Especially if he's feeling low and just sleeping all day.

No, it's not like with a nanny. It's much more draining and their bones are so fragile. A toddler falls and you dust him off and put a bandaid on him. You don't have to worry that a baby will get up from a nap and wander to the bathroom, have a fall and break and a hip. A tot tantrums and it's easier to keep them safe and it's not terrifying the way it is when an elder tantrums. When you do laundry while watching a 4 year old sometimes they want to help and it becomes a cute interaction. It's just all so different and should not be compared to childcare. Unless the elder is extremely easy and low need, keep your expectations extremely low and be grateful for any extras. Tip generously for someone good. Some of these people are truly saints.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sounds like you need a housekeeper OP, not an aide.

for just asking the question? thanks for the input

Ask better questions if you want better answers- the tasks you listed are housekeeper duties.

So an aide hired to care after my mother shouldn't be expected to change sheets?

I wouln't hire an aide that didn't do the patient's laundry or meal making.

Reminds me of a nanny our neighbors had some years back. Nanny worked from 7-5, M-F with twin toddlers that still napped 2 hours a day. When we asked them what the nanny did during those two hours they said they didn't know. Others with nannys explained that theirs did all the kid laundry, cleaned the kid room, emptied diaper pale and prepped the next day's lunch they looked at us with huge eyes. Theirs did none of that and was getting $5000 a month cash.

She got fired about a month later after they found a replacement.

7-5 is ten hours! With twin toddlers! The nanny deserved a mid-day break to eat lunch and decompress

Meh, five grand in cash each month is equivalent to a salary of $90,000 a year. Unless the nanny was reporting the income (highly unlikley given most don't want to pay taxes and many are here illegally) she was getting a damn good deal. Plenty and plenty of legal citizens work 60 hours a week and come nowhere near making 90 grand.

[Anonymous]

NP. We pay $25/hr plus income taxes for an in-home elder aide 4 hours a day for my mom. Private arrangement, not an agency. Aide prepares breakfast and lunch, assists with bathing and dressing, does mom’s laundry, cooks together in the kitchen with mom (when mom wants to), changes mom’s sheets, keeps room and bathroom clean, changes bandages on a healing wound, empties trash cans, and drives mom to doctor appointments (including assisting with wheelchair transfer). From reading this forum, it sounds like we might be very lucky? Mom is a pleasant person. Aide comes 6 days a week. I am already concerned about cost.