Recently considering hiring outside home healthcare assistance for elderly in-laws (97 and 93 years old).
Mother-in-law recently released from ICU (was diagnosed with double pneumonia, UTI, congestive heart failure, Zenkers Diverticulitis, and sepsis. On oxygen, bedridden, unable to eat much (pureed food) or drink. Sleeps 90% of day, needs turning every 2 hours. On hospice now while in our home.
Father-in-law, needs assistance with hygiene and dress and grooming, has dementia, wheelchair.
Their son, my husband, works full-time and I, his wife, have been basically the in-law's primary caregiver. Due to shoulder injury and ongoing back pain, I need more help now.
Hubby and I have discussed possibly hiring 24 hour private duty nurses to come to help. Anyone have any experience using in-home private duty care and if so, what are pros and cons?
When you hire in home care you specify what needs to be done and if you are using an agency they will provide a person that is qualified to do what you need done.
The more that is required the more the cost.
If medications need to be administered you will have to have a nurse. (only a nurse can administer medications but if your in laws can take medications on their own if they are reminded then a nurse is not needed)
Most of the tasks that you mentioned can be done by a good caregiver or a CNA. Again a CNA will cost a bit more than a caregiver.
IF you hire privately you can hire anyone you want and can instruct them do do what needs to be done. In a private house a private hire caregiver CAN give medications to a patient. But you will have to do back ground checks, I would hire at least 2 people so that they work shifts and can cover for each other if one is off. AND you need to follow the "rules" and take out taxes, file the paperwork so that it is all legal and there will be no problems with IRS. In some cases it is easier to pay a bit more and go through an agency. (less/fewer headaches in the long run)
Unless you are wealthy, you won’t be able to to hire but one person.
A facility provides an entire staff for less money, plus all of the medical equipment needed.
The CNA was immensely helpful and more proactive in the care. She was able to instruct the agency and the PT personnel as to his condition and ability for the day. She also was able to handle the medications and administer insulin.
We also made worksheets with specific tasks for them to fill out so we could monitor the trends with his blood sugar and blood pressure, e.g:
7:00am Wake up, dress, walk to kitchen
7:30am Record blood pressure and blood sugar
7:45am Eat breakfast
MargaretMcKen: Our costs were the same. 20$ an hour for agency, a bit less for the less experienced, around 17$ an hour, and a bit more for the CNA.
The last two weeks we had hospice at his home.
It was expensive but he qualified for VA assistance which paid for some and then he had some savings. It was well worth it and he was happy to be home and see his wife everyday. Family got to visit.
I created a daily log that each person filked out to have good communication about care. I also had responsibility for finances, medications, grocery shopping supervising the caregivers and any other needs. It was exhausting.
I do not regret keeping him home. This was at the start of Covid and staffing was low at facilities. He had several hospital stays and rehab so I had a good look at the services that were provided.
I also have my husband's aunt with more advanced dementia @ 92. She is in her home with caregivers 7a-7p everyday. Family members have assigned evenings. We use a Nest camera to monitor after bedtime. She stays in bed the entire night. If needed a caregiver stays the night.
My advice, keep them home if you can manage with help and have the finances.
They deserve all we are able to give if possible. Every situation is different and each family has the givers and takers. I tried to accept and be thankful for what each person could do.
If I didn’t like someone, they would send a different caregiver, but many times not qualified to provide the heavy care, and I had to help. You can let someone else take care of taxes, SS, insurance, etc. after a few months I asked the caregivers who were here to train me to use the Hoyer lift and do the personal care, and now I have a caregiver for 4 hours 3 days a week, so I can get out for walks, see friends, and shop. I do a better job with his personal care than any of the caregivers did.
I can see your dilemma, since no family member lives there to supervise. I think it’s hard to find qualified people. You might start out at home and see how it goes. Good luck. Let us know how it goes.
She lives alone and everyone works or lives far away. She was not capable of caring for herself. Can’t walk or stand and needs sponge bath.
We decided on 3 8 hour shifts so as not to pay overtime. We could not hire live-in help due horrid condition of the house and mom is so demanding and requires lots of attention I did not see how a live in would be able to keep up or when they would rest.
The 24 hour help is very expensive. $25 per hour. She had the cash but it is going fast. I have to say the agency we hired is very good. All the women are excellent with her. This is the second agency we hired and have been the best.
if you try an agency and they don’t work out you can try another. You have no obligation to stay with any agency.
Home care agency personnel have already been screened and made sure they have training. They do cost more than private hire. However, there are people to cover if a worker is sick for a shift.
Private hire personnel may cost less - usually minimum wage. They are screened by you and may or may not have training as a CNA. Please require a drug screen and do a check for a police record. Ask for references and call those people.