How to find a live-in carer for a relative

[TheChosenTwo]

Where do I start looking for round the clock full time care, Is it an agency that I’m after? Presumably, with references/dbs etc.
Do I need to look for 1 or 2 carers? Do they swap over? It’s an intensive job for just 1 person and surely they’re entitled to have some time not working.
What facilities would there be expected at the house?
Sorry, I’m very new to all this and just been told today that I should look at organising something ASAP as my relative is no longer managing on their own. They have dementia and are a safeguarding concern now due to quite a few falls out and about requiring hospitalisation, not taking medication properly, not eating much/regularly, not bathing very much, not keeping on top of the house… you get the picture.
I don’t live locally but manage to get up there a few evenings a week and bring dinners from my house, try and do some housework but I’m not left alone at all, they just want my company, take them to the supermarket for fresh/heavy stuff etc, they’re capable to an extent but things are now just getting too much.
Please, any help on where to start looking? How do I know if an agency is ‘good’?

A private carer is unlikely to stay long if they’re being accused of stealing, it’s too vulnerable a position to stay in. An agency carer would have the support of the agency and if they did want to leave (or your relative wanted them to leave) they’d immediately be replaced by another agency carer. However you could have a look at The Lady magazine to get an idea of how people find carers/jobs.

The job isn’t gruelling or relentless, it’s tiring but can be interesting and fun, often you feel really valued by the client and their family, and it’s hugely rewarding to know you are helping a person with dementia feel safe at what can be a frightening time of their life. We’re not heroes, we’re just low paid workers and the best thing you can do if your relative does employ a live-in carer is make sure their working conditions are good eg. they have a comfortable bedroom, their time off is honoured, separate night carers are employed if the carer is being woken regularly.

The Penderells looks very interesting, thank you @myheartskippedabeat

When DM needed live in care, we used https://www.country-cousins.co.uk and were very happy with all but one of the people they provided over several years.

The agency levy their own fee separate from the fees to the carer, which is paid direct to the carer, so we know exactly how much they are paid.

They came for two weeks at a time, we built up to having three such carers regularly, typically one after the other, so two out of every six weeks. This worked quite well, they could have a rest or move into other clients. Two weeks at a time seemed manageable, too.

This is an advantage over having private carers who will need holidays etc.

They typically worked ten hours in two blocks, morning til lunch, time off in the afternoon and then back in the evening.

They were available for callouts overnight with a tariff agreed in advance based on the likely number of callouts. Up to two callouts overnight could be accommodated in the usual daily rate. If more than two happened regularly then different arrangements were needed, either a second live in carer or another carer to come in daily daytime.

Clients who need help with toileting are charged at a higher rate.

They provided help with washing and dressing, cooking and light housework. It was expected that there would be a separate cleaner and gardener etc.

Overall they did a great job and kept DM company very successfully until she started to need overnight care and two people to move her, at which point a care home became more suitable.

Hope you find what you need.

Thank you @myheartskippedabeat I’ll look into this.
I’m with you in that we will do it until it becomes not manageable any more. He’s got money, he can afford a good standard of living and care, if he prefers that to be in his own home and it’s working for everyone involved then that’s what we shall strive for.
But yes, I think he would benefit from sociable activities.
The lady I spoke to this evening has registered him for dial-a-ride to take him to an age concern centre which he used to really enjoy but his local one closed down a while back now. It was great for him but he really missed the outlet, the company etc so I’m thrilled that she has helped put this back in place for him and he said he was happy about it too.
I didn’t even know that dial a ride was an option for this, I suppose I had maybe thought that they were for hospital transport which is silly really as I know that’s not the case at all when I think about it.

From what you have put on here he doesn't sound like he definitely needs overnight or full time care.
I'd suggest a carer in the morning to go in help him wash, dress and make sure he has his breakfast and takes his medication.
Then lunchtime visit to help him get a hot meal at lunchtime, take medication etc. Perhaps then going on to do things like shopping in the afternoon.
Tea time call if needed or carers to prep sandwiches for him to help himself to.
Evening call to help him to bed and prompt eating sandwiches if not eaten.

If he's a fall risk then get him a fall alarm. It's a big deal going from living independently to having someone with you 100% of the time. Some periods without carers would give him some space. So longs as he isn't a risk to himself whilst alone.

Ready meals and prepared sandwiches are your friends in these situations. There are some good companies out there providing decent options. Including doing smaller portion sizes. Lots of elderly people don't want to eat the same quantities as we do. Having snack options about is always a good idea too. Ultimately it's as much about getting calories in as anything. Swapping things like milk and yoghurts to full fat options etc.

jobs.lady.co.uk/jobs/any/?sector=6054&over

You could place an advert on here

I found one of my ladies thru local social media she'd been working for another family in the area and her client had passed away and she posted saying she was looking for work so I messaged her and got references and she's perfect and her last family she worked with only had the best things to say about her which was reassuring

The other 2 I got with Penderells trust but after they found them I now employ them

@Wisterical in my eyes anyone that can help me help him is a bloody hero. This is a huge weight on my shoulders at the moment and I just can’t juggle everything. My own dd is currently having a mental health crisis and is taking a lot of my time, I’ve had to beg/borrow/steal some tiny amounts of time off work to look after for her and we are having daily calls/meetings/appointments to help her recover (while also trying to squeeze in what work I can at home around her).
I’m also battling with this particular relatives impending divorce and solicitors etc.
It’s taking a huge amount out of me and it’s putting a lot of stressing dh and I.
If we can get my relative in a safe and stable environment at home with help I will feel an enormous sense of relief for him and this should hopefully free up some headspace for me to deal with my own crap!
I’m currently running myself ragged driving 100 miles each way a couple of times a week and then bringing him down here for weekends when we can, it’s just not sustainable for much longer without me reaching total breaking point.
I’m aware that it might not last long with him having people in to care for him due to accusations which is why I initially thought of agency staff but worried that the low pay wouldn’t be enough of an incentive for them to put up with him to be honest. I find it hard caring for him and am not doing a good enough job at it, and I love him. I don’t know if a stranger will be able to hack it I guess. But I suppose it’s their job.
I don’t know, I can’t continue twisting myself in knots about it and trying to consider everyone else’s needs over his. I think this is why it’s taken me so long to think about putting something into place.
It’s just hard to know if I’m doing the right thing by him

@Dobbyafreeelf I looked into getting the pull cord alarms in his house not that long ago but he got quite cross about spending money on it he said he didn’t want anything like that as it was a waste of money.
Yet willingly handed over 6K for some absolute cowboys to take his old garden fence away. Not to install a new one, just to remove the old one. They didn’t have to take it down or anything, he did all that himself.
Literally just carried the panels and post to their van and drove off. For 6 grand.
His perception is totally screwed and has no idea that the whole thing was ludicrous. Yet wouldn’t contemplate spending money on pull cord alarms for his safety. You just couldn’t make it up.

And yes, I think he might find it all quite overwhelming going from living alone to having a constant housemate.
But the carers coming in twice daily just didn’t work out for him because he doesn’t trust people aren’t out to rob him.
Now I’m back to leaning towards a care home for him.
You see how I’m just going round in circles

Would he accept a camera in the house? That way the carers have some protection? I'm a self employed carer and would happily work with a camera running if it made a client feel more secure.
Do you have power of attorney?

A camera is something to think about. Never considered this actually. I recently installed cctv outside his house because he was adamant that people were driving by his house and pulling up late at night and casing the joint!
Yes I have POA for both health and welfare and financial.

You have an awful lot on your plate. This is a familiar situation to live-in carers. I often went into a placement as the first live-in the client had had and it wasn’t unusual for the family to be at breaking point, and the client to be dubious/resistant to live-in care. It usually settles down quite quickly - honestly! It will be much easier for an experienced carer to look after your relative than it is for you, and if you are absolutely honest with the agency/carer about the situation they will be well prepared.

It can feel less intrusive for a client to have someone living in, rather than having different carers in and out throughout the day. And trying to coordinate a package of carers/services from a distance could be really stressful for you. It’s lovely what you’re trying to do for your relative - you’re a bit of a hero yourself @TheChosenTwo

Thanks for the kind words of reassurance @Wisterical
I don’t think I’m coping very well with it all at the moment hence my indecisiveness, it’s usually a good indicator of my own sanity!
I believe you that with everyone being as informed as they can possibly be that it can all settle down quite quickly, and in some ways I think having one or two sole carers that he will get to know may be better than an assortment of agency workers coming and going.
Even before the accusations of someone rooting through his bedroom came to light it was clear he was unhappy with them coming in and out all day. He likes to be able to go out and come home as he pleases so it just doesn’t suit him.
He’s actually really good company when he’s relaxed and lucid, got a great sense of humour and still has a twinkle in his eye a lot of the time. He’s quite mischievous and tries to wind me up. We do have a laugh and I’m keen to retain as much of that for as long as possible I suppose.

There are many accredited agencies providing live in care or daily care.

The one my relatives use set a rate to be paid to the live-in Carer of about £780 per week, and then there is a fee to the agency.

The carers stay for 3 weeks or a month, (2weeks before COVID, but now placements are longer) and are then replaced by another.

The carers get a 2 hour break each day which you need to cover in some way, maybe with another agency Carer. (£17 per hour, thereabouts).

I agree: you need to contact Adult Services about a needs assessment.

Also Age UK have excellent info pages on any entitlements your relative may be eligible for, and how it all works.

You may be able to get a care package to subsidise the cost. If your relative owns their house the LA can pay and then recoup from the eventual house sale.

The alarm for falls is a small wristband with a button on it.

My relative was extremely resistant to having care and didn’t acknowledge the need for it. But then not being able to acknowledge the need is exactly part of the reason it is needed!

Plus not realising or acknowledging the impact on you. Another of our family members was reduced to significant mental health issues because of the relentless burden and worry, before we took the ‘hard hearted’ route of insisting on carers.

It didn’t take that long for the to be incorporated into the routine.

If your relative is settled at night then a live-in carer sounds like it might work.

The carer should have a 2 hour break each day, and not be regularly disturbed at night. Lots of agencies will offer live-in care.

It is quite a big thing to have someone living full time in your home. We had to arrange live in care for MiL last year for a short period after she was discharged from.hospital. She hated it and was vile to the carer. Luckily it was just for 6 weeks.

Good luck

We have a relative with round the clock live in care. It’s expensive but worth it if it can be afforded.

Would a live in carer also be able to take their person out if a car is available with all insurance paid etc?

@CiderWithLizzie

Maybe he doesn’t need a 24 hour carer yet? My parents had a team of 2 carers who came once every day plus meals on wheels (sorry can’t remember which one we used) and a twice weekly cleaner. This worked very well for a year or so until a fall and various other medical issues meant it wouldn’t work any more. Hope you can get it sorted.

Agree with this. It sounds like he needs visiting carers currently not live in. As his care needs increase then you can consider increasing. It can sometimes be counter productive to over do it on the level of care as it reduces independence and then things rapidly spiral down quickly.

I was really surprised at how many days my friend's mum's carer works without time off, and how many weeks without a proper break. But this is her choice - the agreement says daily 2hr break and I think a fortnight every 6 weeks, but she prefers the longer stints.
She does get down time as the mum doesn't wake and be got up until 11ish, then sleeps a lot of the day, and goes to bed about 6. But the carer keeps the house spotless, cooks, arranges medical appointments etc, and otherwise sits and reads or sews companionably with the mum.
She is great - couldn't ask for better.

@KickAssAngel

Would a live in carer also be able to take their person out if a car is available with all insurance paid etc?

Yes.

Personally I wouldn't go with anyone being there full time for several weeks. Consistency is really important for people living with dementia. In my experience it is better to have a small number of carers working in a familiar pattern. Otherwise you can inadvertently cause them distress when the familiar person goes home. The gaps are too long between seeing each carer.
Far better to have 2 or 3 carers working in rotation so faces become familiar.

There was a really interesting documentary on dementia last night on bbc I think, it was the first of a 2 parter. I’d guess it was a repeat as it was on at midnight. Very insightful.
Im just sitting tight at the moment until i hear back about the meeting, there are too many options and avenues for me to explore without having narrowed down to what they are suggesting.
I’m so appreciative of everyone’s comments and I’ll be looking back at this thread when I have more information, thank you