My MIL has the Toto with bidet…and the seat is also heated which is very nice in the winter. And yes, it is a huge help! But she needs guidance to use it. It doesn’t take the place of the caregivers.
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That’s a good point that guidance would be needed. But I’m thinking the helper could be a spouse or homecare aid not certified for shower tasks. Big advantage would be less risk of falls (or scary 9-1-1 help needed during bathing session, which happed to parents last winter).
I appreciate all of the comments. Just to recap the history (and answer some questions raised):
He has post-operative cognitive dysfunction (craniotomy to remove a meningioma in May).
His mental state was so bad that he refused all meds and refused to eat, refused to go to rehab, insisting he wanted to die. Hospital sent him home on hospice care, where he languished in a semi-catatonic state. At that point, he had a 24/7 aide, hospital bed set up in the living room.
About two weeks (?) later, he kind of came to his senses (somewhat) and decided he didn’t actually want to die. Switched from hospice to home care, with in-home PT and OT, visiting nurse, and still a 24/7 aide. His mental state fluctuated wildly and he was verbally abusive to my mother. The whole situation was terrible for her, and I actually worried about her dropping dead from the stress of it all.
He did start to make some physical progress (standing and taking steps with assistance + a walker). Progressed to using a commode. He agreed to begin taking anti-depressants. The mental state improved, a bit, and the ugliness toward my mother mostly disappeared, until he contracted a UTI and all hell broke loose again. He was hospitalized with that for 3 days (thanks to the kind hearts at the hospital who understood the history and that he really, really needed to go to rehab)
So he’s been in rehab for two weeks. Physically, he is making tremendous progress. He can walk with a walker, climb 2-3 steps, is working on getting in and out of the car. He struggles with the transitions, and remembering what he needs to do (feet back, hands on armrest before standing, for example).
His mental state is still pretty unstable. You just never know from hour to hour whether he’s going to be up and positive about his progress, or depressed or, most recently, delusional (did you know there are two cats who sneak into the hospital at night?).
I wasn’t at the meeting where the therapists recommended 12 hours of assistance, so I’m not sure of the rationale. I do know, from our prior experience, that once you have an aide for 10 hours, it costs the same as having them overnight, as well, so maybe they said that knowing what it would lead to? 
I think the belief is that he still could/can improve…that his current state is not the end of the road as far as his mobility, but how much is the question.
My mother is dead-set against sending him to a nursing home, but I don’t think it will take too much to convince her that she must have a full-time aide at the house. She already has the hospital bed, commode, baby monitor…we would need to clear our the dining room and if she decides a shower is important, arrange for a renovation of the bathroom.
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When my father had been in the hospital for a while, they would not release him until they knew he had the correct level of care waiting for him at whatever place he would be going to. They actually kept him longer than needed to allow us to get this in place. The Assisted Living he had been in came and evaluated his condition and decided that they could not provide the level of care he needed. We were very lucky to secure a place in a nursing home nearby to have him released into.
I don’t think the hospital acute rehab will allow him to be released to a place without sufficient care. They will not make the evaluation of what that is until release time (as he will still be improving). They have social workers who do this everyday and know how to handle this.
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For what it’s worth, the end of temporary employment status for Haitians and other immigrants makes it much harder for agencies and facilities to hire hands-on helpers.
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For my mom, when we needed 24/7 companions, I believe it cost about $24,000/month, plus $6000/month for monthly fees for food and her CCRC unit, so about $30,000/month. Many were immigrants and I believe there are greater shortages than previously because of recent events and climate. This may have increased fees and reduced availability.
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When a senior in our family couldn’t easily go up the stairs (to where the bedroom, and bathing was located), the family elected to have a stair lift installed. It made all the difference. Is this a possibility instead if a dining room bedroom, and renovating a bathroom.
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It’s also less expensive than a full bathroom renovation. The stair lift was $4k back in 2020.
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That is a great idea.
Not sure how it works now. But about 15 years ago we had a relative who leased a stairlift. Not cheap, but it was a big help. You do need power available. My father has to navigate 3 sets of stairs (has 4 walkers). All ok now, but we’ve encouraged his wife to investigate a lift system from main level to bedrooms level (OT mentioned the local Acorn reps are good), but she keeps saying it won’t work.
And if you do get a stair lift, get a walker for each floor. Do not carry one up and down the stairs!
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Yes, walkers are very inexpensive. Be sure to have them the correct height for the patient!
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Excellent idea. My mom was able to borrow a 2nd one from her local senior center so she can have one downstairs and upstairs.
Concerning senior centers, our suburbs have excellent services for senior in terms of borrowing items like walkers, canes, shower seats, etc. For future posters, please investigate if your town offers similar services.
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My neighbor said that it’s pretty easy to find used stairlifts. She said to look on Facebook Marketplace & check with your local senior centers.
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indoor stairlifts are MUCH cheaper than outdoor ones
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That is insanely expensive. I can’t imagine the companions were making very much, so the company must be rolling in a massive profit. Unless these aides are doing highly skilled work, I would wonder if one could just hire someone with some medical experience, not through an agency.
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Skill level wasn’t high—they bathed and kept mom company. They weren’t even compensated properly for OT or holidays but no one wanted to complain & be blackballed.
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My friend’s parents are paying $20,000/month for 24 hr care on Long Island NY. Two caregivers each doing 12 hr shifts. They sleep in a spare room , bring their own food.
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Most people cannot afford this kind of money. What do they do? When my father was ill and in the hospital, they would not release him to go home. They said he had to have a safe place to go to (and no way could my mother have cared for him), and he waited in the hospital for several days for a doctor to get off his butt and fill out the paperwork that allowed him to go to memory care.
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When people can’t afford it, they do the best they can and often have suboptimal care and bounce in & out of ERs & hospitals. It IS very costly and when there is no money they have to hope family & friends will help bridge the gap but often that can only last a short while and then burnout and other needs take precedence.
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