Yesterdayanurse Asked May 3, 2026
How do you get a full time caregiver?
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My husband with vascular dementia is in a memory care but high functioning. He wants to come home. He thinks he can do the things that he used to do. Most of the time, he seems lucid. But I don’t want him to come home. I don’t even want to be married to him. My question is, if he leaves memory care, he would be in a senior apartment and I’d need to hire a full time companion for transportation, cooking, light housekeeping and company. How do I go about hiring someone like that? Has anyone else gone this route?
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Many have said over and over, that the dementias are not something that can be healed/fixed and the person will continue to decline in cognition and ability. Many people with dementia are able to “show time” (if I have the right expression), when they are motivated—temporarily able to appear more capable than they really are. So, even if your husband could be safe in independent living with a caregiver now, I would question for how long and how safe? You have already gone through the hard work to have him placed, I would question why you would step out of that now? What happens when he declines and you have to then get him placed somewhere again?
To hire a full time caregiver, I have read there are many avenues. An agency could send people to cover all shifts, for 24/7 coverage. They advertise that they vet their people and of course they take care of all the taxes and insurance, etc for them as employees. I understand you can also get caregivers via the VA, if you or your husband served. Some people hire someone privately but then you have to vet them and take care of taxes and insurance etc. All avenues, I have read, have positives and negatives. One such negative is when caregivers do not show up unexpectedly, then you are left to try to coordinate someone or caregive yourself.
I would recommend that you very carefully consider all this, and I wish you peace and comfort in your future.
Wouldn't acceding to his demands be an exercise in futility? Vascular dementia usually progresses pretty quickly--my mom died almost 5 years to the day from her diagnosis.
Can he afford a senior apartment and a full time caregiver?
You would need to find someone who could withstand his attempts to "fire" him/her.
If he were in a "regular" living environment, would he be considered competent to get rid of caregivers himself? What would YOUR legal liability be?
I would consult an Elder Law attorney before making any moves.
Pleasing him may not be the best goal here.
Best of luck to you both.
We needed a 24/7 live-in caregiver who was a CNA. We needed two other caregivers to help her, stay with the patient when the 24/7 had to go out, help with the Hoyer, the housekeeping, and all the things that are required when someone is sick at home. We had a once-a-week housekeeper, and I was there often to help with the shopping and cooking as well as patient care. This cost around $100,000 a year, and that was many years ago. My parents' dying took 5+ years.
In addition, you'd be paying rent on an apartment as well as utilities and other expenses attached to it. Food - you'll need to feed the 24/7 because she lives there and cooks for the patient, though she might buy some of her own food; she might not have time to cook for herself as well as the patient. Full-time dementia care requires full attention of at least one person and preferably more. If you're the manager of all of this, consider it a full-time job.
I hope your husband stays where he is. They already have the resources that he will need, and that will be easier on you.
Tell your husband he "can come home when the DOCTOR says he's in good enough shape to come home, but not till then." Then change the subject. He's Showtiming for you and acting as though he's perfectly fine when he is NOT. Or he wouldn't be in Memory Care. He's manipulating you, just as my mother manipulated me when she lived in Memory Care. Insisting she was fine, all "the others were crazy, not her". She could come live at my house and HELP ME. Ridiculous statement that was, in reality. She suffered from anosognosia which is the inability to recognize or acknowledge her deficits. A common issue with folks suffering from dementia and/or schizophrenia and other mental health issues. They gaslight us, trying to say WE are crazy and THEY are fine. Don't fall for this tactic, and stick with the line about the doctor. Blame him.
Taking DH out of MC and setting him up in his own place with a live in is insanity. It'll turn into YOUR living nightmare 100%.
As far as guilt goes, consider you're feeling grief instead and remember you're doing nothing wrong to be accusing yourself of guilt. Blame the disease of dementia for all of this, not yourself, and leave DH where he's best cared for and safe every day.
Best of luck to you.
Or you can make it easier on yourself and hire an agency. Find out the hourly rates and do the math.
Either way, will cost much higher than a nursing home. For example figure on 15 to 19 k each month.
Do you have deep pockets? Otherwise, you keep saying you will not take him in to your home.
And BTW, you can block his phone calls. It sounds like he has a repeating mantra. He might need calming meds. This sounds like Lewy body dementia
One way for it to end is if you take him out of his locked memory care unit and he takes off from the apartment you rented because the caregivers you hired are insufficient to manage him.
My husband got out of our house, which I'd worked hard to make secure so he couldn't wander. He ended up in a hospital many miles away as a John Doe. While I was frantically looking for him, good Samaritans saw him walking on a busy highway, called an ambulance and sent him to the hospital. Fortunately he was okay, but he could have been hit by a vehicle, fallen into a ditch, or jumped off a bridge. Or robbed. Or beaten.
A locked unit is the only place a dementia patient needs to be when they get to that stage. You'd feel much more guilty if you take him out of there and he dies as a result of your negligence. Look up the laws in your state and find out what you could be charged with if your "just wanting it to end" results in his death.
Next, you get him on meds for depression/anxiety/agitation.
Then, you understand that wanting to "go home" is a dementia behavior called Sundowning. Often he's not even thinking of his most recent home, but a safer one, in his long-term memory, like from his childhood. You redirect the conversation or distract him. Don't talk to him or visit him in the afternoon as it tends to be worse then. Let his calls go to voicemail and screen them. Once he starts on the going home topic, you change the subject and keep redirecting it. If it's getting him wound up, then make an excuse to hang up.
Hiring aids will be like another full-time job. I hired aids for my Mom when she was recovering from a broken pubic bone. Even the agency couldn't keep enough people and it was a parade of newcomers almost weekly. Finding subs at the last minute is a royal pain and often impossible. All the more worse if you privately hire: many states say you are now an employer and need to have contracts, do payroll withholding, quarterly reporting and issue W2s. To top it off, you lose all your privacy in your home, which is what my Mom hated the most.
Please do not take him out. Keep reminding yourself he is in the most appropriate care for the BOTH of you.
I'm sorry you are finding it confusing or stressful because he is showing signs of lucidity, but he will only continue to further decline. I think he is where he needs to be. If the cost is an issue, obviously an independent apartment will cost far less than long term memory care. You can try that route if you think it will work for now, but don't expect it to go smoothly or last for long.
If he leaves , he will no doubt say he’s fine and fire the companion .
Maybe he needs a med to calm him .
He’s not the first to say he doesn’t belong in memory care and beg to go home and he won’t be the last.
Visit less often . Visits short . Don’t answer your phone , let it go to voicemail . Only speak to him on the phone once every 3 days . The more attention you give to this behavior , the more he will keep it up , because it gives him hope of leaving.
Tell him :
"I am working on it"
"We can discuss this with your doctor at the next visit"
What you are proposing is expensive.
Contact a few agencies and tell them that you need a "live in" or several shifts to cover 24 hours.
Now add the cost of the apartment, food, insurance, utilities (gas, electric, cable), transportation.
If your husband is taking any medications most agencies will not provide a "companion" you would be charged for someone that has more training.
You say "most of the time he seems lucid"
I am assuming that you are not with him 24/7. So, he may be putting on a show for you letting you think he is more capable than he really is.
He is safe where he is. He is cared for where he is.
If this was not the correct placement for him the facility would have suggested Assisted Living rather than Memory Care.
If you remove him from memory care and he suddenly progresses to a lower cognitive and physical level, how would you deal with that. I have not dealt with facilities yet, but understand finding an appropriate one to accept someone with either vascular or lewy types of dementia can be very difficult because they can become very aggressive.
My suggestion is leave him where he is since the staff is already familiar with his current traits and hopefully will be more tolerant and understanding as his disease processes.
We tried an independent senior community a few years ago and it became stressful because there were so many other residents who expected us to help them when their caregiver was off... much like I would expect your husband would be unless you have 24/7 care. They were allowing some to come in with caregivers providing simple medication reminders who needed a lot more supervision and became a burden to the other residents.
Should this happen, you would have spent a lot of money settling him in then if needed, the memory care facility may not take him back and you would be back to square one with full responsibility while looking for a new facility.
Sounds to me if you truly don't even want to be married to him you would be setting yourself up possibly for a total fiasco and in a lot worse scenario! Step back and consider the freedoms you have now that you would lose... even with 24/7 caregivers you would have to oversee his care plan and probably need to be involved much more than you envision. When you hire an agency to send caregivers, that is all they do.... send caregivers and let you know if someone calls out and if they can't be replaced for that shift.