I'm 73 and in fairly good health. My 84-year-old husband's care needs mainly consist of needing help dressing, bathing, carrying things, and often getting up from chairs and walking. He is so far able to transfer with help and is continent. He does have signs of mild dementia that are increasingly more frequent. He is very weak most of the time. Having said that, caregiving tasks have, so far, been manageable. Recognizing that he continues to decline, I recently looked into a home service that would provide companionship, assistance with ADLs, occasional assistance with bathing and maybe some help for me (maybe folding clothes, cleaning bathrooms??). I have contacted two to begin with. Have heard back from only one so far...Visiting Angels. I wasn't terribly shocked to learn their hourly rate was $40.00 (US)/ hour...but I was very discouraged to learn they have a minimum hour limit of 12 hours a week...that must be used in 4 hour increments. Is this typical? We could probably manage the hourly rate, for four hours a week...in 2 hour increments, but $480 a week at private pay is beyond our reach. I'd like to hear how others are managing when paying for privately for assistance.
It can be hard to budget the cost especially if one wasn't able to do the old fashion "rainy day fund" which was popular back in the 1940's and 1950's.
Thank goodness we have Medicaid [which is different from Medicare]. Call your State Medicare office to see what is available for your State.
I have seen ads for Care.com that offer caregivers. You need to check to see if they are licensed, bonded, and insured.
Have you checked with your local area Agency on Aging to see if there are any services that he or you may qualify for.
Have you looked into Adult Day Care programs. Some will pick up in the am and drop off in the pm giving you a good portion of a day to get things done for yourself. Some, depending on the program will shower the participant.
Check with the local Senior Center they may also be aware of programs or Volunteer services that might help.
Hiring privately will always be less expensive than going through an agency. There are advantages and disadvantages to both.
(The 2 best caregivers I ever hired were from the local Community College and had just completed the CNA certification and were waiting to begin the Nursing program that would start the next semester.)
there are services like Care.com that act as a "go-between" (for a fee) for people looking for services like caregiving, baby sitting, pet sitting.
The only caution that I have is that you make sure that background checks are done but even that does not guarantee that you will not have problems.
I also urge you not to "pay under the table" make sure that the costs involved with caring for your husband are documented and this also means that the person that is hired will pay taxes on the income.
Sometimes a housekeeper can be a more affordable source of help, freeing you up to do more of the personal care.
Also when your DH becomes difficult to take out, check into Home Health if you have original Medicare. They have a home bound benefit which will provide a weekly nurse, baths and therapy. Plus blood draws, urine tests. X-rays. Several things that are easier done at home. Your DH sounds like he could benefit from therapy now. Ask his primary to order an evaluation.
Also check with your County Area Agency on Aging. Look on their website for services they offer to both caregiver and the patient.
In my state (with the highest cost of living), the place that we used was under $30/hour and it depended upon how many hours per shift and what was expected during the shift. There were 3 cost tiers: up to 4 hours per shift, 5-11 hours per shift, 12 hours or more per shift. The cost per hour decreased as the number of hours per shift increased. Minimum number of hours per shift was 3 hours with a commitment of 12 hours per week. The cost increased based upon the level of care that was expected. Nurses Aide cost less per hour than registered nurses (prescription meds). Bathing, cooking meals, driving to appointments were an add-on cost. (Housekeepers in my state make more than this per hour.) More commitment of hours per week lowered the cost per hour. Whether you are on a bus route or if they have to have a car to get to your place, made a difference too. Caregivers were not assigned to clients.
Licensed and bonded care givers cost more than unlicensed care givers. I recently looked at 2 other agencies and the cost was $34/hour (12 hours per shift 7 days a week and 2 assigned caregivers) and $35/hour.
For us, 9 hours per night, 7 days a week, plus a daytime adult care, plus food, property taxes, utilities, gas, and HOA fee (notice no mortgage), was more out-of-pocket than to put my Mom in MC. The plan is to rent her condo, which will allow us to make her money last a bit longer.
Look around. The prices vary a lot and the amenities differ considerably. Some automatically include a 21 meal plan and some had a 7 meal plan. Some included excursions, others didn't.
There are people in my Mom's MC ward, where 1/2 of the couple lives in assisted living and the other half lives in MC, in the same facility. The more able bodied of the couple visits the other, takes them out, etc.
While you are not strapped for cash, take a hard look at the out-of-pocket costs. That might help you come up with a plan for the future. If you are thinking that Medicaid will "save" you, don't count on having the same options, as many of the "desireable" places give preference to non-Medicaid, and have long waiting lists. Prior to COVID, waiting lists of 1.5-3 years was common.
Good luck to you. Its a tough, eye opening and exhausting experience.
P.S. Because caregivers cost less than housekeepers per hour, I was told of several instances where the caregivers were expected to clean the bedroom and bathrooms, do laundry, etc. as a caregiver. Those caregivers in the know, told the agency that they would rather not work, than be assigned to those places. Get a housekeeper to do dishes, clean bedrooms and bathrooms and closets, and rearrange the office and furniture. Some of them will even do your laundry. A caregiver entering the field, wants to care for people. If they really wanted to clean bathroom, bedrooms, etc, they would have gone into the housekeeping career which pays better.
I first contracted for 3 hrs. a day, 2x a week because I didn't really knw what I needed. I think that was the agency's minimum. ($29.50 an hour now). That lasted a month because he became profoundly weak quickly, & I got live-in care - $375. a day. He also slipped into dementia quickly (or it was pain, I never found out) & began having psychotic episodes at night. I had an overnight aide 2 nights - $29.50 /hr for 12 hrs. The live-in care lasted 2 weeks, and then he went into the hospital.
We were lucky because my LO could draw from his investments to pay for home health care. We had a limit, but we didn't come close to reaching. He was in the hospital for a week, went to hospice, & died in 4 days.
I went with an agency because I didn't have to worry about coverage or background checks. (Not that that background checks protect you 100%, but it's a layer of protection to fall back on.)
There's always the fear that you'll outlive your money, so people are reluctant to use what they've saved, but that's what it's for.
We had a limit, but we didn't reach it because his illness took him so quickly. There are people on this forum who aren't as fortunate as we were, and they struggle to get reliable help, or their LO or family members resist it, or they think they can do it on their own. My LO was mildly resistant, but our families were happy, & he quickly accepted it. We have 2 floors, so I also got a refurbished stair lift. I kept it because I have a knee problem & I may need it in the future.
It would have been impossible fore me to care for him on my own. The live-in was a kind, loving, caring woman, and she freed up my time so i could spend some quality time with him.
Good luck.
We used them for my dad and agreed on 2 morning hours and 2 evening hours 7 days a week. We had a lot of different workers because of this schedule but most of them worked out.
I’m not sure where you live but in Ohio the cost was $27 an hour. The fees cover insurance, bonding, and background check costs as well as the company management.
Also, I am not sure, but I believe you can talk to your family doctor to have an aid come in to give him a weekly shower. My Mom did that for my Grandmother.
Have you thought about one 1/2 day per week of a "Day" dementia program. Some offer p/t, ot/ and speech therapy, paid for by your health insurance. There is usually a co-pay of some sought for these programs with continental breakfast and lunch included. There is supervision, some have RN's on duty and also transportation.
You could start out small--again the more the days the more $$$. Everyone is in the same boat. CNA aren't not paid enough and it's backbreaking work. I recommend review your health insurance policy, speak with a hospital social worker and possibly a Nurse at the Primary Care Doctor's Office. I find the Nurse Practitioner's are thorough and seem to have more resources and better versed on these things compared to the doctors.
These things are tricky because people need to be paid what they're worth but also you have to keep a roof over your head and food on the table and make sure your loved one's in not in harm's way and that they are kept on track.
Check out the Department of Elderly Affairs. They can come to your home and provide information and let you know what is available. Usually the needs change along with the person's health.
I hope this is of some help to you.
I know Medicaid varies from state to state and that’s another good reason for an elder law attorney. Good luck and don’t wait long.
You can also have his doctor order an evaluation, again what and by who may depend on the state but they should be well versed in it.
Good luck.
There are independent home health carers that you can negotiate prices with.
Good luck.
W
My mother lives with me, so I pay for these sitters with her social security. I don't ask them to do any housekeeping chores, but could probably negotiate that with them if needed.
There are also house cleaning services that you could hire to come every two weeks to relieve you of heavy house cleaning.
Also because of my mother's dementia diagnosis, medicare pays for weekly physical therapy for her.
Blessings.
Some mentioned about Medicaid. It is different from state to state, but if you can be qualified for Medicaid, power to you. It really helps defray the cost!! Keep in mind though that not all care agencies accept Medicaid. This is why so many caregivers are bankrupt to finance the caring of their loved ones at home. Or quit their jobs to do so themselves.
Something is wrong for a super wealthy country in the world with a crappy health system.
or $30-$38 per hour with 4 hour min. One agency said $30 per hour 40 hr week min. I about died at that one.
where do you look next.
They say hours less than 4 require multi different folks to help those in need. And, again most, prefer the same person...hope that helps
I've been able to get help for my mother from a few individuals who help already (within a small condo community).
So short answer to how people manage to pay for home health - they don't.
It's possible a cleaning person to help you out one day a week with heavier chores might be financially doable for you. Do you know anyone who has a cleaning person? If so, ask if you could be added to that person's cleaning schedule. If you have children, talk to them about you needing a little help and see what they have to offer. Start there.
Someone working for themself will not charge as much as an agency. This does make you do more vetting of the people and CHECK THEIR REFERENCES CAREFULLY. Do a little research on the information you need and the questions you should ask. There are also online sites that check for history of legal problems, etc., which are not too expensive.Good luck. Stay around the first few weeks to observe, start on a probation schedule to make sure and the aide are happy with the job.