We’ve almost exhausted our options for local people to live-in with my elderly in-laws. He has dementia, but is a sweet guy and not a lot of trouble. She is in great shape, but cannot handle his physical needs. Right now, we have a merry-go-round of about six caregivers to give adequate coverage. We’ve been looking for a top notch live in person (we could then reduce the six to about three who would provide overlapping and backup coverage). We’ve had no luck finding anyone from our local agencies - all of the people sent to interview seem rather down and out and we are not comfortable giving them free reign in the house. One woman we interviewed has three young children, including a newborn…says her husband will watch the kids during the week if she can go home for the weekends. This seems unsustainable. We thought about getting someone from another country, someone single and willing to do this sort of work in order to live here. Does anyone have any experience doing this?
Make certain that the person has a green card. The federal regulations on wages, (minimum), for “live in” home care workers is a nightmare and a land mine to negotiate. Are you going to be the employer? Does the worker fall under the role of employee or independent contractor? This affects compensation, overtime rules, time off, taxes, etc. I am attaching info from the Department of Labor: https://www.dol.gov/whd/regs/compliance/whdfs13.pdf
After going through six agencies for my aunt, we hired a 24/7 live in caretaker. It is not inexpensive. Her daily rate is more than minimum wage, but I do not have to pay an agency fee. I met with my accountant first to figure out wages, taxes, filings, and federal and state guidelines.
It has worked out well for the past 2 1/2 years. My aunt has one caregiver who knows her well, knows her routine and is dedicated to her care. She recently got married and is requesting time off and she may move. I will have to start the process all over again.
Agree and it’s not easy. I had caretakers for an elderly family member. It worked out with much, much coordination on my part but giving an additional 3 years in the home. Ultimately ended up having to transition to assisted living and then again hospice/nursing home care. I also removed every single financial document and cash from the home and used a pre-paid debit card for anything the caregiver needed to do. I picked up and reviewed the mail everyday regardless of the caregiver, who they were or where they were “from.” It is wonderful if you can “give” them as much time in their own home as possible but agree do make sure if you turn to “foreign” help that you are well advised legally and financially. I used a lawyer and a financial planner every little step of the way through the journey and that would be just a general recommendation for anyone in a position of responsibility for a senior.
Did you try care dot com?
My daughter interviewed many from that site and found a caring mother who comes twice a week during school hours to relieve her a bit from her twins. It has also worked out very well because she can also babysit on weekends and evenings if needed. The site also has a background check option on anyone.
We also interviewed someone who had a 6 month old baby wanting to take care of my grandchildren. Her relatives were going to take care of her son while she was working. It’s sad that many people are in desperate situations.
I found it much easier to find good caregivers when I moved from Boston to FL. I tried an agency for my FA in FL, but fired the woman within first shift. Through another CNA, I hired a friend ( everyone is a relative). When my dad needed 24/7 care, she enlisted her “relative”.
Since you are in Conn., I’d ask all my friends who have help that they like for a referral.
Thanks for the responses. We are using Care.com - most of the people posting there do not want a live in arrangement, but it is a good site that makes it easy to contact local people looking for work. We’ve been in contact with a few agencies who provide foreign workers, but they seem rather shady and I’m not really comfortable that the potential employees have been thoroughly vetted.
I am curious about why you think a foreign worker would be better than a domestic one? Is it because you think they would be less expensive? I visit an elderly woman in an assisted living facility, and her high-end place has a lot of Haitian employees providing care for their residents. The pay is very poor, and the turnover reflects this. My friend there has never had the same helper more than a few months.
If you want high-quality care, you may need to pay more than the going rate in your area. Otherwise, you won’t be able to keep anyone for very long, whether the person is local or from somewhere else.
And I totally agree that all financial documents (wills, etc.) and valuables like jewelry should be removed from the home. A person with dementia is very vulnerable to theft and manipulation.
I had in home childcare for my kids when they were growing up. People have told me not to leave cash or valuables in sight to prevent theft and such, but I always thought if I couldn’t trust the caretaker with my material valuables then how could I trust her with my children? In all of those years I’ve had nannies for my kids, I’ve never had anything taken from me. I have even given the nanny a credit card to buy things for my kids as needed (school supplies, treats, food, transportation).
OP - I don’t think I would get someone directly from another country because there would be too much liability and hassle. I would rather find someone from a nearby large city because there tend to be a larger pool of first generation immigrants. I would be more generous about paying for transportation to go back and forth, not just paying for normal wages. Try to get 2 livings, one for Mon-Thu, another for Fri- Sun, and pay both of them as full time help. As soon as you increase the pay and benefits, you will get a better pool.
We are in CT. When my mother needed 24/7 live in care due to dementia, I hired Home Instead Senior Care. Over the years she needed care, all of her caregivers were foreign-- from Ghana, Nigeria and Jamaica-- and all were good and reliable workers. Home Instead is picky about who they hire. If you are in CT, I recommend them.
Have you tried asking the relatives of recently deceased families in your community? That may sound insensitive but when a caregiver is good,family want to help him or her get a new job
We are spending about $3K a week right now for 24/7 coverage - this is split among five or six people. If we could consolidate to one main caregiver with backup, it would be ideal. A salary of $2500 a week (which includes room and board) is excellent, the problem is that most people just cannot live in, for obvious reasons. There are many agencies who provide foreign workers for this type of work - presumably because it’s a way for people to enter the country, make a good salary, etc. Most of the agencies I’ve spoken with get workers from eastern Europe, but the background checks are not thorough and it seems almost impossible to know who the people really are. My MIL is very picky about her surroundings (the house is always immaculate) the person we find needs to be sensitive to her way of living.
If you’re worried about an agency’s background check, what makes you think that you can do a better background check? IMO, agencies, already licensed by the state, and already having worked out the legal hassles, are the way to go. Yes, you may have to go through a number of caregivers until you find one your MIL likes (or at least can live with), but you’d have to do that anyway, even if you hired on your own.
The agency I work for bonds us and insures us. I’ve been injured in client’s homes and needed medical care as a result (one client’s dog has bitten three caregivers who needed to go to the emergency room for stitches; one of that same client’s caregivers was held hostage for a time during a bank robbery while running errands for that client, and needed psychological counseling as a result).
I've also been accused of stealing by clients with dementia, so removing valuable items protects caregivers as well as preventing any theft that might occur.
The problem with doing it yourself when it comes to hiring is that it exposes you to uninsured theft and high medical cost or lawsuit in case of injury. An agency may cost more if all goes well, but save you a lot of money and stress if things go sour.
Another reason to go through an agency is that sometimes caregivers have to take unplanned time off for sickness or medical appointments of their own, a death in their family etc. The agency will provide coverage for those unexpected and hard-to-plan-for days off. In the 3+ years we had caregivers for Mom, we never had a day when there was no coverage.
I would think that for a salary of $2500 plus room and board you could easily find a nice, mature, respectable person. Have you tried advertising, perhaps out of your immediate area if you are in Fairfield County or one of the more expensive parts of CT.
I know you could find great people in Maine for that kind of money.
You may have better luck with NY-based agencies. There are many immigrants in NYC, so the market is more saturated. I would not deal with an agency that brings people into the country specifically for elder care - there are plenty of people who are already here legally and need jobs.
You need to be aware that there will be a language barrier and your MIL may get frustrated trying to convey her requirements to the aide.
Remember…if you hire yourself, you will need to do all the tax “stuff” for this caregiver. This means…contributions to SS, taxes, and providing appropriate tax forms at the end of the year for this worker.
An agency will take care of the business end as well.
An agency will also take a substantial cut of what you pay, I would assume, so you are getting a person who will work for less.
What you are willing to pay is about $20K above the typical CNA salary. People who work at nursing homes are usually paid poorly. I would think you would be able to find a nice person who would much rather work for you.
Have you read this?
http://www.newyorker.com/magazine/2016/04/11/the-sacrifices-of-an-immigrant-caregiver
Yes, you will have to pay more than the typical CNA salary because you expect the live-in to be “on” more than 8 hours per day especially if your MIL needs help in the middle of the night.
When we hired caregivers for my father, we did have two rotating because I didn’t want them to feel overworked and quit on us. We got referrals from a friend who worked as a physical therapist in a rehab facility.