My in laws caregiver planned most of the meals, but definitely included the requests of the in laws in their rotation, if there was a recipe card available. FIL still went to 4 different stores to pick up the on sale items each week and the caregiver also shopped once a week for what she needed.
@calla1 – I order my mother’s groceries, but she tells me what she wants. A bit of back & forth required as I remind her of items she has forgotten. Caregiver helps prepare the meal, but prep is very simple. It may be a challenge to find a compassionate caregiver who is also a good cook.
Perhaps once you find the appropriate caregiver, she can order the groceries weekly with your father? Or she could email the list to you and you could order?
I wouldn’t rely on your dad to consistently order, including the right ingredients. If it’s an important part of his freedom, he can order a few treats, separate from the meal planning. You can come up with recipe cards for things he likes (and considering any restrictions.) I think you ordering offers you that control. A caregiver can make several meals, freeze some basics, then Dad has some choice available on a given night. (If that works. It may not, for some.)
I cooked extra meals for my mother, froze complete portions, including the side dishes. She was able to reheat, but I made her favorites, made them healthy, and I loved the task.
Yes, we recognize that our elders may need more help sooner than later but for now, 30 minutes/day and LOTS of reminders are allowing them to remain in independent living portion of SR living community. They’ve had the CNA for nearly 2 months and it seems to be very helpful and minimally intrusive.
@HImom – I am amazed that you can hire a CNA to come into your parents’ home for half an hour per day. They all have four hour minimums here, and unless my mother needs to go out to a medical appt, she doesn’t need someone for four hours, but that is what I have to hire.
At the CCRC where my parents were, the model is to try to keep the residents in their apartment. You could have them come in for whatever time was needed. One of the part-time aides at my parents care home works full-time at another area CCRC which has a new system of providing 30 minutes of care for the residents who need personal care help. They are busy and go from one residence to another. The ability for part time care is one advantage of being in a retirement community. However, it didn’t work for my folks as they needed constant monitoring, not difficult but constant, and very little physical assistance (not true now). Mom could be trusted by herself but not to monitor dad and she would get anxious and think people were trying to get in the apartment.
@GTalum – Yes, have heard that aide time can be ‘purchased’ in 30 minute blocks at CCRC, but have not found in-home care for fewer than four hours at a time.
In our area there is usually a two hour minimum. My dad required aides in independent living due to wandering out of his room at night not totaly clothed (among other things). Clearly he needed assisted living and was soon moved to a dementia unit. Our decision was made quickly because overnight aides every night at $20-$25 per hour added up. He eventually improved and moved to assisted living for several happy years. It was a shock to me when we were eventually required to provide aides for my dad in assisted living due to fall risk. 24 hours a day! $500 a day unless I could be there. (He ended up needing skilled nursing.) I thought there should be a way to share an aide with another resident. At night they had to be in his room to make sure he didn’t get up but during the day a dedicated aide could have been shared among several residents at much lower cost.
Some programs don’t require even 2 hours. It depends on the agency, probably easier with a non profit. But those would be focused on elders with limited incomes.
A CNA friend sees more than 2-4 patients/day. Not in-facilty. She assists with bathing, dressing, getting a meal out, etc.
The agency associated with my mother’s IL/AL/Memory Care facility has one hour minimums. They charge $20/hour for <4 hours, and $17/hour for 4 hours or more. Right now she’s in IL but has two private caregivers who work half-days from Mon. to Sat. and we use an agency caregiver for half-day Sundays. We also have an agency caregiver come in for an hour in the evening to make sure she takes her meds and help her get ready for bed. I’m afraid we might have to increase the caregiver hours pretty soon, though. She’s becoming more and more confused, unsteady and forgetful.
My folks live in a SR community and we are thrilled they were able to let us just have someone come in for 30 minutes every day, allowing them to remain in an independent unit instead of being separated and going to assisted living which both were strongly opposed to. Physically, both are pretty strong — just horrible memories.
Paying privately, I wouldn’t have been able to get anyone to come in for just 30 min/day; most companies do have a 3-4 hr/day min.
The person hired is a CNA who works at the SR living community for his full-time job. He just goes in to my folks before he starts work, 7-7:30.
Thank you all for your helpful suggestions about meals for my father. I like the idea of me doing the basic ordering and him ordering treats to give a sense of control. I would be hesitant to give his credit card to any caregiver. Recipe/meal cards are a great idea.
His freezer is overflowing with frozen meals my sister made for him. He is cognitively able to go through the steps to unfreeze and bake them but on his tired days it seems too much effort for him. He is losing weight. Hence our thinking that a caregiver to actually put the food in front of him would be a good idea.
Which leads to other questions about access to the home, particularly as my father is having difficulty getting up and answering the door:
- do caregivers have keys or do you have keys hidden?
- what do you do about grocery delivery, if my dad can’t immediately get to the door? Are the groceries packed with ice? Do I buy all perishables?
Sorry for my basic questions.
I should add that my father is very resistant to all of this, and very resistant to me in particular. He listens to my brother and sister but my brother is determinedly blind as to my father’s needs and my sister lives several hours away. It’s very tough.
I have only used Fresh Direct for delivery, but I think they are limited to parts of the Northeast. I like them b/c I can receive free delivery with a $30 order vs. Pea Pod’s $60 minimum. Fresh Direct offered a free two month trial and then $99 for annual ‘free’ delivery. I can schedule the two hour delivery window to coincide with time the aide is at my mother’s house. The delivery person would bring the bags in, but that had not been working consistently. I don’t know if my mother is taking too long to get to the door or what the issue is. Some items are packed on ice, but I wouldn’t want it sitting out for too long.
They text me the night before when her order is being packed, then again when her delivery is next, and then text me again if delivery is left outside the door. I haven’t gotten a text in a couple of weeks so maybe she is getting to the door on time!
Her CC info is entered on the Fresh Direct site and only the last four digits are visible. I receive an email or text every time anything changes (red peppers out of stock; will substitute, etc), so if anyone tried to order extras, I would know about it.
My mother is still mobile enough to let the aides in.
I hear you on the resistance. Mild passive aggressiveness…I don’t need this much help, but then unable to do handle anything on her own. Siblings think everything is fine, so I just forge ahead w/o looking for input. Trying to stay out ahead of another fall.
I do think the caregiver putting the food out is good. And then maybe sitting with him. So many elders never quite adjust to eating alone.
Many of my friends trust, say, cleaning staff with a house key. I’m about to give one to my plumber and for many years, my contractor had one. Not sure how I feel, though, about someone still a stranger. Hiding a key is no different.
Seems like the first task is to eat up what’s in the freezer.
The delivery problem in my area is they give a bracketed time, eg, between 2 and 4pm. Not helpful. Maybe there’s a day when the caregiver is there enough time to receive the delivery. You can stock up fresh produce and dairy perishables and frozen vegetables for him. There are dairy products that come in smaller bottles/6-packs that don’t need refrigeration until opened (Amazon has them, too.)
HHS Inspector General’s Report Finds Flaws And Fraud In U.S. Hospice Care
We all hope for a little peace at the end of life, for ourselves and for our loved ones. Hospice services can play a big role, relieving pain and providing spiritual and emotional support. But a federal report published Tuesday synthesized patient and Medicare payment data going back to 2005 and found that, as the hospice industry expands, some hospice providers are bilking Medicare and neglecting patients.
Just saying. The article discusses “hospice” and what “some” have done, without noting profit vs non-profit, in-patient vs “home” services, and existing ratings. The annual Medicare reviews require broad and deeply detailed reporting, as well as site visits. That’s not a guarantee, no. But where I vol, every bit is taken seriously, throughout the year, down to what might be seen as minor.
Some of this exploration is based on ACA.
I can’t believe what Medicare pays for my mom’s hospice services. She’s in a nursing home but has been getting additional services from hospice for the past 7 months. A hospice nurse checks on her every 2 weeks, talks to nursing home staff, etc. A CNA spends time with her 3 times a week. Hospice monitors her pain meds. I don’t remember what they bill Medicare every month, but I do remember that Medicare pays them $4900 per month. Seems excessive to me.
My MIL was in a B&C home and hospice billed about $6k monthly, but they also gave excellent service, provided a shower aide twice a week, treated bedsores diligently, and were very good an communicating everything with me.
I just caught up on this thread. Always impressed with what you all are doing.
Regarding my 91 year-old mother with advancing vascular dementia, thanks to those who responded to me on diluting gin. I have been doing that and getting away with it so far! About 1 part water to two parts gin so far. Am concerned about gin followed in 4 hours by Lunesta and have changed that to PRN, working with AL to get her to go some nights without. Her memory is awful anyway but after Lunesta she seems worse.
I briefly considered taking her out of AL and living with her in an apartment, having help come in. She is more like my child at this point. Every time I leave she is at the door saying “I miss you” and asking to live with me. She doesn’t like it when I leave but is probably fine in a few minutes- just like my kids when they were little!
The assisted living called me with an “emergency” yesterday. I drove an hour to get there and found her in a chair reading, perfectly fine. Apparently she had been a bit dramatic with a bowel movement. There are a few PRN meds that only I can give- AL says they can’t by regulation- so I go down for those when needed. Their calls are tiresome but it is all governed by liability, and I understand.
I am moving closer in a few weeks. (Rentals are hard to find.)
I see her 4-5 days/week. Clean her place, do laundry, pay bills, give those PRN meds, take her to appointments, put pads on her bed and hang out. We pay $8k a month and sometimes not so sure what we are paying for. Her dementia is pretty bad, but she refuses services like help with showering and PT agrees she can. So the only service she gets is her bed made and LPN comes when she presses her button.
She has the money and I can drive away. I admire what you are all doing to keep your parents home. That’s what I wanted but siblings overruled. Maybe they saved me !
First interview with a home health care aide next week, it’s so rough to find someone and to feel comfortable leaving them alone in your home and alone with your senior. In my town there is one nursing home, I know the social worker who retired from there, I know the MD who served them, etc. Even people like that did not have any personal home aide recommendations.
Sadly, there is nothing my mother needs done that I cannot do, but I know I cannot do it all and do it well. I promised myself, many years ago when I cared for my MIL when their caregiver walked out on them (FIL’s an ass), I would not cross the boundary to do showers etc. It’s time for that, though she protests she does not want help. Too bad, I say 