If your parent has (paid for) care at home what do they do?

[Honeyroar]

My 82 year old mother has a care firm send carers in for an hour on weeknights. It costs over £35 a day for an hour’s care. They do very light housework and give her her evening meal. But it’s only defrosting something I’ve already cooked or giving her a ready meal. I thought they’d do more of the cooking, but they don’t. They often forget to put bins out on bin days. I’d give them 6/10 overall. Now mum’s starting to mix up her tablets so I’ve asked the carers to take the daily medicine compartment for each day out of the main medicine dispenser each night and leave it on the table so she can’t get confused which she needs to take. . ( I’ve already preloaded the dispenser with her medicine for the week). They say they’re not allowed to touch the medicine and can’t do that. Im not asking them to open it or give them to mum, so don’t really understand.

So I’m going to have to go down each evening and check she’s had her meds, along with still cooking all her meals and doing her shopping. Im starting to think it’s barely worth having them. Plus it’s very expensive and we could do with cutting costs a bit. She likes the company, but I feel like we could have a cleaner twice a week and a hairdresser once a week, plus I’d be popping in.

It would be better if we could find a private carer, have any of you done this?

I guess I’m just interested in what others do.

My late father used a firm called Blue Bird Care. I think they have branches nationwide. We found them very good. It is a few years ago now so I don't know what their current charges are but it might be worth enquiring if they operate in your area

My mum had two care visits - 45 minutes in the morning and 15 minutes at night.

In the morning they would help her dress (she claimed she had already washed although I know that wasn't the case), take her through to her living room, give her a cup of tea and breakfast and hand her tablets. They weren't allowed to take them out of the packets - I would leave them in a pot and they could pass them to her.

In the evening the carer would take her back to the bedroom, help her undress and get her into bed.

They weren't coming to do housework, just to get her up and into bed.

Her contribution towards the care was assessed at £ 100 per week.

Different care agencies, different experiences. Some are really good and some are really poor. We went through a few with my parents.

You may have to change agencies. We also used Blue Bird and they were really good.

If you go to the Care Quality Commission’s website you can check care agencies in your area.

There are also websites where you can sort out private care. Sometimes this works better.

You have to be very specific about the care package you want and exactly what you want them to do each day.

I hope you get it sorted it can be an exhausting experience.

I think medication prompt/provision has to be a SS assessed need. And the carers can't give medication if it's out of the original packaging or blister pack. Who would take blame if she ended up taking the wrong ones, how would you know if it was the carer, your filling it or your mum who'd made the error?

I'm a self employed carer.

I'm a carer not a cook so I would reheat food for people or prepare something simple. But I'm not willing or able to cook meals for someone.

I don't do light housework and nor do I do putting bins out.

I do do medication but only prescribed medication. I'm not insured for anything else. Lots of carers are not insured for medication.

The job of the carer is to provide care. To help with personal care, ensure that they are eating and drinking. And ensuring welfare.

Unfortunately care costs. I charge £21 an hour and I'm independent. Agencies have greater overheads so charge more.

@justgettingthroughtheday am I right in thinking even if prescribed it needs to be in the dispensed packaging so original or blister pack?

Oh lordy, I understand you are a carer but surely care can include a little light housework and putting the bins out? That's all part of looking after someone, isn't it? Welfare? Why can't you do that as long as in your allotted time?

The carers would come in twice a day for my Dad (offered 3 but I would go in at lunch times). But it was hit and miss depending on the actual carer. I always organised all his medication into daily boxes but the carers were not even allowed to pass them to him. He was given a shower but not pressed so unfortunately some days it didn't happen.

They definitely didn't do any housework (we did all that). I'm pretty sure that wasn't an option.

NB I totally get why medication couldn't be passed on. If it were wrong then the carer would be part of it. But I'm just saying that's something that needs to be taken into account.

Not my parent but my daughter is disabled and she was assessed by the adult social services disability team. They worked out how many hours she needed a day/week (hers include social hours) we then were given a ‘personal weekly budget’ and requested direct payments so she can employ a private carer/PA - much cheaper than paying an Agency and the carer is willing to do whatever my daughter needs doing (Inc pills, shopping, laundry, cooking meals, all types of housework but no personal care - my daughter manages that herself)

Yes it must be in original packaging that it came from pharmacy in. So either in boxes/ bottles or in the dispensed blister packs.
Things like paracetamol can only be given with a doctors consent. Ideally it should be written up for them on an as and when (prn) prescription.

Because my allotted time rarely would allow for extras such as putting bins out. We are. Ring pushed to get in and out quicker and quicker. Sadly there is so many people needing care that we have to prioritise them over putting bins out. We don't have time to learn the bin routines of all our clients.

I do things like clear up after myself and take the rubbish to the bins etc. but only care related things.

Ours do medications, personal care, light laundry duties, empty and put out bins, cleaning of relevant areas (eg the cared-for's bathroom but not the family bathroom), take in and sort out deliveries etc. However we have long visit times (2 hours+) to allow all of this. Many agencies allow 45-60 minutes and I don't find that enough. Call round some more providers and see who thinks your expectations aren't unreasonable! Will probably cost you more though.

Ours don’t do housework. We have a cleaner once a week.

They don’t cook, but they will microwave a ready meal or make toast or a sandwich.

They don’t put the bins out but they’ll empty her bathroom bin (incontinence products). Our council know mum can’t move her bins and the refuse collectors collect from where they are.

They help mum wash & dress, & change the bed if needed. I do the laundry.

However, ours do supervise the taking of medication.

We pay £23 an hour (more for weekends & bank holidays). East Anglia, through an agency.

We used to have a care agency. If you change the care plan, like adding medication, it has to be cleared at their office,and added to their duties but it was easy enough to do. They gave mum the medication that we had put in a pill dispenser. It wasn't a problem.

For a variety of reasons we let the agency go. We now pay £16ph to private carers. They give mum meals we leave or make sandwiches, heat soup, make egg on toast etc. My mum leaves it all. 🤬they give her the tablets ftom a pill dispenser we've filled. They do some cleaning, like round the kitchen and bathrooms to keep clean after mum, they put the bins out, do her washing, etc. Mum doesn't get personal care from them. A cleaner comes once a week yo hoover, dust, windows, etc. And she has a gardener. And we do go round and do shopping, personal care and make sure everything is kept on top of.

We're very lucky. And so is mum...if only she'd appreciate it! Basically, it's your money, find someone who will do the jobs that you want doing, not the jobs that they want to do.

Mum is currently main carer for my Dad who has dementia but as she is elderly herself Dad has had a variety of carers.

Initially he had a Social care package which was managed through a direct payment account. This means the council assessed a budget according to Dads needs and the contribution he needed to make from his own funds. Mum also had a respite allowance which she was able to use so that she could get out to do shopping/get her hair done or just have a break. Mum was then able to arrange the care herself and she used a number of agencies plus a private carer. Our experience is that the attitude towards doing more than just personal care varies enormously. The private carer is fab and will do most things including hoovering ironing etc and would take Dad for a short walk when he could still use a wheel chair, Mum used to use her a lot for the respite hours. Some of the agency carers are reluctant to do any of this and I hate to say it but it's mainly the male ones who are reluctant. However I ne of the agency carers even agreed to do an extra hour here and there for a bit of extra cash in hand to do a bit more housework.

Dad now has a CHC package paid for by the NHS and this is more structured initially only allowing for short visits for personal care. However when asked they have added a respite allowance to this so we now have a few extra visits and Mum can get out again. The longer respite visits allow for a bit of light housework to be done.

Mum is a good cook so has never asked for this but she does ask them to put the bins out.

They often forget to put bins out on bin days.

your council should have an assisted bin collection, contact them to organise?

Hi @Mumski45 . Can I ask how your dad got a CHC package? As I understand it, they're difficult to get for dementia. Does he have a lot of other needs? I hope you don't mind me asking.

@MarshaMelrose I don't mind at all. Dad has Lewy Bodies dementia which is a type of dementia which affects mobility more than typical dementia. It is related to Parkinson's.

A couple of years ago he was referred by the frailty clinic for a full MDT to assess for CHC which I didn't think he would get but Mum thought he should. He did not meet the eligibility criteria at that time and was put on a social care package which he contributed to but we were therefore very aware of the level of needs which qualify for a CHC package. He was deteriorating slowly whilst living at home when he contracted Covid in the summer and was admitted to hospital for a few weeks during which he deteriorated quite quickly. In particular he was having difficulty swallowing and became completely bedbound after having been able to bear his weight and move from a bed to a wheelchair before he got ill. He was discharged from hospital with a fast track CHC package which is granted if you have a 'rapidly deteriorating condition which is entering a terminal phase'. At the time I was shocked as I know this is only given if you are not expected to survive much more than 3 months and I didn't think Dad was at that stage. Once home his condition improved to the extent that with some physio he was able to get out of bed again and I was worried he would lose the funding if it was reviewed. However he has since deteriorated again very quickly and is now bed bound, hardly eating or drinking and asleep most of the time and unable to communicate so the assessment in hospital was proved to be correct. 😔

My MIL had carers specifically to make sure she took her dementia medication, this was required by the hospital as they wouldn’t prescribe it without knowing it would actually be taken.

I would switch care providers. Even at her most frail, MIL only ever needed an hour long call when she had a bath. Someone up thread mentioned Blue Bird and I would second that.

Did the current ones come and do a proper needs assessment? Most care providers can give meds as long as the repeats list from the GP or a hospital discharge sheet is available.

Cleaners that we pay for privately. They are lovely and as well as cleaning thoroughly will make mum a cup of tea and a sandwich,put the washing on,empty bins etc. £ 15 per hour

My parents had a private carer and she would make sandwiches or heat food up, help them make the beds, pop a wash load on/ put it out, personal care, and remind mum to take her medication out of the pharmacist made up dosset box/ blister pack. They then had a very understanding cleaner once a week as well

Dad has carers who get him up and showered in the morning and give him breakfast. In the evening they fit his sheath catheter and put him to bed.

There's no cleaning but they do help my mum make up the bed when she has to change it. No cooking either though they heated meals for dad when mum was in hospital.

My dad has carers twice a day but they won't do medication either. I sort out his meds once a week and use a box with the days of the week on it. It's left on the kitchen table and he always takes his morning lot with breakfast and evenings with dinner.

The carers help him to get dressed, will give him a shave and will put any dishes he's used in the dishwasher. They'll also empty wastepaper baskets but that's about it. My dad also has a cleaner who comes in once a month to do a really good deep clean. Everything else, for example bins, washing, general tidying, house repairs etc are all done by me. I batch cook and leave things in the freezer which the carers microwave.

If you're looking to save money, you could reduce the care company's visits to 30 or 45 minutes. An hour is a long time if they don't seem to be doing very much.