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You can't "sign a independent contractor agreement" and rely upon that. Whether or not someone is an independent contractor and not an employee depends upon the facts and circumstances. In almost all cases, in-home caregivers will be found to be employees of either the client/client family OR the company or organization who sent the contractors.
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Lindags, daycare deals with incontinence all the time so please dont let that make you think they wont want her. The daycare we had was mostly dementia patients and most all had bathroom issues or incontinence. If she gets moody , a couple of weeks on a medication (my mom takes depakote) and those go away also. We gve a 1099 at the end of the year. You need to keep all the tax info and what you pay for daycare, etc all recorded regardless of wether or not you use an agency. I found better people out of an agency on care.com who were older and had no small children, etc to make them unreliable, and they have background checks Good luck.
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In home care is more isolating for the parent and for the care givers. We kind of flipped the equation.
When mom lost her license and stopped driving, we rented her house out and did about half the estate sale nonsense and moved her to a little house across the street from the daughter in the coolest location. She played house, gardened and lived independent, while all the neighbors kept an eye on her. As she escalated and needed someone to watch her wandering, no longer able to to the math to buy her own groceries, we moved her to an assisted living. She had her own apartment and ate in the dining hall, swam in the pool with her friends. The center was across the street from the kids school, so they often went by for ice cream and a swim on the way home from school. The center cleaned her studio apartment, could have done her laundry and gave her her medications. We were able to afford this because her house was generating income, she had no more transportation and food costs, she had long term care insurance and it was an affordable facility.
When she could no longer handle this, we evicted our tenants, remodeled the house (walk in tub, widened door ways) and moved one daughter and her kids into the big house. This was a great gift to this family to live rent free for a while. When the daughter went back to work, mom attended day care and we hired a granny nanny from 2-6 pm.
Now mom is escalating to higher care. We are beginning with 24 hour care two nights a week, so the family in the house can have more independence. She will soon be kicked out of day care, as she is starting to poop her pants more. When we need more 24 hour care the family and house will be ready for it. And hopefully we will be in a trusting relationship with an agency.
I agree with everyone that you need a network of caregivers as it is hard when it is on one person whether that person is an employee or family.
The tax paper work for the granny nanny was a pain and that is why we have shifted to working with an agency.
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Carol, I couldnt agree more and I do the same thing here. I even have a contract for them to sign as independent contractors. Moms spoiled and gets one on one 24/7. Cheers to you for what you did, I've been at this over 3 years now! There is nothing like being at home and I couldnt ever imagine my Mom not being here with family and watched and waited on. I feel its her her turn now she deserves every bit of it. Mom doesnt even know me most of the time and is extremely difficult with the extreme difficulty of walking and incontinence but I still wouldnt change a thing, only the best for her, as she was to me.
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The positive far outweighs any negative of in home care. I moved back to my hometown because my siblings had begun making plans to put the folks in a home. So 3 against 1 they tried to talk me out of coordinating care for living at home. Not sure that anyone has the desire to live in assisted living and for the most part I believe these facilities exist for those who do not have family.

Since my brother and sisters were adamant that I was being reckless and putting my parents in danger, I contacted our local VNA to find a geriatric case manager that could advise me on the safety issues and if it would be too risky to keep them home under the care of private caregivers.

Then I asked our local Aging office if they had information about how to hire in home caregivers. Fortunately they had a list of individuals who were willing to be part time or full time caregivers. Since I recruit and train volunteers at work, I applied that sense of professionalism to the process of finding the right caregiver for my folks.

In our case, we have had 2 long term caregivers that have been exceptional in every way. I made it clear to each of them that the caregiving position was as an independent contractor. In that way, they are responsible for their own taxes and we just make sure to give them their 1099 on time so they can file.

The positive side of living at home for my folks is that they still maintain some control over their own lives. I have gotten to know my parents as an adult .

I have a feeling some people feel like our parents would be safer in a home. That's just not the case --- my poor Aunt fell and sustained broken bones while living at a facility. It's not difficult to understand the research findings that conclude the elderly who live at home live longer.

Of course the downside is that caregiving sometimes swallows you up. Actually it's the people on this website that have taught me about boundaries and this support has made such a tremendous difference. I had no idea how similar many of your experiences have been to mine.
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We have been caring for our mother for 10 years. She can not walk or do anything on her own. I work during the day and my brother works at night. When I leave for work my brother will come here intil a home maker gets here. She is here for 6 hours a day Monday thru Friday. The state of Illinois pays for the home maker. My mother does not have any assets so the state picks up the bill. It is difficult to find a good home maker, but, there are some. Also, a family member can apply with the home maker agency, they would be the home maker and get paid for doing it. It is a limited amount of hours. Also, they give us 80 hours of respite care for free for the weekends or nights. This is how we have been able to keep our mother at home. It is difficult , but she would not last very long in a home since she does not walk. It takes a lot out of your life to do this, so if you don't want to give up your time to care for them at home I suggest you don't do it. It does ruin your social life.
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ED
That was a funny story about your Mom's caregiver who dressed her up like a hooker barbie. We had one for my Mom who loved getting her all done up, hair jewlry, nails, etc.She always wore high heels and I couldn't fathom how she didn't break her neck while showering my mom. Not a guy though. At least you had an admirer!
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LILLI:

Three times. The 1st woman who came was very good ... at gossip. She sucked at caregiving, but my mother adored her. What's that saying? "Birds of a feather ..."

The 2nd had a forever-drunken, jealous husband she never told us about. She had to go.

The 3rd, an openly-gay young man of about 26 she met while working at St. Barnabas Hosp., referred to himself as a too fierce, finger-snapping, fabulous for just one man. He's the one who gave my mother that Hooker Barbie outfit that makes her so alluring. The downside of it all was that obsessive compulsive need to to keep the house antiseptic. I told him many times he only had to service my mother, but next thing I knew he was doing my laundry, ironing my underwear and then folding it neatly. My boys adored the guy because he made them laugh and kept them well fed at all times, plus he was on call in case "my mother" needed anything. ... Like some Marylin Monroe pictures I found on my walls, followed by a huge antique dresser "for her bedroom." I picked the lock and found his clothes and a small suitcase containing a travel kit, iron, colognes, a couple of Blue Boy mags, and a pair of stiletto heels. A mix between Donna Reed and Betty Crocker, he cooked up a storm and my kids were well fed all the time. I asked him once if he was planning to move in, and suddenly he started talking about where "our" relationship was headed. To make a long story short, he had to leave. My mother was so overwrought, she barked at me and said he was the best "girlfriend" she ever had. From what I still hear, they still keep in touch and watch novelas together at his apartment two blocks away from hers. ... Whatever makes her happy.

This is my experience with in-home caregivers. You know what? I recommend it. But check those references!
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My mother has her own apartment and after her last hospital stay (due to a fall), her doctor says she can no longer live alone because of her advanced dementia. I hired 24hr home care through an agency and they're good care givers but it's kind of isolated. I found an assisted living senior gardens that also offers a memory support area where she will share an apartment with one roomate. The apartments feel like home and there are so many available activities she will have more of a social life there. They get 3 meals + snacks, there's a large game room, theater, solarium, laundry, outings, etc. I think it will be better for her well-being. In addition, the 24hr home care is double the cost of the monthly rent for the senior gardens. Of course, change is difficult and she doesn't want to move so I'm hoping it all works out and she will eventually enjoy it......
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I have to agree with having the person you are caring for at home. Most places are private pay, we can't afford that. As a spouse with a husband with Alzheimer's it is very challenging. There is hospice and home health home aides for extra help. I am 1000 miles from family so I am on my own
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The continuing care facilities are starting to be popular and our state and nearby states are starting to have more of them some a 3 tierd condo's AL and NH on the same grounds and this seems to be the way to go if the elder has a good amount of money saved up for their care as they age.
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My mother used caregivers which were recommended thru the Alz Society. Some were certified STNA'S and some were not. I payed them and it was not required at the time that I pay taxes or anything for them. Some wanted payment six weeks in advance or wanted to be paid in cash. If she lost a weekend caregiver, I had to find my own replacement. I've also had to let them go. A nurse from Home Health came weekly to check on her. Currently my aunt is using caregivers thru an agency. To me this is so much better. All the caregivers are certified STNA's. They background check them, pay them, fire them and replace them. I don't have to work about paying them or replacing them. If Medicaid eligible, she may not even have to pay. Check with your local Area Office on Aging. A nurse from the agency comes every six weeks to check on her, and a social worker /case manager from the Area Office on Aging comes every three months. Such a program can only provide up to 3 hours per day care. If your mom would need more care, she would not qualify for this program. On the negative side, the caregivers are not nurses, and cannot give meds, suppositories, etc. But Home Health nurses would be available to come to the house if and when the time comes.
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Before my mom went to live in an assisted living facility, I had home health aides coming 2-4 times a week for about 6 hour shifts. On the days that mom didn't have an aide, she went to an adult day care program, supervised by a staff that included nurses to give mom her medications or to address any other needs.
What happened was that mom started having panic/anxiety attacks at the thought of being alone.. We were spending $4,000+ per month for aides (they cost more on weekends)and I still spent a lot of time and emotions taking care of her---with minimal help from my sibs.
The ALF she is now in costs $7,000+ per month (her RX'S are extra as well as hair apppointments, DEPENDS, and other toiletry items). The ALF has agreed to keep mom when her money runs out. She can afford to self-pay for 2-3 years and then she is guaranteed to be allowed to move into the nursing home facility when the time comes and they will help us apply for Medicaid. The advantage of doing this is that we don't have to worry about mom running out of money and trying to find a nursing home facility that is really nice. I shudder at the stories about homes with bed sores, un-needed restraints, etc.
and I was afraid that might happen if we didn't have enough money to get her into a well respected facility. I felt that we weren't "building equity" toward her future care by relying on home aides. I am able to stop by and visit her 3-4 times a week b/c I work only 5 minutes away but she has plenty of support whenI'm not there---BINGO, music, "field trips," movies, etc. as well as 3 meals and snacks a day.
Anyway, this is just my take on home-care vs an ALF or nursing home . (I prefer the term "nursing center!).
Good luck on whatever you decide is best for your circumstances. Mom's dementia is in the early stages but I am already stressed out some days and the ALF gives me a respite.
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You have all given me the courage to actually make this work. I, too, found that by introducing caregivers a little at a time worked better than having several "invade" all at once. This was the problem when Mom had Medicare caregivers - the contractors "require" that the aides come in so many days a week for so many hours. (btw, this is NOT a Medicare rule - it is a way for the companies to bilk the system.) It just overwhelmed her.
The paid caregivers were much better and more reliable. Mom tends to like older female caregivers and they have been lovely with her. They do not come too often, so I do not have to keep watch over them. I do, however, keep all her valuables at my home as to keep temptation away...ya' just never know. The hardest thing is to remind Mom that these people are there to help her...they are not family or friends. I keep telling her to not share personal family or financial information with them. You do need to be vigilent. When Mom was still living in her home state, she had someone just walk right into her apt. claiming to be an aide sent from Medicare. She went into my Mom's bedroom then asked to use the bathroom...of course, she was looking for drugs. Apparently, these creeps follow the cars and vans of the real medical workers and PTs so they can see which seniors are getting care...then they pretend to work for those companies. That's when I moved her to be near us.
Thanks again for all the very useful advice and encouragement. I know that it some cases loved ones need ALFs or NHs, but, in my heart, I just can't see my Mom in one. I just pray for the wisdom and knowledge to help her through this stage in her life. This forum has been a Godsend for me....Lilli
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Lilli

I strongly suggest you do all possible to try to keep mom at home. I left my job after 22 years with AT&T to take care of my mother. Was the best three years I have had in life. I had to place her in a rehab facility for A few weeks to gain strength after a brief illness. After three weeks of being there all day, I would leave at night, and lone and behold they KILLED her one night by placing her in bed on her side at the EDGE of the bed. Really, who in their right mind would put someone to bed that way?? Staff is overworked and under paid; rushing to get to the next patient caused my mother her life! I did have home care while I was still working and the lady was awesome. She became part of the family and loved my mother as well as she took "care" of me. My one suggestion is to please take care of you! Even when I hired help or Mom was in rehab I was home and never took a break. My health suffered greatly and took a major toll after she passed. I have now taken a job in a Home Health company to fight for other seniors and help inform other care givers that there is help, and they are not alone in the care giving process.
PLEASE take care of yourself and think through decisions before making them. Hope my story helps you to make the best decision for you and your mother. Prayers and hugs coming your way. Bridget W
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I remember the night my mother-in-law discovered that she could no longer stand. At all. She had used pivot transfers for the previous nine years of living with us, but her neuro connections to her legs failed that night, and we just had to deal with it. I found a semi-skilled caregiver living across the street. Don't be surprised if you have one too, they're everywhere. While I was at work (at night), this caring neighbor agreed to come when called to assist with bathrooming (we had to buy a sit-to-stand lift) for ten bucks a trip. Maybe twice a night, and $20 got my wife's mom the help she needed, and I could keep working to pay bills. Get creative. Bend the rules. Ask everyone you know who they know who might be able to help. Like my old football coach used to say, "If you can't win, cheat!" Working the system will frustrate you to death first, and then bankrupt you. Good Luck. God Bless you.
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Great thread Lilli, I have had at home caregivers for over 2 years now. You can get some bad people if you arent careful because they dont konw how to do anything except this type of work, usually ungraduated women but if you are lucky, an intern or an older woman who just does it because she really cares for the elderly. You can ask at a college or daycare for a recommendation, those are usually the best! For $25 you can get a form at the Daycare to have their background checked thru your state before you hire them. I have my girls get Mom up and out to Daycare in a 2 hour time slot , sometimes 3 hrs. There has been times when I have had them stay home with her (at my home where she lives) and I watched them thru my nannycam. The downfalls are...they watch TV, they leave on 1-2 Tv's and all the lights, turn up the heat and text their friends instead of entertaining Mom. OF course you need to hide all your mail and anything worth anything just in case. We have keypad combination locks on all bedroom doors so once closed, no one can get into them. Daycare is great because of the activities so I do think both are great. I went to daycare with Mom to gether accustomed to it. First for a haircut, then lunch a few times, to do crafts, etc and eventually she stayed there alone. Daycares are great but there are boring days there also so mix of home and daycare are best in my opinion. Home can be nice if they dont feel well or the weather is bad but daycare has DJ's, bowling, good meals, and socialization going on around them to keep their mind stimulated.
I have interviewed over 25 women and called probably 100 over the years and learned interesting things. Most are shocked thats it only ONE person to get ready, which they love. They tell me in the nursing homes they had 8-14 people to get up, washed and to breakfast between 5-7am ! You need to make a list of exactly what the home caretaker is to do, dishes, laundry, read to your Mom, have her roll up yarn, etc...... depending on your moms health. I have girls who unload dishes, fold laundry and sweep if Moms still asleep. I also had one that sat and text'd her friends and did nothing. The woman you have work on their own, you pay them with a check, and then they pay their own taxes on it, you dont have to do anything legal as far as I know, as they work for themselves. I tell them up front, clean background check, drivers liscense, proof of care insurance if driving your Mom, aclean driving record , and pay your own taxes, never had a problem.
Best of luck, write if you have any more questions.
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My Aunt & Uncle used in home caregivers, some were very good however they had a real ugly experience with one in particular! She stole money from them, she stole checks & forged their name, she had her husband doing odd jobs out doors & he changed the locks on my uncles home after my aunt passed away & they were letting themselves into my uncles home, on one particular occasion it was the middle of the night & someone came into my uncles home & my uncle yelled he had a gun the person ran out! My uncle had to take them to court & pressed charges against them for forgery & won the case! I don't want to scare you, but be very careful who you hire, make sure you research & check references, this is your loved one that a total stranger will be caring for! On a good note, my uncle has since hired around the clock care through a reputable agency & he has two really good quality caregivers now! M in Illinois
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Hi Lilliput-Yes I have tried this course, however Mom refused to let them in..I had no choice (in my situation) but to have her in assisted living, as it was too dangerous for her to stay in the house alone, and she was not getting the proper nutrition or care that was needed. So I guess-it all depends on the situation that is going on with your parent. I also felt this placement in AL-was best for everyone...and was suggested to her by her neurologist. If there is a dementia or AD involved-and she is placed-Make sure that the facility has a special unit to meet her needs as well as yours.

Good luck on your journey into caregiving~

Hap
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My next door neighbor has started using daily caregivers and has also used them for respite. This seems to be a very positive situation from what she is telling me; her mother seems happier. She is able to stay with her dog and seems to be functioning well despite increased signs of dementia. I would like to do the same thing for my mother if needed.
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In-home care is available and the best option in many cases. I am the owner of an in-home, personal care agency and we place caregivers in the homes of seniors throughout our area. In-home care can start with possibly a few hours daily, or a combination of day and night hours depending on the needs of the individual and their available family support. No one wants to leave their home of 20, 30, or more years. And although many assisted living facilities now resemble a resort, the old adage "there's no place like home" still rings true!
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We use a combination of in home heath aides and a lovely day care center. Mom is happy with this arrangement.. She thinks she is the girl's mentor as this is one of the volunteer act she used to do. She does need 24 hr supervision and we have had both good and not as good experiances. We monitor each one very carefully, keep a running care plan handy at the door and make unexpected visits often. The aides know exactly what is expected od them. We are very pleased. This process can be made smoother with open and often contact and communication. We actually like the companies that are not connected with the state run mandates. They are better screened and never lazy.
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Mom has dementia and she currently has a companion. It is working very well for us, but then again, she isn't unhealthy, she just has poor mental capacity.

Two of my aunts were kept at home and hand round the clock health care givers in their home. It worked very well. It may take you some time to find the right person but it was the best situation for my aunts.

Good luck.
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kd: I, too, wonder about the cleanliness of institutions. The rehab where Mom stayed was clean...but not like my home. I have heard of seniors picking up infections in hospitals and rehabs, etc. I can see why. Most healtcare facilities are understaffed. Cleanliness is probably a lower priority. If the patient becomes ill they just blame it on "old age" or claim they had it when they arrived. There is very LITTLE accountability in any of these places because they depend on family members not being vocal...most do not have the time or want to look away. Sad

195Austin: Nanny cam is an excellent idea...I saw them in a magazine and it looks like you can monitor activity on your computer. If Mom ever needs round the clock care, that will be my first investment.

rip: All these places look good on paper...or even when you visit them. But it would break my heart of Mom was injured, neglected, or abused in one of these facilities. And I agree, there will be tremedous profit in the future as the entire baby boomer population needs care. I also think that the boomers (of which I am a latter member) were responsible for ushering in this philosophy of "not me" when it came to caring for our parents. Now, what they sow they will reap.

Sskape: what is it with the guys. Recently, I have had two male cousins place their parents in nursing homes who were no where near ready for one. These were once vibrant members of the Greatest Generation. Now, they are wasting away in NHs. One cousin claimed his father had Alz. and the doc gladly obliged with a diagnosis. (everyone who visits him says that his mind is as sharp as a tack.) The other cousin claimed dementia too - come to find out that his Mom is being sedated and was hallucinating. When she got to the NH she quietly stopped taking the meds and is now just fine. But their fate is sealed while their darling children fight over their properties. Breaks my heart in a million ways. Out of my huge extended family of many cousins I and one other cousin are the only ones who have cared for their parents directly. We were not raised this way. My grandparents were all cared for at home...but I have to admit they did not have severe ailments...just died peacefully in their sleep...a blessing.

I had good luck with an agency called Visiting Angels. I found it by asking the hospital's social worker. It is a franchise, so I am sure it is only as good as its local management. The owner came out to meet Mom, assess her needs, and actually brought the caregiver over to meet Mom. They call me once and awhile to see how things are going. If the customer has 24/7 care...they come out to evaluate the caregivers on a bi-weekly basis. Also, Mom had a great Medicare caregiver. So after her time was up, we hired her privately. Nice to have two.

Again, thank you all for the info. This forum is the only place where I can not only find answers, but peace of mind......Lilli
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This topic is pertinent to my situation. From day one my brothers wanted the nursing home option, while I feel strongly that home care is best. I am a physical therapist assistant and have worked in nursing homes and rehab facilities. They are in business to make MONEY and will try to keep the person in the facility as long as possible, even if they are well enough to go home. And all of these assisted living facilities popping up, these young investors think they are going to make a lot of money off of the aging "baby boomers" and the elderly. It makes me sick.
I'll say that there are good facilities and that it is an option for those who need it, etc., but our healthcare system is kind of a racket these days.
That's my rant for this morning!
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Lilli!
Thanks for posting the link about care facilities.
I was dumbfounded by the lack of "advertised care" where my father lived. He was OK since I was nearby ~ yet their advertising indicated much more "care" than other residents received.
Of course it is all the individual patients & employees, some were great - others dropped the ball big time.

The scary thing is that corporate didn't seem concerned about the low paid employees who didn't provide decent care.

After too many incidents with others as well as my father, I moved him home with me. I know he is safe & cared for here.
Much loved too!
Looking into visiting care givers now so I can have a break now & then.

You raise a good question about insurance. I spoke with an agency which "trains" their people & does back ground checks. I should have asked about insurance, but early on I realized we couldn't afford the fee.

I look forward to learning more from this thread!
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I hired both private help-aides who had cared for him in rehab and they charged a little more than they made per hr. but had no taxes taken out and the nursing home they worked in was about 10 min drive to our house but before long they were calling they could not come for many reasons and one just stoped comming without letting me know at all and I was worried about insurance the agency cost more and most of the aides were lazy and if I tried to take a nap because the husband had me up all houres of the night they always woke me up-one time to get something from our car while the aide and he ate ice cream-I finally found a good agency who interviewed him and me and the staff at rehab and was going to work the hrs. I wanted then he got critical and died. One aide a male-could not wash his private parts so I had to be home when he came and his mother owned the agency -go figure-others from agency's slept other did nothing if I was not at home that is when I decided to place him-all the agencies pushed for full time 24/7 care in the home. If you can afford it in home care is good but do not be surprised if it does not work for you and it may be more work for you rather than less and get in touch with your insurance carrier to see what additional cost you will have to pay for anything that does happen or is inferred happens-I would get a nammy cam for sure either with an agency or private and if there is a nursing school near you I would have nursing students work for me. You have to do what you feel is right for you at the time.
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Hi! My mom has had caregivers during the day for the last 3 years and I am currently in the process of going to 24 hr care upon her discharge from the hospital. My mom was in assisted living for a while and hated it. When she was in rehab for 2 weeks she hated this also but the worst part is she received a staph infection and is back in the hospital. she will need 24 hr care when she goes home. Hopes this helps~~ :) The day "crew" was wonderful and kept my mom in her house 3 years longer than she could have stayed. I have my fingers crossed that the 24 hr care will be ok......
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In home care is usually preferred, however, can be more expensive than being in a facility. Just make sure you check out several agencies. They should be bonded, trusted, you need to interview each caregiver to make sure each one is compatible with your loved one, is responsible, has a good record with others, has experience with the elderly, and understands the needs and sometimes challenging behaviors of those with dementia.
In a facility there is around the clock care, activities appropriate for those with dementia, others in similar situations and conditions, 3 full meals a day, laundry is done weekly and as needed, a nurse on-site at least 40 hours a week and on-call 24/7, and more. There are generally 2 caregivers and 1 medication aide for each shift. The number of employees working each shift can depend on the facility and if they accept Medicaide residents. All the above and more can relieve a great deal of stress for the family member caring for their loved one.
To be able to decide which situation is best for your Mom or Dad you really need to write down the pros and cons of each situation.
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...btw, do you have to have insurance coverage, in case a caregiver is injured on the job or claims that they were injured in your home?
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