In-home caregiver for parent

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  • #79501
    AnnaMAnnaM
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    I know we have a lot of posts about nannies and babysitters, but I am looking at the other end of the life spectrum currently. My mom, after living alone for almost 20 years since my dad died, has developed Alzheimer’s, and in the past month has begun to have trouble with her COPD. She has been remarkably healthy for a woman who has smoked for 70 years, but she caught a cold, which led to pneumonia, got out of the hospital, started smoking again, and landed right back in with acute exacerbation of COPD. She got seriously deconditioned over three weeks and was sent to a rehab unit after the second hospitaliztion. She got pneumonia again there (new location from the one she got the first time)and we almost lost her on Tuesday night. She has bounced back amazingly well, but if she continues to progress, we will be faced with finding someone to live in with her at home, as she desperately wants to go home, and we would like to try to get her there. She cannot live unsupervised anymore. (We are taking her car away, but if she decides she wants to smoke, she will try to walk to the store to buy cigarettes and won’t get very far before collapsing.) My question is, has anyone here dealt with this, and do tyou know what sort of salaries live-ins expect to care for a senior citizen who needs mostly just supervision, reminders to take her meds and inhalers, and some light housekeeping and meal preparation? What sorts of issues might come up? Would appreciate any info, advice, or experiences.

    #79503
    sahmdsahmd
    Participant

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    AnnaM, I’m sorry your mother has been so ill. 🙁 Here is some information about home health aides, from the perspective of a woman who runs an agency in NYC:

    http://newoldage.blogs.nytimes.com/2008/12/30/home-health-aides-what-they-make-w hat-they-cost/

    (The New Old Age Blog has some other nice articles about caring for aging parents.)

    It will probably be less expensive in your area, and it will be less expensive if you hire directly rather than going through an agency. Possible pitfalls include the cost (very expensive), unreliable caregivers, dishonest caregivers, your mom’s possible refusal to cooperate with the caregivers, and progression of her condition to where much more care is needed. However, if you find someone who can do what you want at the right price, it would be great for your mom.

    I hope she gets back to baseline soon and I hope you can arrange a good situation for her after that.

    #79504
    merrimerri
    Participant

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    AnnaM – have you had any luck finding someone to take care of your mom? So so difficult. I think about this often – as my parents age… Also as my in-laws become sick (they are in Europe). I’m not sure how we will deal with this ourselves…

    I agree with the above poster – there are pros and cons to hiring privately. Like for children, a nanny cam might not be a bad idea..

    When I was younger, I worked in a nursing home. I never saw any abuse, but some caretakers were just more caring and gentle than others.

    Also – I imagine that caretakers get more frustrated with the elderly than with young children because adults can be mean, fight with you, hit/hurt you, swear, etc. It’s hard to separate what may be that person’s personality – and what is the disease.

    I would suggest finding someone that has good experience with AD – so that they have an idea of what they might be in for.

    I really feel for you. Let us know how you are doing.

    #79506
    kpzr /9145kpzr/9145
    Participant

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    Kids can be mean, fight with you, hit/hurt you, swear etc too!!!!

    #79508
    Doc201XDoc201X
    Participant

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    With any type of dementia unless you can afford the kind of care Reagan had, I’d strongly advise against home health care. The issues are endless and end up being far more of a strain on the family members of afflicted than the patient.

    #79510
    merrimerri
    Participant

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    kprz – sure, I guess normal kids (when they’re small at least – daycare age and no pathologies) don’t inflict as much damage as a 150+ lb adult…

    I was comparing nl, healthy daycare (not kids with anger probs, tourette’s, etc…) to adults with AD.

    Also – with kids, they’re still learning behavior – whereas with adults, caretakers may think that “they should know better” – which of course can go out the window when someone has AD/dementia.

    But in general – many of the same concerns do exist with the elderly and kids… of course I won’t argue with a pediatrician!

    #79511
    AnnaMAnnaM
    Participant

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    merri, thanks for asking. She is currently still in the rehab center and probably will be for about two more weeks. She desperately wants to go home, so I want to get her back there, knowing full well it may not work out. I have been cleaning her house these past few weeks. What a mess! In addition to the chaos generated by a woman who has been filing things randomly for the past two or three years, everything, and I mean everything, is absolutely permeated with cigarette smoke and yellow from nicotene. Just finished washing and rehanging the heavy drapes from her french doors (thank goodness I have a front-loader!)
    I am angry when I read her mail and see all the tricks that bogus charities are using to get money out of her. Disguising solicitations as “surveys”, scaring her with bold red headlines that say things like “Save Social Security!” or “Next month could be your last social security check!” I swear there is a mailing list circulating somewhere titled “biggest suckers” and my mom’s name is on it.
    Today was a bad day. She has been calling every day, asking when she can go home, but today I took her to my niece’s graduation party and she got pretty obnoxious, trying to get cigarettes, telling people I took her car away and telling me she is going to buy a new one and I can’t stop her from driving if she wants to (I bought her car–paid Kelley blue book retail price for it). She says the doctor never sees her (he has seen her 4 times) and telling me she doesn’t need any help and I have no right to move someone into her house (I have saved her life three times in the past 6 weeks and she would be dead now if she was still living alone.) It all kind of piles up, and it doesn’t help that my crazy sister has been leaving abusive messages on my machine and sending me abusive e-mails. She lives 2 minutes from the rehab, and I live over an hour away, but guess who is taking care of everything and guess who can’t even bother to visit but will critique everything by phone and e-mail? *sigh*
    Waiting for the discharge planner to give me some idea of how much her long-term care insurance will cover for in-home care. She said she would get back to me and after three days she tells me she needs a release from my mom before the insurance company will talk to her. My mom’s room is a 15-second walk from her office. Do you suppose she would stroll over there and get a release signed? ARRRGGGHHHH!

    Re: Kids vs. parents: I’m not sure who is driving me crazier at the moment, my Mom or my three 20-something kids who can’t be bothered to tell me whether they will be home for dinner or not and get annoyed when I ask. Well, 2 of them will be moving out in a month, and the other one goes back to school on Labor Day weekend.

    Thanks for listening, ladies.

    I actually talked to my husband tonight about installing a “nanny-cam” in Mom’s family room before we bring her home.

    #79513
    SW to MDSW to MD
    Participant

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    :grouphug:

    I am so sorry you are going through this- alzheimer’s is particularly tough.

    I am in the midwest too- one of my good friends was a caregiver to someone in a similar situation while going to nursing school. The family set up a schedule with 3-4 different people taking shifts. Everyone was at the point of clinicals in their nursing program, and background checks were done on everyone.

    I think they split the shifts into a 9a-5p and 5p-9a. It worked out nice b/c they could study while at work, and as newer students to the health care field, they all had the empathetic, caring style that worked well with the gentleman they worked with.

    Pay was not great, but when you are allowed to study on site, that makes up for it.

    I hope everything works out- and can I just add:

    Shame on that discharge worker for dropping the ball. It most likely took a 5 second phone call to figure out a release was needed. Discharge planning should be started at admission, at least if you are patient-focused!!!! :rolleyes:

    #79515
    sahmdsahmd
    Participant

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    AnnaM, it is admirable that you want to respect your mother’s wishes and get her home, but it does sound like it will be a big headache. You will probably want to start thinking about Plan B and check out the facilities in your area (or the area of whoever will be most involved in her care). Also consider how you will physically get her to a facility if that time comes (will she go voluntarily, will you have to trick her somehow, or will she just refuse to leave her home at all?).

    I also hate those charities. They absolutely prey on the demented elderly. I have seen some that appear to be from President Bush (when W was President) that say that he wants them to send $1000. Elderly people who respect the President take that kind of stuff really seriously. I have seen one company send 3 or 4 solicitations per week, knowing that those with poor memory will not remember the last time they sent money and may send some more. The other reason your mother may be getting so many solicitations is because she has given money to them in the past. If your brother has DPOA, hopefully he can get control of her finances and keep her from throwing any more money away.

    I know exactly how it is when you are dealing with so many dependents and so many crises. I am really sorry you are going through this. I hope it all works out.

    #79516
    AnnaMAnnaM
    Participant

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    Yes, she has been sending them all money. There are several with similar sounding names that all have the words “senior citizen” in their name (Senior Citizen’s Coalition, American Senior Citizens, etc etc.) Turns out many of those are run by the same guy. Even our local PBS station has been sending her solicitations every month.
    My brother has financial power of attorney but has been in denial. He’s finally waking up to the situation, but also does not follow through on things.
    The facility where she is now is also a nursing home and they are remodeling the third floor to be a locked Alzheimer’s unit. It is an excellent facility (my mom even agrees with that assessment and she is a former nurse surveyor for the Joint Commission), well, except for their discharge planner I guess, so my backup plan would be to take her right back there, and she will have to go if that’s what it comes to.

    #79518
    asunshineasunshine
    Participant

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    AnnaM, you are a saint.

    #79520
    AnnaMAnnaM
    Participant

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    LOL. Would you call my Mom and sister and tell them that?

    #79522
    merrimerri
    Participant

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    What are their numbers??? 😉

    #79524
    AnnaMAnnaM
    Participant

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    An update: We brought her home from the rehab on June 11 (Thursday). She was walking, even without her cane if we didn’t remind her, eating well, breathing fine, off O2, and not even short of breath with exertion. She was, as I predicted, upset to find a live-in helper at her house and insisted she did not need her. (I had interviewed one young woman, but two days before Mom was scheduled to come home, she had a family emergency and had to leave town for a week, so the agency called and said they found another lady and did I want to run in and interview her. I did, and she was much better than the first one.) The live-in was a wonderful woman who knew just how to balance taking care of things with letting my mom feel like she was still in charge. Even before she unpacked her stuff, she was busy cleaning the house and making dinner for Mom.

    The reason I am writing about things in the past tense is that the whole going-home experience lasted less than 24 hours. At 9:30 yesterday, my little sister called and said our middle sis had just called her to tell her Mom was sick again and what should she do. I’m getting pretty good at diagnosing my mom’s pneumonias over the phone now. She had a temp of 101 and was talking gibberish, just like the last episode, so I told sis to call the ambulance and met them at the ER. She was complaining of pleuritic right chest pain and having shaking chills when i got there, so i diagnosed RLL pneumonia, probably pneumococcal. Her X-ray and the ER doc concurred. She appeared to improve initially, but last night her B/P dropped to 57/28 and she got a central line and some levophed and vasopressin. She is better today, thank goodness. Her blood cultures are growing gram positive cocci in chains. The question is, if this is pneumococcus, why did it recur so soon after she finished a 14-day course of IV Rocephin? Of course, she has an ID consultant on board now. They did a CT scan this AM and switched her to vancomycin. Waiting for CT scan results before I go home. I have no idea what to do now that she is getting better. She will be REALLY resistant to going back to the nursing home, but I’m kind of afraid to bring her home again now. I guess we will have several days to figure it out.
    On the plus side, my abusive, complaining, criticizing middle sister is being polite and human when we communicate. I guess that’s something.

    #79526
    sahmdsahmd
    Participant

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    :grouphug: Scary! I hope she gets better soon. I’m glad the caregiver worked out, if only for a day.

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