My father (93) wants to remain in his home. What services are available?

Call your local homecare provider agency. This service will be paid out-of-pocket unless it is ordered by an MD.

Diane, I agree with Pam above, you would need to call a caregiver Agency to see what is available to help your Dad. Maybe he would need someone in the mornings to make sure he eats breakfast, gets a shower, takes his morning pills, plus do some very light housekeeping if Dad doesn't do it himself. And to get lunch ready for him, and then leave something for him to heat up for dinner or to eat cold. He could also get Meals On Wheels, if it is available in your area.

I had Agency caregivers for my Dad and it cost in my area around $28 per hour. Eventually Dad needed more hours each day, thus it was costing him over $400 per day. No over-night service as Dad would sleep through the night as the evening caregiver would help Dad upstairs, help with his shower, and make sure Dad was safely tucked in bed before he/she left.

Eventually to save money, Dad wanted to move to Independent/Assisted Living. He had caregivers only in the mornings but in the evenings he would forget to take his pills, even with me calling to remind him. The caregivers would tell me they think maybe Dad was forgetting he already took his pills and would take them again [even when using an AM/PM pillbox] or not take pills at all at night.

Eventually I had to use an Assisted Living option where the Independent Living complex would come in twice a day to give Dad his pills.

Companion care usually requires a three hour minimum amount of hours. They can do minor cleanup meal prep, laundry and remind him to take his medicine. They can not set up medication. You will need to do that. If his memory is failing, be aware of his safety. He may get to a point that he can't live independently for safety reasons.

Does your Dad have long term care insurance? Is he a Veteran that served during war time? a caregiver from 9 to 3 or 10 till 4 would be idea? I do not know what state you are in? In Florida we have a site care.com that people can say what they need and those that are caregivers reply.

There are automated pill dispensers now on the market. They are timed to only allow access to the exact pills at the times set. A buzzer sounds and bugs the person to take those pills- then it rotates to the next pills for the next medication time. Would this work with your father?

Care.com is an excellent resource throughout the US. I got an excellent lady from them and we remained friends after my mother's death. At first she worked 3 days a week for me and did an overnight gig for another family. Now she is working for a stroke victim, part time. Many of these wonderful caregivers are supplementing their income from other jobs and are happy with a few hours a day. Also check out the VA Aid and Assistance pension that veterans are able to receive. I think the vet can get up to $1800 per month depending on their other income. Medical expenses offset income and home care is considered a medical expense by VA.

I just wanted to add if your dad is a vet he can receive hearing aids and a small device that he wears around his neck. This allows his cell phone calls to go directly into his hearing aids. It was a life saver for us because my dad also could not hear us on the phone. All free of charge. Phonak was the maker of the hearing aids. Any cell phone that is blue tooth compatible will work.

We used a automated pill dispenser on the market by an excellent oompany called MedReady. We bought the one we could have monitored and that we could change the alarm on from home online. However, they makes ones that are not monitored wirelessly too. Now that my dad is no longer living independently we don't need it. I wish I could sell it. It wasn't cheap but worth EVERY penny. You can dose 28 single days or up to a week of meds 4 times a week. An alarm goes off, they open the little door and take out the medication and close it. Then at the next appointed set alarm it rotates and will go off again to alert the person. It was a godsend because we knew he would take it. We trained him on it a few days and then he was good.

Not eating when he should and not always taking his medication are signs that he may need to be in assisted living or at least have someone in charge of seeing that he takes the medication and eats properly. Options of course are Assisted Living or having a caregiver or caregivers. I would consult with his primary physician for a recommendation and then call the State Dept. on Aging for referrals. There may be an Interfaith agency with volunteers and Meals on Wheels that bring a main meal to your home each day for a small donation that is up to you. There is also Catholic Charities that come to the home for a agreed upon hourly fee that the person can afford. They will do light meals, housework, sit and talk with the person, take the person to the doctor, etc. . You may also consider calling your Dad (or someone else whom he trusts) whenever he is supposed to take his medication to remind him, and stay on the phone until he take the pills. Also, the doctor might prescribe At Home Care under Medicare that is temporary, but could start the ball rolling to get the necessary help. You did not mention how old our Dad is and whether he is cooperative.

All of this information is great but when you have someone like my father who refuses help (even refuses to apply for Aid and Attendance), it's difficult and not fair to the children (mom passed away 5 years ago). The doctors have been direct with him and said he can't live at home. He didn't like Meals on Wheels, he fired a 'companion,' refuses to fix the house which is falling apart. We're having to consult an attorney unfortunately.

Get a "personal assistant" (I worked as one for several years) who comes in as needed. I did not refer to myself as an aide or nurse, but "personal assistant" gave my clients a certain feeling of power and respect that is sadly missing in elder care.

I wasn't supposed to touch or organize pills--but I did b/c my clients usually couldn't. And sadly, no alarms or reminders in the world will help some people to remember to take their meds.

I was a 3-4 day a week companion, but it sounds like your dad needs more. My clients lived with family--this was a "break" for the family. The PA could at least make sure that the meds are in order, make meals and have some extra for the days they are not there. Family will have to fill in, of course, sounds like dad needs daily care.

I know that I was grossly underpaid for the kind of service I provided--so be prepared to have to possibly work through several no-starters as you accustom yourself to this kind of care. I know I was the 3rd person to work for my client in one week. We "clicked" and I stayed with her until she had to be placed in a NH.

Good Luck!!

'Homecare' is most definitely paid out of pocket - your or your dad's pocket - whether a M.D. 'recommends' it or not! If only it were that simple!

You will have to pay someone to come in morning and evening, 2 hour minimum each time, at about $25 an hour ($100 a day). (This will be the bare minimum, and you will very quickly realize you need more home care or he will have to go into assisted living or a nursing home. And probaby go on Medicaid.)

Maybe the VA pays for some things. Medicare will not pay for home care unless your father needs a visiting nurse after an operation or illness, and that's temporary. If you get him on Medicaid after spending down, they will take his social security and pension, probably his house. Better consult an eldercare lawyer if you haven't.

Sounds like your dad is stubborn and very set in his ways. I am sure contacting an attorney was not an easy decision for you to make. Here's hoping that he realizes he needs help before you have to go thru the competancy and guardianship issues. Good luck

I think that the attorney route is probably necessary at this point. Sounds like he is having severe depression. He may end up declared incompetent so you will need to appoint a guardian.

Diane, make note, if you hire a caregiver who is an "independent contractor" [doesn't work for any Agencies] that your Dad would need to put on his homeowner's insurance policy a "workman's comp" rider just in case the caregiver gets hurt doing his or her job.

cps, ah those stubborn parents, I had such parents who refused to have any type of outside help... my Mom wouldn't even let a cleaning crew come into her house to help her clean, she was insulted that I thought her house wasn't clean enough [well it wasn't but I wouldn't dare tell her that]. If that was me, I would be holding the front door opened and letting the crew come in, with a big smile on my face.

Um, I worked for an agency and was paid $8.25 and hour. Slave wages. The family approached me just months after I began and asked me straight out what I made. They were appalled--and routinely "tipped me". So I made closer to $15. And worth every cent of it. Agencies take a HUGE cut. Privately, if you want to contract with someone you know, that is doable. I was in the process of negotiating a contract with a friend for her mother and they finally decided to place mom instead. I would have been paid $20 an hour. They were working with an attorney to set this up. The agencies bond you and such, if you are independent, you should have an attorney handling some parts of the deal. To be on the safe side for everyone.

Long term care for my mother is like a soroty house. He will have someone to talk to laugh with and even cry with. Watch tv etc. Most have to fight parents to go! Look hard for a place that is airy and bright with happy talkative nurses. We are fortunate

I know for my Dad [94] staying in his house of 30+ years he was in constant worried mode about the lawn, the weeds, the trees, which trees needed trimming, cleaning the gutters, leaves needed raking.... the snow, who would shovel, where would the caregiver park if it snowed overnight....

the refrigerator was making a strange noise, the toilet needed repair, this room needed painting or that room.... he wanted to go into the basement to get his tools but the caregivers wouldn't allow him to go down there as he was a fall risk, but he would try to sneak down.... daily he was out in the garage trying to charge up the battery in the car in case someone needed to drive it.

Dad would eat alone because the caregivers weren't allowed by the agency to have dinner with Dad. Dad was bored even though the caregiver would try to start conversations, if the caregiver was 90 that would have helped.

Now Dad has been in Independent Living going on 4 months and happy as a clam. He wished he would have made the move years ago. The car been donated. He now calls Maintenance if something needs to be fixed. He is so happy to be away from that house. And he has regular dinner mates at supper time when he goes to the main dining room, and you better not be standing in his way when it is almost 5pm.

If he wants to stay in his home: #1 hire an RN for a 12-hour overnight shift, #2 put in place Meals on Wheels, #3 hire a cleaning person and #4 hire a medication management person. A lot, right? You may want to consider that he CAN'T live alone.

freqflyer, I, in so many ways, wish my dad had just gone on into Independent and/or Assisted Living; I think he, too, would have enjoyed it so much; I so hated the thought of him eating alone - yes, even though he'd had his grandson move in with him; he wanted him there for companionship but he did not eat with him but hard to get out once you get them in and if he were going to be there he was going to have to have somebody but once that was done dad also wasn't going to consider leaving

We had a meeting last night with Comfort Keepers out of Spring Lake - We are going to try having them out to help with medications and dinners starting next week. They are going to start on Wed of next week, and there are a lot of things I need to get put in place first, but I think it will be worth it.

Diane, my father is determined to stay in his house for the rest of his life, so we've made and are still making accommodations and plans. Perhaps some of what we're doing will be of help to you.

1. Daily Reminders: One of the things I'm going to be doing is making a color coded daily chart of things that need to be done. Taking meds isn't a problem, but sometimes using nonprescription eye drops isn't done as often as it should. And usually the humidifier doesn't get turned on. My chart will be something like:

Morning: AM meds, fill and turn on humidifier; check and fill if necessary water filter on oxygen concentrator; use dry eye drops.

Lunch: Meds, dry eye drops.

Dinner: Meds, dry eye drops.

Bedtime: Turn off humidifier; prescription eye drops.

My chart is mostly for the humidifier and oxygen maintenance issues, such as changing cannulas, checking the filter bottle and humidifier level and making sure to turn it on to counteract the dry heat in the house.

I think I'll include a place for a check mark so it can be checked off when done - especially for the eye drops.


2. Meals.

Dad gets Meals on Wheels through the Senior Center in his community. They're $3 each, with options for additional meals just before holidays. The people who deliver are volunteers who enjoy seniors, bring him extra food, and provide a nice human touch during the day.


3. I subscribe to a monthly Medic Alert monitoring service through a Michigan company which initially began in the security service industry. Over a few years, they've proven to be outstanding in their support, calling both Dad and then me repeatedly if his monitor shows a change in position which could indicate a fall.


4. We bought and installed a lock box on the exterior of the house, next to the front door. There are 2 kinds: one has an upside down U shaped handle which fits over the door. Dad examined it and rejected it b/c he said he can be sawed off. I tested mine on my door and saw that his observation was correct. I could actually get a hacksaw in to (tediously) saw through the handle, releasing the entire device.

So we bought the kind that installs directly into the studs adjacent to a front door. The combination to the front door key inside can be changed anytime. I give the EMTs the combination when I call if I can't be there in time to let them in.

I've also given it to friends when Dad and I have both been ill and I couldn't get to his house to help him.


5. I recently bought an AT&T corded phone with caller ID, and extra loud (I mean loud enough to hurt my ears) ringer. Dad too has hearing problems. There are some phones with "boost" capacity for hard of hearing people but I haven't checked them out. The problem we haven't worked out is when the phone is accidentally put back in the cradle but not seated properly, and any calls I make just don't go through b/c the phone is literally off the hook.


6. Some of the neighbors are especially helpful and will go over to Dad's to check on him if I can't get in touch with him.


7. One of the neighbors has 2 children who take turns bringing his mail to him so he doesn't have to go outside in the winter. He gives them candy treats.


8. He still has a snowmobile suit as well as plenty of blankets to keep him warm in the event of a power failure. I'd like to get a generator but he doesn't want one.

I raise that issue b/c I have family near you and I understand that one of the winter storms knocked out power in your area either late last year or early this year.


My next big project is getting him qualified for VA Aide & Attendance, then hiring a cleaning service. I contacted a few, including one which uses only earth friendly cleaners.

If I can think of other things you can do to help your father stay at home, I'll post back.

Tacy, if that system could alert when a phone is just enough off the hook to disable call connections, I'd get it in a heartbeat!

GA, what do you plan on doing with the VA Aid and Attendance for your dad if you get it?

Here is one word to remember "enabling".... that was something I didn't realize I was doing for my parents while my Mom was still alive. My parents life in their house never changed but my life had changed completely once I was their life-line. Don't get me wrong, I liked helping but it caused my own house and health to take a side line.

If I had to do the past 7 years over again, I would have set boundaries and limited my help. By limiting my help maybe, just maybe, my parents would have realized that their single family home was no longer elder friendly and it would be time to downsize into something safer, with help already at their finger tips.

Then I wouldn't have lost so much sleep over worry over all those years :P

We are going to work with comfort keepers first on the medical problems - when asked my Dad couldn't tell us which medications he was on anymore. He has a lot of old prescriptions around that have expired that they are going to go through. He hasn't been monitoring his blood sugar for months because they sent him a new system and he doesn't understand how to use it. These are things he wouldn't tell us, but the woman from Comfort keepers was able to get an answer about it from him. I want to get all his medical issues taken care of first, then we will get into different dinners. For now, they are going to pick up things for him at a local deli or from a local restaurant. I will let people know how it goes - so far I am impressed with the people from Comfort Keepers.

So sorry that you are struggling with this! After working in the home healthcare field, I can tell you I saw this situation more often than not. What I have seen work above anything else is finding a caregiver that is a great match and can be VERY consistent. From the time they come and go, their routine when they are there, and even what they wear- consistency is key! I really think if you can voice this to a local home health care company they can try and help you. I'm all the way in Iowa so I'm not sure what agencies are available to you and how they would respond to this. I just know after managing a company and running into these situations, that is what I would try.

As far as payment goes, most home health care companies accept long term care insurance. Some even accept Medicare/Medicaid. I guess getting him signed up for those types of services would be an issue but if you can work with your attorney on power of attorney, it could be a possibility.

Best of luck to you and sending you warm wishes.

I was so fortunate to have a caregiver come 3 days a week, from 1 pm. till 5 pm. That lady was a TREASURE (and she lived only 3 blocks away from my mother.). I gave her a house key (a huge no-no) and for a while she was just 'checking in' with my mom on her way to or from her other jobs. The agency she worked for had a fit and forbid her from doing that or. else! I must state of course no agency anywhere would pay one red cent, it was strictly out of pocket as I spent down mom's checking account before Medicaid. The caregiver agency took a lot of the money we paid per hour, but I brought her some things when I went grocery shopping for mom - I'd bring her some nice artisan bread, or cheese, or even flowers. Gift cards on holidays. The lady was so hard working and she had her own burdens. Still in touch with her today, bless her!

HI,
The VA Aid & Assistance was a minor deal for me with my mother. We filled out the paperwork and WALKED IT IN WITH HER IN TOW. We had a check within 45 days. Don't procrastinate. Also, list all medical expenses, including a sitter to take up ALL of his income before you start, make sure that you list everything so it's "0" left over after housing & medical care.

sherry, you did have a sitter, right?