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Caregiver in home is almost always private pay.

We went thru 3 different fully licensed businesses when my mom was recovering from rotor cuff surgery. It was $ 17 - 25 hr with a 4 hr minimum - usually it was a 6 hr day as they had to drive her to PT or MD appt and wait so that was 1-2 hrs. They had to drive my mom's car to medical appts. and we needed to prove insurance/liability etc. However, if they went grocery shopping they did it in their own car. No pets.

All 3 did the same thing - case manager came to the house with a worker, had a visit and went over what needed to happen.
Our needs were very simple/level one as she just needed help getting dressed, getting in and out of shower, changing bed and doing laundry, grocery shopping, garbage out, watching her as she did her arm exercises according to the chart given,
making sandwiches and leaving in refrig. (Mom had a 3 times a week senior meal service so main meals from that). My mom is tiny and under 100 lbs so she could be lifted if needed. If they are heavy it will cost more or certain services will not be done.

The first one - was always late. Late getting to work and late in getting my mom to her appointments. After 3 weeks that one was gone. I refused to pay several hours and sent certified letter to company to say why and filed a complaint with state
attorney general's office. They dropped past due notices.
This service had workers at 2 of my mom's friends that why they were the first one chosen plus this one was a CNA - certified nursing assistant and worked for an orthopedic group.

Second one - main problem here was that she brought her son with her twice as "babysitter' problems and then a couple of times her boyfriend waited in the car for her. Neighbors called the police. My mom called me all what to do. I call the manager and told her to get over there right now so she could see. To her credit they did and she got fired but the next one from that group also had child care issues. This one was the cheapest.
Maybe a month for this group.

The 3rd group was smaller, run by a MSRN, they required a 2 month 3 day 8 hr minimum, which was fine as that was about the end of my mom's PT needs, with $500 advance- this was a hold your check advance not credit card already run thru. They were great, comepetence and caring but an older worker. Turned out the owner dated my cousin in high school - she told me that most firms pay the very young limited education workers minimum wage and they keep the rest for their adminstrative costs so there is huge turn-over because as soon as they get a job for .25 cents more their gone and they are encouraged to push the meter to add on another hour.Her main revenue was weekend respite care, where caregiver came in Friday afternoon and left Sunday night and most of her gals worked full time but did one weekend a month because of the $$$ extra income. I'm thinking her split was 70worker/30 agency and most were LVRN or RN and they had quite a few that were male and had been medic's.

But I digress, alot depends on the level of care. For us there was an immediate medical/physical therapy need for a limited basis. Only 1 of 3 actually had what I would consider competent educated health care workers although the others sent nursing assistants who had certificates.

All 3 were BBB companies - 1 was affliliated with a national company & this was the worst one to deal with. All workers were contract labor so if you ended up with a real problem with one the agency isn't responsible. This seems to be how they are all set up - remember as you or your mom sets the time that they work, where they work and what they do, the worker can be considered contract labor by IRS guidelines. That is the out the agency can use if there is a serious problem.

Oh, my mom wasn't happy with any of the caregivers. There was "too much detergent or not enough detergent type" of issues on whatever they did. You know, "she drove the long way to the Dr's office...." type of comments. If your mom has
been real independent you're going to hear alot of that. FUN!

If what you need is more of a companion and maid, I would contact churches close to your mom's house or a short bus-trip away. I would draw up a contract that specifically states what
they need to do like garbage out every Wed at the end of
their work day; sheets laundered and changed every Mon, etc.

Also if they need to do any shopping, I would really suggest that you get a re-loadable pre-paid shopping card from the grocery store, WalMart or SuperTarget, whatever. That way mom isn't worried about having a $20 for Maria or getting $ 3.18 cents back and fretting about it. Same for bus passes or gas cards. Just alot less headaches and possibility of $$ concerns. They should leave you the receipt for you to review. Put this in the contract. Most will be so happy not to have to worry about having to spend their own money if they come up short and those that don't like it you probably don't want in the house.

Mileage is @ .50 per mile and you should be paying for that if you are hiring someone directly. Also you should w-2 and tell them that yes they will get a 1099 unless it's under $599 for the year if you are hiring them directly. Now whether or not you actually do that is up to you. But I find if you get this info from them at the beginning it establishes who's in charge. Those that won't fill out a W-2 you probably don't want.

IMO background checks are a waste. Because of HIPPA and privacy laws you as an individual really can't find out too much of value on a person unless they have a committed a federal crime; declared bankruptcy (again a federal filing) or done jail-time in a larger metro area or a crime-against-nature/child molestation (which again has federal issues). But you can google up most of this type of info on a person on your own although it takes time. Unless you have a very unique name, there will be thousands of Maria Smith's out there and the info you get from a paid background check gets jumbled.

I own a business and whether good or bad, whenever someone calls for a reference our stock answer is "our personnel files are closed and we cannot comment on that individual's tenure due to confidentiality and privacy issues". And we keep a record of who contacted us w/date & time. A business needs to do this so there is no future liability. So former references aren't at all reliable because of this.

Good luck!
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Hi Deb~ I also hired someone privately, however it was for extra care while my Mom was in a skilled nursing facility.....I did this thru reccommendations, what I observed, and finally doing a personal interview of the person I was to hire. Persoanlly, I think you are best off using reccommendations, as oppose to an agency-if this is possible in your particular case.
Best~
Hap
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We are probably the exception to the rule, but I hired a caregiver privately. It is about half of the agency cost. It took me 2 months to find someone (i had to take medical leave) but I worked through the local hospice and home health and churches. I have had the same caretaker for almost 3 years for my mom so I can work full time, this is the only way we could afford someone and even this isn't going to last forever because funds will deplete (just a little slower). I believe I have much better control this way than through an agency.
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There is not much in the way of government help. Depending on the size of your town, there may be many paid caregving businesses. I asked for references from the social worker at our local hospital and had the representatives come out to meet Mom where I was able to ask questions. We found one that hired locally and actually matched caregivers to clients. The cost here is $19./hr. If you Mom needs more intensive care, you may have to hire someone full time.
Whether you use a company or hire someone privately be VERY cautious, do background checks, and interview and monitor this person who will be in your Mom's home. Place all her valuables and documents in a safe place. Do not have money, prescriptions drugs, or valuable items out in the open.
good luck
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