My mom is in rehab after a stroke. Her discharge date is coming up and she wants to be at home instead of in a facility. (I would vastly prefer a facility, but she completely refuses to be in one, so we're trying this first.) I know the rehab isn't going to discharge her until we have a safe place arranged. I have not begun to set up home care yet and am not even sure where to begin. I'd have to get her a hospital bed as well as set up a place for the nighttime worker to sleep in my mom's large one-bedroom apt. I realize there is no standard amount of time that all this will take,that it varies from person to person, but given that I have a f/t job, are we likely looking at a couple of weeks or longer? My mom is BEGGING me to get her out of the rehab asap and I keep telling her it will take some time to set things up at her home.
One of the fortunate things is , Xina's mom lives in NYC, where 24/7 homecare is covered by Medicaid if one qualifies.
1. Do not use any of your own money to pay for care - only your mom's.
2. I didn't realize your location and family commitments. Yes, these should be considered first.
3. I do believe you will feel more at peace trying the 24-care option, based on your mom's wishes, and if it doesn't work, at least you can say you did your best.
Let us know how it goes.
You have skin in this game...your marriage and your kids. Decide how much you can do and set the limit there. PS, I'm in Brooklyn too!
I remember my Dad thought that social security paid for the Agency caregivers.... hmmm, no. Don't know where he got that idea. He was able to deduct the cost off of his taxes [I think]. I now handle all of his finances and that's a part-time job in itself at the beginning sorting through everything.
Oh my gosh, back when my Dad and late Mom lived at their home, I was up and down the roads running errands and going almost weekly to doctor appointments. Then there was groceries... I tried shopping with my own list and with their list, but pulling two grocery carts because a nightmare... I was getting things so mixed up...[sigh].
Thank goodness for Peapod on-line grocery service where they do the shopping and you can either have home delivery for a fee, or curb-side pickup for a smaller fee. Look to see if any local grocery store offers that service.
Oh, I also use Home Instead and have had excellent service. The rates also depend on where you live. Usually a large metro area you will find higher rates.
1. Go with the 24-hr home care. It sounds like your mom is adamant and, for now at least, it sounds like you are more comfortable with it too. I use Home Instead. The rate is in the neighborhood of $20-$24/hr depending on weekday/weekend/holiday/night. Others have thrown out some prices. We are spending roughly $12,000/month, and that is with me doing a "shift" of 20 hours a week to save on costs and keep everything on track.
2. Like you mom, my mom is in great shape physically, but due to a couple of falls/breaks, must use a wheelchair. She has minor dementia. These two factors call for the 24hr care.
3. My attitude is if you/mom has the money spend it down until it runs out and then going into a different care setting won't be an option. I know of no state where Medicare/the feds pays for 24hr home care. Just bite the bullet and do it.
4. The caregivers at Home Instead are reasonably reliable. If one calls in sick, they - not you - are obligated to arrange coverage. So that is a big advantage and the reason I have stuck with them through some bumpy times.
5. You will still have a lot of responsibility, from paperwork to grocery shopping to emotional support. But I think right now may be the worst time because it is all hitting you at once. (1) Take advantage of the social worker - she should be a resource and I believe they can even send someone out to the home to make recommendations, order any medical equipment, etc. (2) The Home Instead supervisor comes out and sets up a plan of care - they can make some recommendations too. Once you sign up with them they can arrange 24hr care pretty quickly.
Yes, Mom will probably whine and groan whatever the arrangement. But she sounds pretty with it. If you go this route, then you have to be forceful and state unequivocally, You go home and have 24 hr caregivers or you go to a facility. Those are your two options. You decide. And prepare to continue. I have had to do this with my mom periodically and she always backs down.
Having said all this, I think so far the money and effort have paid off. She just went to the dr office - blood pressure was 110/76, oxygen 97%, in a generally cheery mood. I couldn't do it without the Home Instead helpers, although I will give myself some credit too.
Good luck! Let us know how it goes.
Although she is severely limited mentally and physically, she says and believes that she can take care of herself if I go on a two-week vacation. I know leaving her alone for that long would be an absolute disaster, pretty much like leaving a young child alone. My mother is diabetic, so it isn't a possibility I can even entertain. When we know their limitations, we have to make or encourage choices that are in their best interest, even if it is not what they choose for themselves.
I have a feeling your life is going to be very busy filling in the spaces that the hired caregivers don't cover. I admire what you are doing in trying to make your mother as content as possible. I hope that you are able to provide the things she needs without driving yourself crazy. If it becomes too much, you can always see about finding her a good facility. Please let us know how it is going as you work things through.
I think of it this way. If your 4 year old told you that they were fine to live alone in their own house without assistance or supervision, how would you respond? No matter how determined they might be, would it be feasible?
Some people may be able to work a crossword puzzle, but not be able to plan a meal, operate a stove or bathe themselves. I think that the professionals who handle home assessments will be able to assist you. That and the financial aspects should sort a lot of things out.
Is your mother's BF going to be any help?
Get a file folder, or a notebook. My little notebook, with mom's insurance cards, doc's phone numbers, etc,is always in my bag, along with a precis of her medical history.
Don't forget, a caregiving Agency is licensed, bonded, insured, and offer workman's comp for their employees. The Agency has to pay all the payroll taxes. Most have office overhead to pay [rent, supplies,utilities, advertising, etc], plus have employees who do the scheduling every day of the week, plus weekends, and work on holidays. Some Agencies offer sick days and vacation days. Some offer continuing education. And some Agencies offer a higher pay to caregivers who are LPN's or RN's. Thus profits are needed to pay for such expenses.
As for waiting lists for a room in a continuing care facility, my Dad is currently on a waiting list for a memory care facility, it is a refundable $1k fee if he doesn't use it. Theses fees can vary depending on supply and demand in your area.
Oh, how I wish I could keep her in a SNF! She will not have it. And then if she's at home and the SNF option seems better, how will we get her into one since they all have waiting lists? I was awake all night thinking of how to cope with all of this!
The Agency I use for my Dad, they charge $30/hr weekdays and $33/hr on weekends. Yikes, that's is very expensive. Dad is billed every two weeks and the payment is pulled from Dad's checking account, so I need to make sure he has enough available.
As Babalou mentioned above, make sure your Mom knows about the cost involved. I am lucky that my Dad is very careful about cost, and now he is willing to move to an one room Assisted Living/Memory Care because it would save him money. That way he wouldn't need 24 hour care at his Independent Living apartment.
My Aunt and Uncle, he with dementia and she with advanced heart disease and mobility problems, stayed at home successully with 24/7 aides until my aunt died. But they were millionaires.
"If time is an issue for setting up all of the home care, then I can't imagine how much more time supervising how things are going on in her home, once she arrives would be." Sunnygirl1 Exactly. Sounds like your mother would be complaining about the caregivers. And, as someone already mentioned, you will be on the hook if someone doesn't show up.
Now's your best time to act, since your mother is in rehab. If you go against your mother's wishes (facility for her), what is the worst that can happen? I can well figure out what the worst will be if you DO NOT keep her in a facility.
The other question, of course, is how mom is going to pay for home care. It's about $25 per hour. Until Medicaid gets approved, i guess she is going to have to pay privately. So each day would be $600 or 4200 per week. (That's the way I'd present it to her).
The thing that took a LONG time to sink in for us? The fact that mom WANTED something didn't mean it could be done, or that it was the best thing for her. And sometimes, rather than pushing back, you just have to let that sink in, both for you and for mom.