Typically, what is the cost for a home companion?

I just hired a home health care to come in 6 hours every other week. 2 hours for shopping and errands and 4 hours personal time. It will cost $21 per hour. I applied for a respite care grant from the Alzheimer's Assoc. and respite care grant from Helping Hand a local agency. Get all the information before making a decision.

Yeah, 3 people for 5 days and a separate 3 - person crew for weekends and holidays. And sick days. Yes the caregivers can (and will!) get sick.

I think if it is 24 hour care, you would need at least 2 people; if not 3.

The cost for someone to stay awake overnight, that might vary from daytime hours. Better make sure the person has no other job during day, otherwise they will quite naturally be sleepy in the middle of night, perhaps when your mom needs help the most.

We pay $20 an hour through an agency where I work with the owner directly. I wouldn't want to hire someone on my own not being sure of background.

It depends. If you can find someone you trust (not with an agency) the cost can be from $12 to $24 an hour. Agencies are more pricy usually about $20 to $26
A friend of mine had 3 aides who took care of her mom. They worked privately and were wonderful. they charged $15/hour. Took care of everything. If one got sick the others covered her shift. But this is the exception I think. It sometimes takes a lot of time to find the right one. Agencies do all the vetting, but even with them they cannot always cover a sick call. You need to have a back up plan.

Finding the right fit takes a LOT of time. Felt like each new companion was an experiment. And in the end a college student interested a future in gerontology was the one that worked.

I used Comfort Keepers for my 89-year-old healthy mom. Mom loved her companion who came three times a week as needed. They laughed, cleaned house, shopped, took selfies,and whatever I would do for her but couldn't because I'm 900 away. The women were all vetted. It cost a reasonable 18.50 an hour and was worth every penny.

Ask friends from the community and ask friends from church. Call Visiting Nurses or Hospice. I am a private sitter I live in a small community every one knows me. Each job may pay differently its according to what is expected of me and how much travel. I am taking care of an 86 year old woman with dementia but is right next door. No wear and tare on my vehicle. We have good days and bad days. The same if they were in a nursing home show up at different times. You are paying someone to look after the most important person in your life.

I too am an RN. My comments were attempting to list the pros and cons of the home care/aging parent dilemma. If you took my comments the wrong way, it is too bad. I would love to have been able to hire RNS for round the clock care for my mom. Financially we could not afford it. And as her health declined, it was necessary for her to go to skilled nursing as she was not a candidate for assisted living. For a short time she was at home with Visiting Nurses Agency coming in and they did a wonderful job. I would love for her to be at home (as would she) but it is not feasible. She is in a safe environment now and is being cared for by a wonderful staff.
I will dispute your statement about the nursing/medical profession. I think it is a very worthwhile field and would encourage anyone who was interested to pursue it. I worked in nursing for 40 years and would do it all over again.

ProfessionalRN, you seem very upset and bitter about something you have seen in your time.
NOT ALL AGENCIES are like you described, and I would appreciate if you would consider that fact.
Our goal is life enrichment for our team and our clients. That costs a lot of money. We pay $10-12/hr and charge $20, which is not even enough to do all I want to do for our team and clientele. Taxes alone are 15-20% on top of that. So right there wages jump to 11.50 - 14/hr! The I have to insure in case of theft, damage or accident, as well as pay unemployment to the government for people who aren't working and workers compensation in case one of our team is hurt. That's another $50/per team member, PER MONTH! Not to mention that I have to pay for your drug screens, back ground checks, software to keep you with the schedule, another $18/per team member for continuing education for you, payroll processing costs (in house or outsourced still costs money), equipment, uniforms......etc.
So much more to this than you seem to understand. You want $25-$30 per hour, and that is just for you! Who is the one that is worried about the money here???

What do you do for a living? How much can you afford to pay to do what you don't want to. You not only want moms care but the house cleaned and other services...
I'm a RN and off the books would only work for $25 to 30 per hour and your mom would feel cared for. I don't call in sick because I enjoy what I do but would only work for someone that respected me as a person, professional.. Nursing agency would change you the same and you'd get a aide and someone that works for the agency and not you or your mom... Think, nursing and care is not free. You demand to be paid for the work you do, but for some people they think caring for others is nothing to be paid for. Years ago I got paid $50 to 60 dollars per hour (1991)

Send you mother to a Senior Citizen Home that charges you $3500 for basic no care, just companionship, if they need medication reminders it's extra, change the bedding, help dress that's extra. If it's for mom and dad it's double that cost but they have bus trips, meals in dining room and friendships. Most can't afford so they wait and try to get into nursing home for free because families have hired Eldercare attys to hide your parents money and homes turned over.
Want you parents properly cared for take you salary and pay for the services because you don't want to. I do understand that. It's hard to care for our parents but like kids it is our responsibility. But would be better just to collect the estate and no have to spend their money on them...
I have worked for many loving families. No families around some even out of the country but I was respected, trusted and paid as a professional and they client lived and was far better off.
My friend and I hired private aides to care for his parents. I taught every aide and made sure they were treated very special. I did half the care myself and it was a lot of care on my part but I'm a RN and was able to diagnose something far before someone else so she live almost 10 years. I thought when he was going to take her home she wouldn't last a year.. You want someone to care for your loved one and your don't want to do it pay your wages and benefit and that's what you will get....Live in aide work 24/7, with the agencies it's two persons.

I only wish the opinions of the public would change because within time there will be no one in the medical field.... Hospital one RN for 30 to 60 patients..Look at the bedsores and infections and lack of care because medicine is a business.....

I find it interesting cops are paid $100,000 with zero education, high school degree, teachers $100 to 150 thousand for 184 days per year but people have major issues paying for medical help or care of your loved ones.
Re read you email because you make no sense. How can I trust someone. Do you think a nursing agency is trust worthy. What that they charge you $25 to 30.00 per hour and pay the aide $10.00 per hour. They refuse to drive your loved one anywhere.. Pay for a cab. If they get sick do you think the agency will find you a quick replacement, NO.
For $13 to $15 dollars per hour they are not going to want to be on the books. If your loved one gets hurt because they fall, think about it is it something that won't happen if your in the house also. Mom goes to her bedroom or bathroom and your making dinner and mom slips and falls who fault is it. I wouldn't want to work for you... Agencies could careless about you or your mom they care 1st and for most for your money. The aide Nurse you hire privately care for your loved one, they work for you and mom and not agency...When you sign with a nursing agency you have to sign a paper that you are responsible for being there if a call in... Sorry that's a fact. As I stated in my other emails agencies do not check records....I know they make you think they do, but most get a job within hours and they was no time to even review recommendations. You can check your own person out.
Pay a medical professional a living wage like you would want oto get paid, or stay home and care for your parents yourselves and you may have a different opinion of how hard it is to care for your parents.....
There is only peace of mind if you do the work yourselves.. I wouldn't want to drive your parents around and enjoy getting them out, I'd be to afraid you would sue me and charge me if your parent got hurt..
Your children play on the school yard does the school and teacher have the threats of lawsuits if you kid skins their knees.
This is why after 30 plus years as a RN, BSN I would not tell anyone to enter medicine.. Teacher and cops are will paid with super benefits, pensions and you home care works and nurses get zero benefits low low pay and total disrespect..
If you can't trust with a house key you shouldn't trust them to care for your parents loved ones.

I could only work with someone that respected me as a professional RN and trusted me. Do you know how many times I haven't been paid because another nurse charged for my nursing hours with NYS Medicaid.
But I have also kept patients/clients out of the hospital far longer than most agency staff because of extremely quality care and being super clean.

I love being a RN but wouldn't do it again today... Become a teacher or cop they are the ones respected... How the cop or teacher stops at your auto accident and saves your lives and walks away and you didn't even know my name but your loved one or yourself lived.... House cleaner charge you off the books $25.00 per hour if they are worth anything.. You get what you pay for...Go hire a illegal and pay them less than $100.00 per day.
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this is a difficult situation. I was looking for home care for my mom before her condiditon declined and she went to subacute rehab and eventually skilled care.
My dentist had a group of women who took excellent care for his mother in law. Two people in my mom's condo had home health aides they recommended. I did interview them and along with the recommendations of others who employed them decided to set up a schedule with them. They charged between $13 and $15 per hour. The concerns: what happens if they call in sick, can't make it to work due to weather, we find that they are not doing what they said they would do, how do you handle tax deductions, pay issues. Are you liable in any way if you pay them privately? what about their liability if your loved one falls or has an injury while in their care? They offer to drive mom to her appts, again what if there is a car accident while they are transporting her? Can you trust them with a key to her house or do youhave to be there to let them in? How often do you check on them? How do you check if they had a criminal record? Can you leave valuables in the house? There is a lot to consider---and having said that, yes, it is a great solution depending on your loved ones needs. It gives you a break from being the constant caregiver and can provide you with some peace of mind. But try to consider everything before you go this route. This is not to say that you don't have some of the same issues if you go thru an agency. Just check, check and check again. I know there are some wonderful caregivers out there and hopefully, you will find the right one for you.

For companion service it would be around $10-12 per hour. If you go through an agency they take a big percent, so you pay more and the caregiver is paid less. I have used both agencies and private caregivers for my parents.... there are no guarantees either way. If you can find someone you know and trust that is best. If not, be sure to interview the person and do reference checks. Maybe start out on a trial basis. Also provide a specific checklist of what you want them to do. My parents caregivers send me pictures via phone to show what they're doing. You may want to consider a hidden camera and/or unscheduled visits. For some reason there are a lot of lazy, dishonest people in this profession, but also some wonderful caring people. I had to get rid of several before finding the right ones. Make sure to remove expensive jewelry etc. from the home first to minimize worries about valuables.

Also, in my opinion, a private caregiver should give a different experience than a agency caregiver. If you work for the family privately it should not be a problem to cook dinner (for the family) do laundry, clean, etc...as time permits when the primary patient is settled and safe. These things can even be tuned into activities for some patients.

I have been a caregiver/CNA 16 years . There are different ways to do this and different benefits and problems with each way. You can go to a site like care.com and hire a private caregiver. This is cheaper for you. They are background checked already, you can drug test them yourself as a condition of employment. I charge 15 an hour and with all my experience I think it is wrong to charge a family more than that. You cannot bankrupt someone for care. You will have to figure out taxed on your own with that person. Some of these sites will help you. If you hire private it is important to have a relationship with a agency also. Everyone gets sick from time to time. You can use agency as a back up. Hiring an agency full time is expensive. They underpay the caregivers and take more than half of what they charge for themselves. I worked for an agency for years and often they cannot find replacements at the drop of a hat. They are not all they are cracked up to be. An underpaid worker is not a happy worker. Number one important thing is INSTALL CAMERA or listening device in your home. You just never know who you are letting in. Trust is built, not just given.

We do have horror stories out there that do need gov't help and they don't get it.
A family where the father gets Alzeimers disease at 39 yo. Wife, two young children and own a home that they have a huge mortgage on.. They get little to no help, told to sell the house, wife works full time just to pay for someone to help care for her husband.
I was a young woman when my husband came down with cancer, I had two young children and no one jumped in to help I cared for my husband myself, and kept my children together. But 30 years ago medical paid all the medical bills, today the co payment bankrupt you. I have watch many young families in these situations and they lose their homes and partner has to work full time. They have to beg for help and get little. I know I worked as a care consultant and heard many of these horror stories.
Your parents bring into your home and take care of them. Hire care givers if you want to continue to work full time, but pay these people a living wage. Then you'll find honest ethical people. Pay what your making a hour and get the help needed.
Agencies are not the answers and your not getting quality people but quality office staffing.
Riverhead Senior Care gives Seniors housekeepers for free to these people that have hidden their parents homes.
Have a person move into a apt in your parents home just to have someone there if you don't want to do it. But that doesn't mean they cook for your parents do medical care. But you could at least have someone in the home with your elderly parents.

Do you know the number of people that for their sick children get MEDICAID for free and the parents don't even change a diaper. Father's hide their salaries or aren't responsible for child's care. Mom's don't work or care for their own child, it's medical.???? These parents are living in MILLION DOLLAR HOMES. YES, this is a fact. Father's are making over $100,000 per year salaries and this is not looked at. Families are running fund raisers and it's not looked at either. My heart used to go out to these people but I now after years feel very differently.
Medicaid Nursing caring for children under 21 top pay, $42.86 per hour, but the minute the person becomes 22 yo the nurses salary goes down by $12.00 per hour. Now I understand it's down to $30.00 per hour for twice the job.
Seniors that have the money that they have hidden need to be responsible for there parents medical and safety care.
Yes, there are many people that can't afford the needed care, bring your parents into your home, make a apt for them and then hire limited care person for at least $10.00 per hour off the books.
I know many many many children that have made sure there parent money has been protected for there parent use. Elder care attys are great at that.. Go to the meeting and they teach you how to protect your money for the future.
Think about a living wage for these care givers.. Sitter care, pay sitter pay like you would for your children's sitter. $10.00 per hour, need help bathing, dressing, cooking should be at least $20.00 per hour. Nursing care should be nursing wages. $30.00 or more a hour. I took care of many sick family members and made $50- 60.00 per hour and these people got quality care because you paid for quality people to care for your loved ones.
Do you know how many families that have the uneducated care giver doing medical care, wound care, giving medications, doing tube feedings. Cooking for their parents, cleaning their homes. A housekeeper charges $20.00 per hour at least. These are your loved ones. Seems most paying more to have their dogs walked, then what they want to pay for their parents care.. Elder care attys have taught families how to hide parents money turn over or put in trust. A 5 year look back, is nothing... There parents homes and back accts should pay for this care but the kids don't want this. I could write a book on the games that are played to hide parents money to get free help.
The best way I have found to obtain money to pay for these medical bills is GET A REVERSED MORTGAGE and therefore there is money for there parents care. Should a care giver make as much as a local teacher or police officer. If you want quality you have to pay for quality. Most the people I have seen want to hire Island people that don't even have the rights to work in this country. Illegals that American don't want in their country are doing most of the care to your parents for $3.00 per hour at the most. The families will tell you they are getting free food and board, no they are caring for your loved ones.. Are your parents care less
important than your children's education expenses.
I know right here in my area three senior that have plenty of money and the families refuse to hire someone to over see there mom's.
Privately you should be paying at least $20.00 per hour. Most want 24/7 and only wish to pat $100-$150 per day, divide that by 24 hours and see what your paying for your parent's care. Then they want to have taxes taken from their salaries?
Do you take taxes out of your babysitters salaries. A babysitter for a child is $10.00 to $15.00 per hour today.
It seems you teachers cops are worth a living salary be the professional that cares for your parents or family no one wants to pay for.
Maybe the public doesn't know it but you do have some responsibilities. I have watched many 80/90 year old home alone and need help but they say their church should help more and protect there parents. These people are allowing there parents to continue to drive while they have been told it's not safe. Is anyone aware that ADULT PROTECTIVE CARE or the Police can be called if there is Senior neglect.. It is a crime.
I personally took in a friend because she was in her 90's and afraid to be home alone, and it was a unsafe situation. Al her children lived withing 5 to 45 minutes away, and they did nothing. They refused to hire someone to be with their mother. All we professionals themselves with adult families.
They could have hired a sitter/ just a person to stay with her 8 PM to 8AM and she would have felt more comfortable. But that would have cost $10.00 per hour off the books, what $120.00 per day. This woman was in her 90's and family had been bright enough to turn everything over to their names and therefore there was ? No money, get Senior care to help for free.
My mother sold her home because it was to expensive and took that money for her care. But it seems more children want the final estate money.
How much do you pay teachers to care for your children does a medical professional not have the rights to the same salaries. These are your loved ones. I guess I don't understand why children think others should care for your parents and you should pay little wages.
Money can be gotten quickly for there care by Reverse Mortgages, this is their money not the children's. Medical care and care of parents today no one wants to pay for.. At 40 yo get ELDER CARE MEDICAL INSURANCE, this way the aide can be hired for home care, the parent can go into Adult living.. Do you know how many people I have been asked do you think my mom should go into a nursing home. NO she 90's but needs assistance but not a prison.
Your children's children are paying for you parents medical bills through Medicaid Nursing Homes.
Go back to the early 1900's you cared for your own children and your parents. But it's not my job any longer. Yes it is....All is worried about what is stolen think about it it's also the children that are stealing from the parent by neglect.

I pay 15 per hour directly and have a service that takes care of payroll and taxes. Occasional help can be paid like babysitters.

Costs vary, whether it is agency or private. Quality varies, whether it is agency or private.
If you want to put your elderly person's safety as most important, don't just rely on an agency to do background checking....that assumes their checking was actually done and that their worker provided honest answers to the questions. Background checks are not as important as actual Client Testimonials. You might not get those at an agency at all.
The only way to really know these paid caregivers is to do you own background check, and ask for several Real Names of past clients. Also you should have a Credit Rating check run. And you should know the potential caregiver's home address. Drive by, get out, knock on neighbor's doors and ask if they know the lady? Would they trust her in an emergency? Would they trust her with their jewelry and valuables?
I doubt an agency would let you do this for their workers.
Another angle, check the Credit Rating of the franchise owner, and drive by their home, and ask their neighbors about them.
For those reasons, we have hired a private, known person for our parents, and it works out fine for now. If the needs become more medical, we will find someone privately. Paperwork is not as painful as theft and endangerment.

I had a situation in Mt Pocono Pa. My sister had dept of the aging supplying 5 hours per day for my critical ill sister.
This was through a so call quality Nursing agency. 1st time the girl stole everything she could get her hands on and the Dept of aging and nursing agency did nothing. She even broke into the house 5 weeks after she was fired and stole my sisters washing machine. If you can believe it the police dept was called and the girl said 'MY SISTER BORROWED THE WASHER FROM HER'. If you can even believe this. This is the God's honest truth, Monroe County, Pa. She flooded the place and the police said they saw nothing, but the walls are now black mold.

Another Nursing Agency with RN staff to over see the aides, was hired through the Monroe County, Pa dept of the aging, for 5 hours per day. They called no one and for 4 days my sister had no one with her. Critically sick on O2 24/7 and can't walk. Nov 30,31, Dec 1 and 2nd she had no one and no one was called to be informed.
I came from NY Dec 3 not knowing of the situation and found my sister set her self on fire because the aides were getting her cigarettes I had made clear she was not to have, had a stroke, NO FOOD OR WATER for 4 days and covered with feces and Urine.
She ended up in critical condition and at 68 ended up in a nursing home. December 2012 the day before Christmas. Died November 18th.
But this is the Monroe Dept of the aging adult protective services and the agencies they hire.
During Super Storm Sandy I begged for someone to be with my sister. Life threatening situation. Commissioner promised someone would be with her. The storm was coming thru her area.
O2 is electric to breathe, Telephone is connected to ambulance.. Not important enough because Patti the head of the Dept of the aging in Monroe County, Pa never made sure anyone showed, until the following day.
This is a example of a nursing agencies, dept of aging and adult protective care supplied.
This condo my sister lived in refused to allow me to have someone live with my sister to protect her.. Foxfire Condo, Mt Pocono Pa as per the Monroe County Court and their attys a LIVE IN AIDE is a tenant and therefore not allowed.
Unless the president and his secy allow it and they get paid under the table. My 68 yo sister died in an nursing home because she was refused the rights to live in her home she lived for over 10 years... A live in aide would have saved my sisters life and protected her.
My heart bleeds because I fought non stop and couldn't protect my sister. She was even made to go through a guardianship hearing and proved she could have safely lived in her own condo with a live in aide..She proved she was safe with assistance but refused by the president of the condo board. He holds 30 votes for people that rent their condo out so he does as he pleases and nothing that anyone can do.
Have a atty that wants to help I have the proof. President of FOXFIRE Condo is over 80 and his Girlfriend in her late 50/60's there is a god and they will in time get theirs. Their atty was never given the doctors orders she needed 24/7 help. Dept of aging in Monroe County, Patti, refused to give it to protect my sisters life.
Local Monroe Pa Commissioner is very aware of this abuse but Patti and the rest of the staff still have their jobs....
So hiring my own person to live with my sister would have saved her life.

Pa and Condo refused it. AIDE per PA law they told the judge was and is a tenant.
Condo has at least 30 tenants living there, but my sister was not allowed.President Henry holds all there voting power.. If you can believe that. Go look up the case and you will see the proof yourselves. God's honest truth..

I buried my Sister November 30 back in NY. Pa laws and condo president has the blood on their hands and killed her..

Hello, we are going through ResCare and we have a nice young woman who comes for two hours a day from 1-3PM to assist my mother in law to the toilet, change her, clean her up if needed, prepare her lunch, make her bed, cleans the kitchen of dirty dishes, etc. She is awesome, and my MIT loves her. ResCare charges $18/hr. She also is flexible and comes more often when we are away for more than a day. I think they are throughout the US.

I agree with meatjeanne. I was told by multiple home health that they were not "hands-on" in the case of helping patients remain steady and do not fall. Also the dispensing of medication was an issue also. My father takes them 4 times a day so that wouldn't work for us. I found the recommendation route to be best for us.

Hmmm.

Disclaimer before I start this … for my Dad, who has progressive dementia and lives in another state, I currently hire home companions/caregivers (4 hours a day) through an agency. We have been with the same agency now for 2.5 years. There are three or four agencies in his small rural town, all competing for the same small pool of potential caregiver employees, and all providing the same sort of services for roughly the same costs.

I have what I'd describe as a good working relationship with the agency, and have dealt with mostly the same person there for 2.5 years. (Note that two of the other staff members with whom I regularly dealt in the office have left the company in that time.) I believe the agency does its absolute best to try to match the most appropriate caregiver to each situation, and to take clients' needs into account. Despite this, based on my experience, I am not convinced that agencies are worth the very high cost of their overhead. Your mileage may vary if you are in a larger, more metropolitan area with a larger hiring pool. But let me explain.

First, note that all of the agencies try to convince you that going through an agency for this service is the only safe and reliable way to get real peace of mind when it comes to hiring a caregiver. The first reply post in this thread is pretty typical of what you will read on agency brochures … the gist is basically:

1) If you don’t hire through us, you won’t be hiring someone who’s undergone a background check.

2) If you don’t hire through us, and something comes up so that your caregiver quit or can’t come at a scheduled time, you won’t have a “stable” of caregivers from which to find a last-minute replacement.

3) If you don’t hire through us, you’ll probably get into trouble for not being able to figure out how to do payroll or pay taxes appropriately.

4) If you don’t hire through us, you run the risk of your caregiver getting hurt on the job and suing, because you’re not covered by workman’s comp and liability insurance, the way we are.

5) If you don’t hire through us, and the caregiver isn’t working out, you’ll have to fire him or her directly. If you hire through us, we’ll take care of the hiring and firing for you.

Of all of these arguments, #5 is probably the best, followed (somewhat) by #2.

Now, here’s what the agencies DON’T tell you.

1) The background checks they do are minimal at best, and you can easily do the same checks for yourself on anyone you consider hiring.

2) Having “someone” come out in the event of a scheduling hole is better than nothing, but sometimes only slightly (particularly if the care needed is for someone with dementia or memory difficulty who relies on routine).

3) When you hire through an agency, the caregiver receives a fraction of what you pay. For example, to Dad’s agency in rural Southern Oregon, I am paying the agency $22/hour, and Dad’s actual caregivers are only receiving $9 or $10 of that. This pay rate is not high enough to attract a lot of experienced, reliable workers … mostly, workers are very young or recently laid off from some other profession entirely and just looking for a “stop gap” job. The low pay rate also contributes to high turnover rates in caregivers, who frequently only last a few months before finding a higher-paying job. The agencies typically don’t see this as a problem, as long as they can find someone else to “plug into” the slot … but when you’re caring for someone with dementia, consistency is important. (And even if the person needing caregiving services does not have dementia, having a constant parade of strangers coming in is unsettling at best … how would you feel, if it were you?)


4) The taxes/payroll/insurance bogeyman sounds scary, but is really an empty threat. If you hire directly, you do not HAVE to risk making expensive and frightening tax mistakes, or stumbling through a quagmire of incomprehensible tax forms and confusing regulations, wondering constantly if you’ve withheld the right thing or are reporting the right thing. Here’s why: Because there are PLENTY of online payroll services you can hire directly to manage a household employee’s paychecks and tax withholding/reporting (for example, HomePay by Breedlove, GTM payroll services, savvynannypayrollservices.com, HomeWorkSolutions, and so on – just Google “household payroll services”). Many of these services also offer insurance programs (worker’s comp, liability, employee dishonesty, etc.). No, the services offered by these companies are not free … but their monthly fee is typically a fraction of what you are probably paying the agency over and above your caregiver’s actual pay.

So, all this being said, why, you may ask, am *I* still going through an agency instead of hiring directly?

1) Dad has a long-term-care insurance policy that is helping to pay for his care. The insurance policy pays a higher rate if I hire through an agency (50% of his monthly maximum allotment) than if I hire a private caregiver (25%). Simply put, I can afford to have caregivers at his house for more hours of the day if the insurance company is paying rather than I.

2) I live in another state, and am not in a position to check in on Dad regularly in person, or to track when the caregivers arrive and leave. Dad’s memory is so bad now that he doesn’t know when he last saw a caregiver, even if it was just a few hours ago. The agency has a “call-in” system where the caregiver has to check in and out from my Dad’s phone. Foolproof? No. But possibly better than what I might manage.

3) During the 2.5 years we’ve used this agency, we’ve had many caregivers come and go … some who never showed up for the first day, some who lasted only a few weeks, and many who just never seemed to understand dementia needs (and kept moving stuff around the house where THEY thought it should go, for example, causing him great anxiety) … but early on, we somehow lucked into one caregiver who has stayed and stayed. I now consider her Dad’s “primary” caregiver. He knows and feels comfortable with her. I am more comfortable with her grasp of his dementia issues and needs than I have been with any of the other caregivers the agency has sent. If she leaves the agency, I will probably strongly consider either hiring directly (despite the insurance ramifications) or moving Dad to a facility … but as long as she’s there, I’ll stay with the agency. I am contractually obligated not to try to hire her directly, and I respect that, but if I could, I would … I’d much rather she get the $22/hour I’m paying than the $10 she’s making.

Anyway, that sums up my experience, situation, and thoughts. If you're just hiring someone here and there for the occasional respite, the extra agency costs may not be an issue. If you're hiring to try to make it possible for a parent or loved one to continue to live at home as long as possible, then managing your costs as efficiently as you can becomes more important. (Increasingly, I bump up against the question: Is Dad better off with the agency caregiver I can afford to have there 4 hours or day, or would he be better off with the private caregiver I could afford to hire for 7 or 8 hours a day for the same money? Or with the private caregiver I could afford to hire for the same 4 hours for the same money, but who has better qualifications?)

Complicating the question are the new overtime rules, which remove the overtime exemption for home companions. Now, if you need someone more than 40 hours a week, you'll either have to pay overtime rates or hire two different people (or three, etc.) to cover the shifts.

I understand that agencies have overhead costs and need to make a profit ... but this does not change the fact that money paid to cover agency overhead is money clients do not have available to pay for care. The more hours of care you (or your parent or loved one) need, the less you may be able to afford acquiring that care through an agency.

I worked as a caregiver for women who had Alzheimer's for about 5 1/2 years, part time, and then had to quit to stay home and care for my husband who had just been diagnosed with dementia. I can honestly tell you that there are some very responsible, caring, serious-minded caregivers out there, just as there are some whom I wouldn't trust any farther than I could throw them. And to be perfectly honest with you, it depends on who within a particular company is vetting them and interviewing them. Sometimes the ones who are hired were figuratively speaking scraped out of the bottom of a fish barre. If you decide to hire a caregiver, don't take the company's word for it that she is A-okay. Tell the company you want her on trial for several days and that if she doesn't work out, you want a refund. And be sure you get it in writing.

I know what I'm talking about. I've seen them hired and fired. I was one of the very good and stable caregivers. You have to be very, very careful. Just because you choose what you think is a reputable company, that does not mean that the caregiver they send you is reputable. Be very, very cautious!

When Home Health people came in for my husband, they would recommend those who would sit with my man. You have to listen very closely....how long they have known this other person, how reliable, how much they charge, etc. Most were 10 to 15 bucks an hour, most would do some cleaning while they were there. That was NOT what I was looking for, a housekeeper. I just wanted someone to sit with him, help him get up and maybe change him if he didn't get up in time. Fortunately someone I worked with had a daughter who did that type of work..... so ask friends, neighbors, anyone you know. Sometimes those recommendations are much better than hiring a 'stranger'.

I also wanted to add this thought;
Not all agencies are the same! You need to interview them and find the company with the culture that fits your family and needs. Our agency strives to retain the same team member for each client/shift providing continuity and personalized care to our clients. I know many agencies do not do this...but many do. Talk to the little guy as well as the big franchise guy, and determine who best suits you. This will result in a higher satisfaction rate and better over all scenario for you and your family.

I have just had an appointment yesterday with a home caregiver service that does background checks, drug tests, educates and checks references for all of their caregivers. They are $19/hour and will perform home visits for housework, personal care tasks (bathing, toileting, dressing, etc), laundry, meals and companionship. This is *just* what Mom needs if I have to be gone for more than a few hours - someone to keep her company and help her remember to take her pills, keep her incontinence pads changed, change her bedding and chair pads if needed, etc. We are given 2-3 caregivers to choose from and interview on our own. I'm hoping we will find a good fit so that I can take a day off now and then to go see my grandkids or just get away for a while without worrying that Mom is home alone for too long.