Seeking Caregivers?

"WHERE DID YOU GET YOUR GREAT CAREGIVERS?"

From those seeking practical dementia related advice, that’s my most Frequently Asked Question to date.  The answer is, “lots of places.”  Over the years, Gary’s care needs ranged from accompanying him on a walk with him, to complete physical care.  We had a team of family, friends, volunteers from church, agency care givers, private hire care givers and home health aides (through hospice).

Perhaps you can no longer leave your loved one alone.  You need to go to work, or need respite time.  You are ready to hire a care giver.  I hope that my experiences will be helpful as you navigate this new season in your family’s life.    

For both my parents (in their 90’s) and Gary, I have used a care giving agency AND have hired my own caregivers.  Between my mom and dad, and Gary, I was managing eight caregivers concurrently, for over a year.   There are benefits and challenges with each method.  Mainly it depends on your availability and your personality. 

Many think it is not possible to have private pay caregivers and do it legally, without paying “cash under the table” to hide the income, but this is not true.  Payroll can be done properly with use of an online payroll system.  There are many payroll services, but I used Intuit.com $20/month. At hiring time, I entered the employee’s information, then each week, entered their hours and mileage if any.  Intuit generated the pay stub and I wrote the check.  Caregivers are classified as Household Employees by the IRS so you don’t have to withhold their personal income tax.  You DO however have to withhold and contribute for FICA (Social Security and Medicare) and a few other taxes, but like I said, Intuit does all this calculating for you.  Then they generate the Quarterly tax forms when they are due. 

These observations are based on my experience and are intended as an overview.  Please do your own research regarding your own situation.

This entire post (including the table below) is available as a pdf file. To print, click HERE

A couple of suggestions to get started if you choose to…

 Use an agency

 1.      Ask around for some word-of-mouth recommendations.

 2.      Call the agency to set up an interview.

 OR...Hire your own caregivers

 1.      Be sure you have the personality to hire and fire, keep records, and do payroll, AND the connections where you can find some good, qualified people.  I personally would be hesitant to advertise in the paper.  I met someone in our Alz. support ministry at our church, and also advertised for caregivers in our church opportunity sheet.  Either way, you’ll need to manage the caregivers, by training them to the specifics that your loved one needs.  (Their tastes in food, music, tv, hobbies, etc.) 

2.      Call your homeowner’s insurance.  Ask them if they cover household workers if they get injured in your home

3.      Ask around.  Talk to lots of friends and acquaintances.  Maybe someone knows someone…etc.  Run an ad in your church opportunity sheet.  State the job requirements, hours rate of pay, and the qualifications you require.

SAMPLE:  Elderly couple in Santa Clarita, need part time caregiver.  Must be able to assist with transfers from bed to wheelchair, provide transportation to appointments, (fit wheelchair/walker in trunk and have a good driving record. Assistance with phone calls.  Housekeeping (laundry, meals, cleaning, etc).  Assistance with bathing.   Certified Nursing Assistant level of experience preferred but not required.  Must have strong communication skills.  Character and/or professional references needed.  Rate: $10/hour and $.50 per mile for use of car.  2-3 days needed.  (Especially weekends) 7:00am-3:30pm.  Payroll status: “Household employee” for tax purposes.  Contact information: (your info here)

4.      Integrate the paid caregivers with the free services available.   Friends or family who offer to help regularly, Hospice aids (if hospice is involved) should be worked into the routine for your loved one.  If a friend has offered to help you on a regular basis, reduce your care giving needs by that amount of time.    

5.      Be flexible.  There may be seasons when an agency is a better fit than a private caregiver.  For instance, most of our caregivers were folks from our church, so when it became impossible for Gary to attend church with me, we had an agency caregiver who was willing to work on Sundays.

6.      Build a team.  We started with one agency caregiver, and as Gary’s needs increased over several years, we eventually had four plus a hospice aide.  If someone was sick, or planning to be out of town, it gave me some others to call on.  Sometimes my plans had to be changed, because there was no one available, but that was true with the agency too.

Take your time in deciding what to do.  It may feel like you must decide immediately but a little more thought sometimes is just what you need to be confident with your decision.  As with anything new, there is an adjustment period.  Give your choice a chance to work out, before you panic and go back to "square one."  Communicate with your new care giver to help them understand your loved one.  I truly hope you have benefited by our experiences.  Gary would be pleased as well.  

Please feel free to ask questions in the comments below. 

Nine

Last January I posted a summary of the last 8 years of Gary’s dementia. (Click HERE to read it.)   I wondered if there would be a 9th.  Well, here we are on the brink of 2015 so as of today, the Lord has seen fit to give us more time with Gary.   I thought an update might be in order. 

Frequent visitors in 2014...Canada Geese

Frequent visitors in 2014...Canada Geese

Some of you know there have been many challenges in our lives this year, with the loss of both my parents (in their 90’s) who lived right across the street.  Between Gary’s and my parents’ failing health, and my own health issues, 2014 rivaled 2002, (the year I had cancer), and (2006-2007) the years we were first faced with Gary’s dementia.  Even though there were many special moments, and encouraging days, in the midst, I’m glad 2014 is over.  It’s easy to say something glib like that, but not at all realistic.  I don’t know what lies in store tomorrow, or today for that matter.  2015 might be even harder.  It is so presumptive to think that we can so easily dismiss difficulties, with the turn of a calendar page or a New Year’s resolution. 

The good news is, that God has given us lots of leeway within the responsibility of stewarding our time, bodies, and resources.  With less loved ones to care for now, I’m seriously trying to do some things to “catch up” on my own health, and do what I can to make Gary’s life comfortable, and interesting. 

The following is not a list of resolutions.  Just things I’m grateful to have the time for and a feeling of stewardship of the gift of time. 

More time with the Lord

I sure do need it.  The keys to wisdom and peace are within the pages of the Bible.  Many days this year, my soul has been sustained by a familiar verse studied long ago.  But on recent days, I’ve been able to dig in to God's word, exploring more deeply, and finding rich treasures there.  Recent curiosity of mine:  If a Christian’s sanctification is guaranteed, how does a Christian with dementia grow spiritually?  Thankfully, the Word of God speaks to this. 

Used my mom's dishes for Thanksgiving 2014.

Used my mom's dishes for Thanksgiving 2014.

More memories to savor

It's been fun to go through my parents' things, and sort what to keep, give, and toss.  Discovering little instructional notes from mom, and some of my dad's old model airplanes he'd packed away, were like having them here again.  I miss them so much.  I'm looking forward to preserving my dad's movie films digitally, and using some of my mom's paint brushes.   

 

 

I'm pretty sure this was Gary's last outing...a family birthday party.  It became too hard on him to drag him to social gatherings.  March 2014.

I'm pretty sure this was Gary's last outing...a family birthday party.  It became too hard on him to drag him to social gatherings.  March 2014.

More time with Gary

Another milestone of loss...during the summer I decided to stop getting Gary out of bed to walk him to his recliner.  He does better in his comfy bed.  July 2014.

Another milestone of loss...during the summer I decided to stop getting Gary out of bed to walk him to his recliner.  He does better in his comfy bed.  July 2014.

Since my dad passed away, a couple of Dad’s caregivers came to work for us and we’ve all been pretty busy getting Mom and Dad’s affairs settled.  Now that things are wrapping up across the street I’ve been finding a more comfortable balance of time with help and time alone with Gary. 

More focus on Gary’s needs

Physically, Gary has stopped losing weight but this is not good news.  It’s because he has no fat or muscles to loose.  He is literally “skin and bones.”  Diligence is required to protect his skin from breaking down, and a careful touch as he has no padding.  His heart and lungs are good but many things could trigger an irreversible downturn; a pressure sore, a couple of days of not eating, pneumonia, etc.  Mentally, it’s getting harder and harder to find ways to stimulate him.  He can’t hold his eyes open for more than a few seconds a couple of times a day unless he’s lying flat on his back or on his side.  I found a kid’s animated acquarium-nightlight, that I can put on his tray, or prop next to him.   Truly though, most of the mental stimulation he gets now is hearing, and touch since he really doesn’t focus on things more than a few feet from him.  I try to play hymns for him daily, and read short passages of the Bible out loud.  He loves his Christmas Bells.  I wish he could listen beyond Christmas, but I need a way to hang them, other than the Christmas tree.  Hmmmm…

 

 

A visit from family and their doggies...good medicine!

A visit from family and their doggies...good medicine!

More focus on others.

I'm not sure exactly when or how, but I miss having a regular ministry at church, and have had to put off friends I care about.  Hope to have a bit more time to invest in others.

More attention on my health

For the month of January, I’m trying the “Whole30 plan” hoping to eliminate inflammatory foods and then reintroduce categories to see if I’m healthier without milk, grains, sugar or legumes.  Click HERE for more info on "Whole30".  I’ve been checking off some deferred Dr. visits, and trying to find ways to exercise without hurting my heel spur.  I’m looking forward to a couple of days away by myself pretty soon (like I did last May) for a little time of mental refreshment.  I’ll bring my watercolors with me this time too.


Will there be a "TEN" year post about Gary?  I don't know.  For now I'm happy just knowing that today he is comfortably snoozing away near me.  We made it to our 40th Anniversary last week.  I get really sad sometimes seeing how weak he is, and wonder how much longer he will be with us.  Only God knows the answer to that, so I will keep entrusting my sweet husband to Him.  Each and every day I have with him is a privilege.  Meanwhile, thank you for your love, and prayers and going along on our journey with us. 

Our 40th Anniversary - December 28, 2014

Our 40th Anniversary - December 28, 2014

"Our soul waits for the LORD; He is our help and our shield. 

For our heart rejoices in Him,  Because we trust in His holy name. 

Let Your loving kindness, O LORD, be upon us, According as we have hoped in You."

Psalm 33:20-22

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