Changes to in-home caregiving support. What haven't I thought of?

If the company that employs your present caregiver is closing and/or being sold to another, your present caregiver MAY no longer be bound by whatever contract she was under. She is not necessarily company property (like a pencil sharpener or stapler) that can be sold to another company unless there is a specific contract provision to the contrary. That is for her to determine and provide satisfactory proof if she goes the self-employed route. You are free to choose any available caregiver you want. You can certainly try her sister out as one possibility if you think she is a person of good character and responsibility. But, you may want to follow laws for self-employed care givers by using a payroll service like HomePay.com. They will take care of all of the necessary paperwork and most filings for you to employ her. Some states require additional liability insurance - some don’t. Use a lawyer if in doubt. You can use their sister site Homecare.com to find possible caregivers. I have used both, and they have been very helpful. Good luck!

Even the sweetest caregiver will get burned out by working too many jobs.

If you can afford both I’d use both the agency and the recommended CG. Especially if she has a full time job then she can probably only commit to a few hours a week. I like the idea of a trial run as well especially to see if she’s a good fit for your husband.
I currently have CGs from two different agencies and a private one to help me care for my Mom. Always need back up! Definitely pros & cons for both.
Best of luck to you and your husband.

* If she is not through an agency, she is not bonded.
- The best you could do is ask her to do a criminal check (fingerprinted)
- Get a copy of her driver's license and current car insurance.
- Try out the sister for 2-3 weeks and re-evaluate with her.
- This is an ind contractor assignment: No benefits. No workers' compensation. They report their own taxes.

* You will need to find supplemental care providers as 'back-ups'.

* You will need to ask her how she will manage working full time and then working with you/r husband. Clearly, she will be exhausted. "Somewha", it could depend on the timing, i.e., will she work with your husband first ... and then work her 8 hour shift elsewhere? You want her before she has worked all day.
I sense she'll be exhausted no matter what. Even if she works 7 days/week or 12-15 hour days.

* You can try it out and see how it goes AND could also hire through the agency to cover your bases.

If you need help in finding an independent caregiver, not through an agency, please ask. I have listed the needs/questions a few times and hope that I can find my notes.
- You can contact CNA schools for graduates (Certified Nursing Assistants)
- You can call colleges and speak to dept heads: geriatrics, nursing, social work - and see if student might work out
- Contact local churches
- Post on neighborhood networks such as Next Door (if you have that).
- Ask your friends to ask their friends -
- Ask your networking groups / clubs (tennis, quilting, swimming, gardening - wherever you socialize, ask them to ask their friends.

Have your interview questions ready.
Have a list of duties in writing.

Create an index card size ad (for posting) consider including:

Needs/duties
Experience desired (if you want someone experienced)
References required "personal & professional"
Hours per week (or by arrangement)
Contact number

Keep this short - it is an ad to get someone to call you to discuss further.

Gena / Touch Matters

Judycares: See if perchance this proposed new caregiver could do a trial run.

Thanks for the link. I just browsed it. I'll need pencil, paper, my tablet AND my PC as I go through the text. Lots of words, but not sure they mean much until I untangle them! You are so right about APATHY. It is definitely the right descriptor for my husband.

Not answering your original question, but responding to your comment "Yes, we've had at least four rounds of both physical and occupational therapy. After the therapists leave...my husband never would follow through."

The worst "non-motor" Parkinson's symptom I have dealt with my husband is APATHY. It took several years for me to finally get it that I could not count on him to follow through on anything much at all.

It has been proven that exercise is one of the best medicines for PD. PT and OT may not help him improve but may help him from getting worse or at least slow down the progress. If the providers have limited his sessions because he was not improving please check out... https://www.cms.gov/Center/Special-Topic/Jimmo-Settlement/FAQs It was a legal case questioning the requirement to improve.

A lot of providers... especially those from big organizations will not provide care beyond a certain amount each year, the old way, because it takes more documentation to show the benefits of therapy for maintenance. Therapists that work for smaller companies are less likely to have their hands tied.

I have found that my husband benefits from the male companionship he gets during his sessions, he is getting exercise, he is getting out of the house whether he follows through at home or not. Recently I realized he still has strength in his legs. When he can no longer get out of the house I will consider the various in home therapists. Fox Therapy is a national company that comes to your home and they are able to bill Medicare Part B when someone does not qualify for home health which has more limited benefits and billed through Medicare Part A.

There are pros and cons in all situations. If you really want to try the caregiver that was recommended, you could see if she is willing to do a trial period at first.

My mother lived to be 95 years old with Parkinson’s disease. It’s very common for them to have strength and balance issues, especially as the disease progresses.

Mom benefited greatly from participating in home health. Has your husband ever tried home health to improve his balance and strength? Your doctor can order it.

Home health will send an occupational and physical therapist to your home. along with an aide if needed for help with bathing.

Best wishes to you and your husband.

Why not give her a try? Perhaps start by asking her her availability and seeing how much of it overlaps with your respite time. If she can cover some but not all of it, you can always use your existing agency to cover that time.

Also, money savings is a big deal. Right now, your husband doesn't need much but his needs will only increase, and she may grow into the role. And her sister may be available to you for more time if she starts working on her own, or after however long she may have to stay away because you are her old agency's client. Then again, good caregivers are hard to find so I say do what's best for you.

And remember, it's always better to ask for forgiveness than permission. Also, remember that most people ask for permission.