And now a breaking news update… Dad’s wife finallllly agrees she needs help at home, beyond the recently hired weekly housekeeper. Yay! My sister will fly to NY to try to help arrange caregiver help.
QUESTION - Has anybody arranged Medicare-covered caregiver help?
I’ve heard that there can be up to 10 hours/week covered, with a doctor form (which I think they finally have - probably it says assistance needed with at least 2 ADL). But so far the places they’ve called say that is only for Medicaid recipients (very low income). So I’m confused, perhaps there are caveats like post-surgery requirements or something. They will be able to pay if needed but wanted to first follow any freebie leads.
My understanding is that Medicare only will pay for caregivers if the person has a skilled medical need and is homebound. Skilled need is usually stuff like IV medications, wound care, etc…
Interesting. When I called a Palliative Care organization (for chronic patients, sort of non-terminal Hospice) a few months ago, I asked about arranging a shower helper. The rep said they did not offer Skilled Nursing services… but they could make referrals. So I guess I need to research the term more, find out if shower assistance (the most urgent need) qualifies. Dad is mostly homebound. He does go out sometimes, with a great deal of effort from him and his tired wife (and sometimes a neighbor assist - lots of stairs).
My in-laws just went through trying to set up in house care. They rejected most of it but I’ll tell you what I found out.
This is Michigan.
Anyone, regardless of income can get mobile meals. There is low cost transportation services. All other services were income based, the income levels were quite low. They weren’t even discussed after finding out that my in-laws were able to hire housekeeping
In my in-laws area, the in house care aids were $35 an hour with a minimum of 3 hours per stay. They could help with showers and light housekeeping, doing basically what they were asked as long as they stayed with the client. They would not take care of animals. They could drive the client places but could not go to the store for them.
I was there when the agency came out, I thought they were pretty good as far as explaining things.
All in all I personally thought the service was well worth it. My mil hated that they had to come for 3 hours. They came 4 times and she cancelled.
They now have their dog sitter/housekeeper come and help with meals and she is in the house while they shower.
I hope that is somewhat helpful, it was our experience. Things may be different where you dad is.
I spoke to various services, including Visiting Angels and one that was more like a Taskrabbit for the elderly.
Visiting Angels required a contract and required that you use them in at least three- or four-hour increments, I firget. The price was maybe $29/hour two years ago. This is Texas. They could do more because I think they use CNAs, but we didn’t need four hours in the morning. If they would’ve done two hours in the morning and two at night we might have used them.
The Taskrabbit place would do nothing nursing or what I would call health care. No bathing or dispensing of medicine, but they would cook and clean and run errands. That’s not what we needed. We needed someone to get her up and changed and bathed while we changed sheets and cooked her breakfast or whatever. A strong extra set of hands.
She had too many assets to qualify for any help, even from the VA.
We had great luck with Care.com. We paid out of pocket, generally 4 hours at a time. Back then it was $20/hr, but now it would be $30. Through that site, we got a great woman (sort of like an aunt) who helped with meals, company, and administering meds. (She did not help with showers but would have been nearby).
It is possibly time for hospice services? I think they will help with showers once a week. This may vary by region.
My MIL gets a shower twice a week from the hospice aides, and the nurse visits regularly. She’s been on hospice more than three years - she qualified because she has congestive heart failure. The thing about hospice is that care is managed by their doctor, and care needs to be geared toward improving quality of life, so it doesn’t work if the patient is treating cancer or doing other treatments that extend life.
When MIL fractured her pelvis, hospice sent her to the hospital because she needed to get care that would make her life more comfortable. But she had to go off hospice while in the hospital & in rehab. She went back on when she was released from rehab. Hospice arranged for PT to come to her room in AL, because the purpose of the PT is to improve the quality of her life.
Thanks for all the info. As far as I know, no qualifying diagnosis for Hospice. From a psychological standpoint, Hospice would be tough for Dad, still very optimistic and sharp as a tack (once he hears the conversation). But certainly Hospice programs do offer some great services.
I’ve done quite a bit of checking on local Care.com caregivers. Some of them do look great on paper. (Emails come now and then on other appealing candidates too.). One concern vetting candidates (seems not done by Care.com?). Now that there is more buy-in to getting help, it would be great to hear some tips on that. Trying to find help with local friends/references has not worked.
We hired someone last summer for my Dad from a local agency in the Southern California town he lived in. This agency did not require a minimum number of hours. It cost $35 an hour and she could help my dad with showering, took him for walks when he was able plus did all kinds of housework. She would also run errands if needed.
Ah yes, now recalling that my father did some initial investigations last year after coming home from rehab (broken hip). He was not willing to sign a 6 month contract when not yet understanding what/when services they needed. I get that.
Even with “Hospice would be tough for Dad” - one can remind him that there are people that survive under Hospice a long time. We want to make life better for our loved one and also safer.
Similar to @kelsmom, my dad received twice a week shower assistance and weekly nurse visits when hospice started. For the last 6 weeks, we had 24 hour live-in aide which was paid out of pocket ($10k a month). Even then the shower assistance and nurse visits continued.
In IL and MN, private aide is $40 per hour with a minimum of 4 hours a day. The agencies wouldn’t guarantee same aide every time for consistency if not 8 full hours. FIL did not want full time help, so he had different aides each time. It was an awful experience for him so he eventually went to an assistance living, which is what my H advocated for from the beginning but was overruled by FIL and his girlfriend until it was inevitable. FIL paid $12k a month for about 3 years. He was very unhappy there because he never thought he would live in such a facility. It was one of the best in the area, but he never left his room. We couldn’t say or do anything to change his mind about going to eat in the DR or participate in social activities.
Our hospice was great when we finally put mom on it. I know it sounds scary, but I also know someone who was on hospice for three years. It doesn’t mean that you’ve given up.
Investigate the various Hospice available in your area - for profit and not for profit. When I worked in skilled care and rehab, I would see some of the Hospice staff and also heard from relatives and others about what was the best at that moment in time in our area.
I am ready to advocate for Hospice when/if medically suggested. A friend’s mother rebounded nicely (at a facility) once she was under their care, with proper pain meds. Just so far not wanting to be the one to try and get the ball rolling (dad’s wife handles all medical matters, til now resisted family input). However their palliative care sister organization could work, also help ramp-up for possible hospice one day.
I had good experience with hospice in our area with my mother (though I had not been prepared for the very many different contacts etc - I should have started a notebook sooner). She did not want the free shower help and insisted on minimal visits from nurses (also free). She did adore the hospital bed they provided. When she needed to move to my house, hospice arranged transport and delivered a 2nd bed to my house as well as another oxygen setup.
For folks considering hospice, if it matters to patient/family, see if patient can continue with his MDs or can only use hospice MD. Only one hospice locally will allow patient to continue with existing mds and not switch care to hospice md. That was important to our friends & us. The family md is more tuned into the patient from all the years of caring for patient.
One way to present to the parents who have preconceived ideas is don’t tell them which option is which, i.e., don’t give them names. Call them Option A, B, C or TIger, Leopard, Zebra, whatever…and then give the basics. Cost, coverage, contract. Hospice sometimes looks very appealing if you can get past the stigma.
Otoh, sometimes parents have to experience real difficulty and be scared before they change their mind. We never did get my father to concede he needed help, and it was awful to watch. My mom, however, was braver and she is infinitely more content in AL (she is not a happy person, so I am settling for content). My inlaws will definitely be the people who are abruptly hospitalized with something acute, and will have zero plan or knowledge for what to do when the hospital won’t discharge them to home.
As I dig a bit deeper into Care. com, it seems that “employer” may need to contribute to caregiver’s social security(?) Has anybody dealt with this kind of thing?
I’m remembering now that it was one of my father’s reasons last year to be leery about hiring help.
One of the reasons we used an agency is they took care of all contributions to SS, Medicare & WComp. They are all important to worker AND patient (for safety and protection of both).
It is crossing from being an ‘independent contractor’ to working enough for a family to be considered an employee and needing contributions toward the individual’s SS. It seems care.com is not really working as an agency that is ‘full service’.