Pay the weekend (private pay) aide well. Even for agencies it is challenging to fill the weekend hours.

We tell caregivers before storms to be prepared to be there 24 hours or more. Bring extra clothes etc. We supply extra food.

Set up accounts with 3 agencies. Use one primarily but having open accounts with other agencies gives you options.

All of my caregivers work for 2-3 agencies so I thought I'd set up accounts with 3 agencies also.
i.e. Many of my caregivers will work 35 hours with one agency and 36 hours with another bringing in 72 hours of pay in a week.

In my town (Maryland) the caregivers are told by the agencies that they cannot leave until they are relieved even if if means they have to work and extra shift.

We have had better luck paying direct private duty but we pay they caregiver about what we would pay an agency so the caregiver gets really good money.

Best to have a lot of caregivers that work fewer hours so they are willing to work extra shifts.

What will happen is that she’ll have a fall, hospitalized and then sent to rehab. It’s sad but I suggest you save the worries for your nuclear family.

Home health aides are people too, and sometimes they have kid emergencies, family emergencies, health issues that require them to call out sick, or transportation issues. When an elder is aging in place and using private or agency caregivers, they have to be aware that there can be no shows for whatever reasons. The way things are at present with staffing issues, many agencies can't always cover a no show even though in marketing to clients they may say they are more reliable.

Any physically frail elder living alone at home should at minimum have an emergency alert system that is wearable so they can call for 911 if they fall alone at home and cannot get up.

Thanks everyone. The feedback gives me a lot to think about. She mainly uses an agency but has a privately paid aide on weekends. The privately paid aide has a 2nd job and family so she can’t be a live-in. I discouraged her from going solely with private providers because if they get sick or have an emergency she’d have no coverage. At least the agency can send a sub. But thinking about the winter weather it hit me that this plan isn’t foolproof. I do feel responsible for her as I have her medical POA and her friends and distant family count on me to be looking out for her. But ultimately I can’t force her to make better decisions. I just don’t want her to suffer needlessly and I think her decisions are going to end with suffering.

Interim health aids

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You should probably be looking to hire a live in, with proper pay and benefits, and rely on the agency for days off, with the understanding that if, e.g., a snowstorm prevents a day off the live in will get overtime and/or comp time later. Check your agreement with the agency before you try to hire somebody you met through them, but it may be worth it to you if the agency can find somebody better than you can.

From what I understand the way a "live in" works is they are there for the night shift and a new person shows for the day shift. You cannot hire someone to just live with you and be responsible 24-7. So you still need the next person to show up. Also, make sure there are not valuables around, expect stuff to get stolen, be careful about making accusations unless you witnessed it on a camera because seniors are forgetful and nobody should lose a job due to a senior memory lapse.

Theoretically yes, but you would hope that during a one off emergency such as a snow storm, the capable adult in the home wouldn't completely ignore the dependent one...

This is a very privileged take. These jobs pay poorly. Some of these people are taking on more than 1 job or have their own family to take care of. If anyone did this for your parent I certainly hope you would pay double and give a bonus.

Anonymous wrote:

Anonymous wrote:You should probably be looking to hire a live in, with proper pay and benefits, and rely on the agency for days off, with the understanding that if, e.g., a snowstorm prevents a day off the live in will get overtime and/or comp time later. Check your agreement with the agency before you try to hire somebody you met through them, but it may be worth it to you if the agency can find somebody better than you can.

From what I understand the way a "live in" works is they are there for the night shift and a new person shows for the day shift. You cannot hire someone to just live with you and be responsible 24-7. So you still need the next person to show up. Also, make sure there are not valuables around, expect stuff to get stolen, be careful about making accusations unless you witnessed it on a camera because seniors are forgetful and nobody should lose a job due to a senior memory lapse.

Theoretically yes, but you would hope that during a one off emergency such as a snow storm, the capable adult in the home wouldn't completely ignore the dependent one...

Anonymous wrote:You should probably be looking to hire a live in, with proper pay and benefits, and rely on the agency for days off, with the understanding that if, e.g., a snowstorm prevents a day off the live in will get overtime and/or comp time later. Check your agreement with the agency before you try to hire somebody you met through them, but it may be worth it to you if the agency can find somebody better than you can.

From what I understand the way a "live in" works is they are there for the night shift and a new person shows for the day shift. You cannot hire someone to just live with you and be responsible 24-7. So you still need the next person to show up. Also, make sure there are not valuables around, expect stuff to get stolen, be careful about making accusations unless you witnessed it on a camera because seniors are forgetful and nobody should lose a job due to a senior memory lapse.

Anonymous wrote:My father is in a similar boat, but he has my mother (who has early dementia) in the house with him. The more practical choice would be for him to be in assisted living, but they are determined to stay in my childhood home. This is their choice.

Your relative is choosing freedom over safety. It is her right to make that choice. However, you are not personally responsible for things that go wrong (aid not showing up) because of her choice. That risk is a reality of her choice. You can explain to her that you are concerned but it's not on you to solve that problem.

This. They do no show. You have been fortunate. They also come late. One of the many hard things I had to work on in therapy besides how to handle a verbally abusive elder was to accept she could die a tragic death as a result of her choices made when deemed cognitively capable. Even worse, in a dysfunctional family, someone may blame you for the death because you are supposed to magically make sure no shows don't happen or take advantage of a neighbor to fill in or suddenly appear and make it all OK.

Having been at this for a long time I can tell you several of my friends have lost a parent to a fall down the steps, or an emergency when no aide was around. Of those with parents still living there have been falls where the elder was on the floor for many hours. People complain about how in a nursing home you can an hour or 2 without help, but that is better than going 8 hours or 12 hours without anyone knowing you are on the floor. Neighbors burn out after a few emergencies with those programs you can set up to alert someone is there is a fall. They aren't always available with a key and you have a new set of issues if the EMT and fire department have to breakdown the door.

My husband was so fortunate one of his parents died peacefully in his sleep after a brief illness and a long and beautiful life he could enjoy.

My parent lives in a warm state, but the one time it looked like it might be icy the next day, we paid the caregiver who had the day shift to spend the night.

The reality of even if a home caregiver does not show for a few hours, your relative is probably getting more care than in a home.

You should probably be looking to hire a live in, with proper pay and benefits, and rely on the agency for days off, with the understanding that if, e.g., a snowstorm prevents a day off the live in will get overtime and/or comp time later. Check your agreement with the agency before you try to hire somebody you met through them, but it may be worth it to you if the agency can find somebody better than you can.

My father is in a similar boat, but he has my mother (who has early dementia) in the house with him. The more practical choice would be for him to be in assisted living, but they are determined to stay in my childhood home. This is their choice.

Your relative is choosing freedom over safety. It is her right to make that choice. However, you are not personally responsible for things that go wrong (aid not showing up) because of her choice. That risk is a reality of her choice. You can explain to her that you are concerned but it's not on you to solve that problem.

My family member is mostly bedridden due to multiple health issues. She can’t get out of bed alone. Even if she were able, she can’t use the bathroom or perform other basic tasks for herself (she uses a walker only with support). She basically is 100% reliant on her home health aides when awake. She probably should be in a nursing home but after a bad experience won’t consider it which I understand. So far the agency has been mostly very reliable and the quality of aides excellent. However, in reading the winter forecast I am concerned about what happens in bad weather, especially a bad snow or ice storm. What if the agency can’t send an aide? How likely is this to be an issue? I don’t know what we’d do if nobody could get to her. She lives alone and has no children. I’m her closest family member and I can’t physically care for her.