Are there any affordable homecare options?

[Elderlyaupairquestion]

Does anyone have advice on alternative homecare options? Particularly something similar to an adult au pair for elderly care where someone could be around in case they are needed, including occasional help with cleaning up accidents and changing underwear in the night.

My dad has mid-stage dementia and wears a catheter and is occasionally incontinent now with frequent toilet accidents. He is very easygoing and currently prefers to spend a lot of time in bed or sitting on an armchair.

He has carers coming in 3 times a day and currently my brother and myself take turns in looking after him for long periods. We live at different ends of the country though, so we really want to find someone who can stay semi-permanently to look out for him and help him with toilet trips (while the carers still drop in 3 times a day and my brother and I do more ad-hoc shorter visits).

We're hoping someone might be happy to do this for free accommodation, free food, maybe around £1000 a month and be able to still have a part-time morning job (or even work from home for another company), but have an ear out for our dad when needed. And ideally cook dinner for him and eat with him several times a week and keep him company.

My question is, has anyone got any experience of doing something similar?
We're just starting to look into this and have no idea where we can advertise, if this is even a possibility and how to get started.

We've had quotes from agencies which were completely unaffordable for us unfortunately. But we're desperate for any ideas or advice on this.

I'd really appreciate any advice from anyone who has done something similar and managed to make this work?

This type of one on one care is the most expensive there is. Staff that need to care for incontenance issues can demand a high rate of pay. As you are aware,this type of work is really exhausting. It is unlikely that anyone can do the job well and hold down another job too.

the vetting that you would need to do is likely to be beyond your capabilities.

BUPA offer this service and that would be a good place to start to get an idea of the costs involved.

@Elderlyaupairquestion completely unrealistic I'm afraid. Your looking at more like £1000 - £1500 a week for that type of care.

There's an agency called Share and Care, bit less care than you suggest I think, worth looking into though. Cheapest livein care otherwise is 1000 pw, or if living out £25 an hour.

I doubt you would find someone happy to be permanently oncall, especially overnight, they will need days off, rest time. You say he has frequent accidents, is the continence nurse involved, can he pay for a night visit to check him.

Hi everyone, thanks so much for getting back on this. I realise it's unrealistic for full time care, and we also found this based on previous agency quotes. However, we do have the 3 drop-in carers a day who do much of the toilet help. So it really would be someone for less care work and more company / keeping an ear out (although occasional care work might be needed too).
I've heard of elderly au pairs before and really hoping someone might come along with some advice (although in reality when looking into this I've found it super hard to find more information). I realise that this type of arrangement might be difficult with a dementia patient though (albeit a very easy going and amicable one).
With days off, my brother and I will still come but we're hoping for shorter and more ad-hoc visits. We've completely turned our lives upside down to care for him over the last year, and so we're really hoping someone might come along with some creative ideas for that wrap-around company (with some care) when we can't be there.
Our dad didn't have a company pension but (only just) doesn't qualify for council help. So we're funding everything ourselves. But it's just so, so expensive.

Thanks @HappyHamsters for your comment about the continence nurse. He doesn't have that actually so I'll look into it and see if we can get some help to deal with that.

I'd suggest you seek advice from the Alzheimer's society, Carers Uk and Age UK.
I had 1:1 care I place for my parent whilst I was working. Otherwise I did the bulk of care. It still cost over £60k a year via an agency. That was pre-Covid. Costs are astronomical.

You asking for a waking night that willl not be cheap

with cleaning up accidents and changing underwear in the night.

https://www.elder.org/pricing/

No help at all? Are you sure OP?
I would ask for a Social services needs and financial assessment and also see if he may qualify for CHC funding x

Hi there, we organised for a wonderful lady to come and live in with my father from South Africa. The company I think is is called Country Cousins. They come for 4 months at a time then swap over. She was more like 3,700 a month but there might be other options from them like part time/work from home carers. They are older ladies who work for the company and we have been impressed. Though I think medical care is out of their remit.
Have you thought about placing an advert somewhere? I am not sure how you would vet people but perhaps even asking on Facebook etc - someone you know might know someone it would suit. Good luck x

https://www.helpinghandshomecare.co.uk/home-care-services/overnight-care/what-is-overnight-care/#:~:text=Overnight%20care%2C%20also%20known%20as,breakfast%20or%20taking%20bedtime%20medication.

It's kinda funny on here, if you were looking for a live in as hoc mothers help, everyone here would tell you to go to the lady. Old person, forget about it.

I did a job share (had a nightime live in carer), was one of my nicest jobs ever but VERY boring. Mum just needed a babysitter really and she was quite set in her ways re interaction so I mostly did ironing or cleaning to keep me entertained.

Oh yes look at The Lady ads

If he's over the limit for free care, then he pays, not you! When his savings go down he'll get free care.

www.shareandcare.co.uk
is the homeshare agency

If you advertise you might be lucky. However dementia is a progressive disease and what works now might not be suitable in 6 months time.

I do this. I'm a self employed carer and when my clients deteriorate I live with them for £500 a week. It has to be local to me though and they have to let me take my little dog and do my part time job.

So yes, there are people who do it but not for £1000 per week

We're hoping someone might be happy to do this for free accommodation, free food, maybe around £1000 a month and be able to still have a part-time morning job (or even work from home for another company), but have an ear out for our dad when needed. And ideally cook dinner for him and eat with him several times a week and keep him company.

I'd stop thinking in terms of this being a good deal for someone - free xyz, still have another job etc - and be honest that it means someone dedicating their life to being there and looking after him. No one is going to do that for 1k a month. Without family bonds/unconditional love/duty in the mix, the only people who would do this can charge a lot. I completely understand and agree it's really hard - I've got a similar situation looming and also live far away, but if we can't do it ourselves then we have to be clear eyed about the commitment involved and the cost of it. Thinking it's easier because he has carers coming in as well is kidding yourself - you're still making this person primarily responsible for him and that's what costs, as much as making his meals and keeping him company, which is also a big ask. This is why people end up in care homes, but this interim period is very hard and costly so I wish you good luck and strength.

I don't think this is realistic I'm afraid, certainly not for £1000 a month!

There are home sharing arrangements where someone (often a student or someone young in a big city who can't afford to rent on their own) gets to rent a room at a v cheap rate in return for providing companionship. But that's not providing care, and definitely not toilet/incontinence help! Even an elderly au pair wouldn't be suitable as they can only work a limited number of hours, not available for waking nights and v difficult to find now anyway.

It's unlikely to suit someone who can WFH - my employer's WFH policy explicitly states I cannot be responsible for a child or elderly person whilst working. It's also intense - there's no way I'd be able to do it whilst also waking at night so deal with incontinence problems!

Live-in care is expensive because it's hard to find suitable people who are willing and able to live in someone else's house. Minimum wage will soon be £11.44 an hour so £1000 a month, would only pay for 2-3 hours a day of care/companionship/meal prep/dealing with toilet issues - is that realistic?

How much does he have in savings as he should be paying for this? Once he's below the limit then SS should pay but will assess on his needs. If you're struggling to manage at the moment then you need to tell SS you're stepping back.

I don't really understand why you're funding this - it should be coming out of his savings and then sorting out his house to fund it (assuming he owns his house?)

The best thing would be for him to have a care needs and financial assessment, possibly a capacity assessment too from social services and his district nurse or gp. He may benefit from some adaptations at home which are free to £1k, continence services care alarm etc. Does he own his home, would he consider moving into more suitable accommodation for the future like an extra care facility which you rent but have 24/7 care on hand. L8ke others say you shouldn't need to be paying for all this. Do you have power of attorney.

If you're going to speak to his gp or district nurses you can ask why he is being incontinent, is he constipated, not able to get to the toilet, a commode might help, he may also find a hospital bed comfortable, does he use a walking frame or have any equipment at home. All this is available from the community therapists.

Forget about someone being able to work from home while caring for your dad. I know a few people who have tried it with their parents and it has never worked.

In the kindest way, this is unrealistic.

When my dad had dementia & became incontinent it was a sign that he needed nursing home care.

Incontinency is unpredictable & messy, plus compliance with pads/pants can be an issue - my dad would just take them off & wet the bed.

By this point his overall dementia had progressed & the other behaviour associated with this were starting - spitting, difficulty swallowing, anger etc - very out of character for my dad.

Things were deteriorating on a monthly basis & we made the decision for a care home, as we wanted to pick one for him rather than to wait for an emergency admission & be allocated one.

You have some tough decisions ahead, but please bear in mind you might not be in control of the process.

@Elderlyaupairquestion, my sister's friend is a live in carer for an elderly lady who is frail but still has all her mind working. She lives in 3 days/nights one week and 4 days/ nights the following week. She gets paid £700 per week and the lady she cares for has a cleaner 3 times a week and a gardener. She gets her scrambled egg for breakfast, 1/2 a sandwich with no crusts on for lunch and cooks small light meals a couple of times a week and the lady has frozen meals bought in other days and they just need microwaving. Another carer gets paid the same for rest of each week and the carers get paid off or holidays and get paid properly with employers NIC etc. I think £1k for a whole month is wildly optimistic. The hours they are with the elderly person overnight are counted as they are on call if there is a problem or the person needs the loo or anything, so you'd need to be careful you were covering at least minimum pay plus antisocial hours pay normally and employers NIC'S.