Housekeeper / nanny planning advice for when terminally ill mum moves into granny annexe

[ThatKeenPeachUser]

Hi! I was wondering if I could get your ideas/opinions on who you'd hire and for what sort of hours if you were in my situation. I have an 18 month old toddler and am soon to have my parents move into an annexe we are having built in the back garden, as my mum is quite unwell with a degenerative neurological condition. I will be her carer, which at the moment is just making her meals, supervising her eating them and taking her on outings/to appointments, however in the near future her needs will increase. I also run my own little consulting business, which does mean my work is flexible and can hopefully fit around these responsibilities. But running a business, looking after a toddler and an unwell mum is a lot! To make it all work with these extra responsibilities, my partner and I will need to hire either a nanny-housekeeper or a separate nanny and housekeeper. My dad can also look after my mum but he has his own health issues so it cannot be relied upon. My parents have offered to pay most of the costs of this extra help we'll need, which is great, so we do have an ok budget to work with.
I wanted to get opinions on, in this situation, what roles would you hire and for what hours? And any tips/ideas in general! The routine we establish will be so important in making the balancing act work, and making sure my mum has a good quality of life.
FYI, my son will be at a childminder from January, 8:30am - 3pm Monday - Friday and until then has a nanny as part of a nanny share 9-5pm. My parents will move in in mid September so our new set up needs to be from then
thank you!!

You need a elderly careperson dedicated to your mother.and with adult care experience potentially future nursing care needs like injections?
Separately whatever you need for you maybe nanny housekeeper
Assume your mother will need full on care and support so you likely cannot mix with a childcarer

Nursing and nannying do not mix. Palliative care is personal nursing care, hygiene, medical assistance and 24 hour. Very different to what you are currently providing. I'd talk to an organisation that deals with your mum's condition, to get a realistic picture of what is to come and then plan accordingly.

Surely you would be better looking for experienced care for your parents?

Thank you so much all for your perspectives, I really appreciate them as I am very new to this! Very grateful. The caring role at the moment is not very full on as my mum is quite independent still, its just the cooking and eating that she needs help with, plus outings. Which is why I feel like right now I would quite like to do that, as it also means spending more time with her, which I really want to do and is very precious. However as things progress I am aware that an elderly carer is what we will probably need, perhaps for first thing getting up/showering/dressing/breakfast. However, setting up stuff so I don't need to do much housework or childminder drop offs/pick ups would ease the load a lot - to make it all manageable and to spend as much time with my toddler son and mum as possible - especially with them together as my mum gets so much joy from being with her grandson.
thanks again i appreciate this a lot!

Once your childcare starts in January, will you then have sufficient capacity to enable both your work and caring responsibilities, or will you still need extra support with the caring? When your toddler is unwell and can't go to childcare, is your work flexible enough that you be able to care for your mum and also care for your toddler? Or will you need backup childcare to enable you to work? What about when you are ill yourself?

If you can juggle work and caring, then it sounds like you just need some temporary help with childcare between September and January, and then a backup plan going forward. But if you still need help, then I'd suggest you focus on one specific thing (e.g. caring) and free up a larger chunk of your time that way, rather than juggling different people doing smaller things?

Good questions! Considering what we do when me or my toddler are ill is so important and tbh I hadn't thought about that bit. I mentioned before we have full time childcare now, so I am ok on that front, it just changes in Jan to childminder rather than nanny and slightly diff hours

It's the mornings and evenings I can sense will be tricky. I think I will be ok juggling caring and work together, in the day, they can be compatible. But when one of us is ill it could throw a carefully thought through plan out the window! Thanks for pointing this out!!

I think initially hire a cleaner/housekeeper who is basically an enhanced cleaner eg comes for 3 hours twice a week, puts on laundry, changes bedding, does basic organising like kitchen cupboards and can think for themselves. If they are willing to cook a meal that can be reheated on those days/load the slow cooker up even better. Separately look at elder care services eg sitting service if your mum can’t be left for extended times, getting her up and showering each day, perhaps these could be the same person but it’s hard to find (we did)

Do you have any experience of being a carer for an elderly person? And have you talked to people with experience of having elderly relatives live with them or very close to them.

I grew up in a similar situation to the one you’re describing and there is absolutely no way I’d do the same thing to my own children. The needs of the children and the elderly person/people become increasingly hard to juggle alongside each other.

What happens when you want to go on holiday? Or are ill?

Rather than a nanny to free up time to care for your mum, in the longer term you should consider hiring carers to free up time to spend with your DC, and this also allows you to be DP’s daughter not their carer. Plus they’re practiced professionals who will do it better than you. Don’t get sucked into ‘we moved here so you would look after us, not a stranger’. It’s incredibly tough physically, mentally, and emotionally to provide that kind of care for someone you love.

Planning to combine mum and DC time might work for a while, but it will become difficult, and will eventually expose DC to things they don’t need to witness. DC should be your priority here.

It’s a very kind thing to move DPs close (my PILs are next door) but with kindness you don’t seem to really understand how hard this will become. Set priorities and boundaries early. Take care OP.

Gosh, this is a big ask of you. Your parents are really happy to proceed with this?! Those I know who’ve gone down a similar road have all ended up on antidepressants. It’s not a life I’d foist on my busy adult Dc with jobs and families of their own.
I would make sure your parents are also paying into a pension for you.

Christ, I wouldn’t entertain this. Have you any experience of caring for the elderly/ill for extended periods of time? When she starts to deteriorate you’ll be run ragged, so make sure she’s going to accept outsourced carers. They will need to take the lion’s share of the work if you have a child, house and your own business to supervise. Also consider how long this scenario may run for - sorry to be blunt but your mother may be replaced by an ailing father. Start as you mean to go on and pace yourself would be my advice. It’s all very wearing.

Thanks so much all for your very frank perspectives, honestly i appreciate it a lot. My parents aren’t anti having carers, in fact that would have been their initial assumption. It’s just I want to spend as much time as possible with my mum in the limited time we have together. It was also my idea for them to move to the annex - again, because I want to be close, and I know how much of a difference it makes for my mum to see us a lot. I haven’t been happy with the care she’s been recieving at the sheltered accommodation they’re currently in - it’s a different person every time it seems, maybe agency staff, and they don’t seem to know the breif - eg crucial safety things relating to how her food is cut up (many people with her condition end up sadly dying due to food aspiration as it affects swallowing). When she’s fallen and needs to go to a&e they haven’t taken her or even called me to tell me.

So if she has a carer come in a couple of times a day perhaps, but in the annex that would be much better as I can hire and breif them etc.

I am aware it’s going to be tough - but of course you never know until you’re in
it just what it’s going to be like. What we do have though is a decent budget for some
help, which feels incredibly reassuring and makes it all feel possible. The question is, what to spend that budget on. Seeing everyone’s answers here, it seems like carer time is maybe more important than nanny time… a good idea to protect time with my DC and DH.

Thanks again for your thoughtful and frank responses - I am grateful! 🙏

I know this is a bit off topic, but my advice would be consult an occupational therapist about the annexe, if your mother has a degenerative neurological condition she will at some point need significant equipment to assist with getting her in and out of bed, in and out of the shower, and ultimately a specialist bed with specialist mattress to be able to nurse her in bed. Thresholds will need to be wide enough for a wheelchair etc. An OT may also be able to give an idea of prognosis and time frames of deterioration and level of care needs to help with your planning for care. Mornings will be a pinch point- who will you be getting washed and dress- your child or your Mum? No right or wrong but both need care over a 24hour period and certain times will have more competing demands than others.
If you get a nanny, do you want someone who is happy to do both sole and shared care- if you want to spend time with mum and toddler together they need to be happy to be in the family mix when working. Some nanny's would prefer sole care so best to check this at interview stage.
I'd also start putting feelers out for carers now- good ones can be hard to find in some areas, and you may need double up care when things progress and carers will need to be trained and competent with the appropriate equipment.

It’s worth talking to a solicitor and maybe also a financial planner too, depending on whose money is being used to build this annexe and who it will ultimately belong to. Are your parents selling a sheltered living flat to pay for it or using their savings? You could end up in a mess if one or both of them end up having to go into a care home when their care becomes too much but this could be a problem if their money is locked up in an annexe on someone else’s property.

You've said there is a decent amount of money to pay for care but only you can know how much that is, to be blunt what the prognosis is for your mum and what state of health your dad is in. Decent could be £50k to one person and more than a £million to another. I have one relative who has already got through about £400k paying for care.

Thanks for these pointers, super helpful thinking. My parents aren't paying using their sheltered living flat, its from separate savings. If they needed money for a care home that would come from selling other property they own and currently rent out. I had considered speaking to a financial planner but hadn't thought about solicitor.

and gosh - £400k for care is so much!

The condition is hard to predict as everyone who has it seems to have different timelines and symptom onset. And healthcare professionals/doctors never seem to to want to say anything concrete

I think you need to think this through much, much more carefully. You seem very naive about what the future holds. Consider:

Will the annex accommodate a wheelchair? Is it being fitted with grab rails and ramps and a wet room that can be accessed by a wheelchair? Is there room in the bedroom for a specialist bed for your mother and a hoist to help lift her in and out of bed?

Are you experienced in personal care for someone in your mother’s condition? Are you physically strong enough to be able to manoeuvre her for toilet trips, washing her, changing her clothing, etc? Will you be able to lift her by yourself if she falls?

As her condition progresses, are you knowledgeable about how to manage her food preparation so that she can continue to eat for as long as possible?

Do you have medical and financial power of attorney for both your parents?

Have you liaised with her GP and any consultants she is seeing?

Can you afford respite care? Are you prepared for the fact that once you step in as her carer and the NHS and social services have you identified as such, it will be incredibly hard to relinquish that responsibility, even if you find it all much harder than you anticipated and need help?

I know I make it sound incredibly bleak. But I speak from years of exhausting and distressing experience. Please don’t go into this without really researching what lies ahead.

I understand about wanting to spend time with your parents but if you get sucked into personal care and are knee deep in incontinence pads, physio and meds or whatever it won't be quality time. IMO better to get carers in to do the caring and spend your time with them as social time - building their relationship with your DC, trips out for coffee/pub lunch/garden centre/watching TV/ nattering at the playground or whatever floats their boat. When they are gone you won't be wishing you'd spent more time changing pads but you may wish you'd spent more time chatting and laughing.

and gosh - £400k for care is so much!

it adds up very quickly. My MIL has a live in carer at £950pw also my FIL has 4x daily visits for personal care at c.£875pw (he has 2 at a time because he’s so heavy).

£400k is slightly more than five years of
care in a care home. It would be a similar
cost for live-in care usually (more if overnight care needed so more than one carer).

Nursing care of the type the OP’s mother will end up needing can be over £2k p/w in a care home. £400k might not even cover four years.

"So if she has a carer come in a couple of times a day perhaps, but in the annex that would be much better as I can hire and breif them etc".

Who is going to pay for these carers and where are you going to source them from?.

I am so sorry but you come across here as terribly naive and I feel moving them into your annex will cost you ultimately your s/e job. Your relationship to your child and husband could suffer too and your mental health could go down the pan. Caring for relatives like you're planning to do is both a thankless and painful task. And what happens if your child or you get sick or are otherwise incapacitated?. I would urge you to think again.

It is unlikely what you want to hear, but it sounds like a lovely and well-meaning idea that has the potential of going horribly wrong. Others already pointed out the challenges of becoming a carer to your mum, this massively changes the dynamic and will unlikely give you the quality time you are hoping for. Have you got a plan B in place at all? As in, what happens if the reality of caring for your mum means that in a couple of months time you end up burnt out or even injured from being on call 24/7 and doing the heavy lifting? If your parents have used up their savings towards the annexe, this could be considered as deprivation of assets and they could be treated as still having the money if assessing their financial situation for care.

I am very grateful to all replies and the time you’ve taken helping me think it through. I know many of you have had or are having really tough experiences looking after parents and relatives - I really am
grateful even to v frank responses, I know many of you have lots of life experience here.

I don’t know though in my original post if I was v clear about the stage of the condition my mum is at. It’s early to mid stage, my mum is still mostly independent now, apart from mealtimes which require supervision due to choking risk. Eg she can dress, shower etc by herself. So the advice I’ve been asking for has been about the situation now. Care needs will evolve, we will need more of it I know. I do think some posters may be responding thinking I’m asking maybe about what our set up will be when the condition is much more advanced. At the sheltered accommodation my parents are in now they only have 30-60 min care a day, at lunchtimes.

In terms of experience , I have been the main person already helping my mum manage her condition. So I know her consultants, physio, OT and have been to many appointments. I’m with her a lot. She broke her neck a couple of years ago with a fall, related to the condition, and I was her carer then - she stayed in a ground floor flat on the same street as mine and the set up worked really well. So I guess I learned from that experience that life is easier for me too when she’s physically close.

my big takeaway so far from everyone’s replies is that even from this early stage, it would be more sustainable to have a carer in rather than just free up my time with a nanny/housekeeper so I can be the carer. This will also set the tone for later on as care needs increase, it’s not assumed it will be me. So thank you!! I appreciate your responses!

Is the annex attached to your house - i read it as a separate garden room building. You may need an occupational therapist to assess it. Fir example as to whether there a safety or nobility issue.

Mobility - sorry!