Arranging live-in care for elderly parents self-funding, advice please

[NetZeroZealot]

After several recent crises, DP have at last agreed to a live-in carer. Luckily they have an annex in their house which is ideal accommodation.

We want to put this in place in the New Year.

Mum is early stages dementia and was caring for Dad who is very frail, but they don't need round-the-clock care. Help with basic day to day stuff, reminders to take medicines, food planning and preparation, occasional driving to appointments, no personal care. They already have a cleaner.

Grateful for any words of wisdom from those who have been on this journey already. Thanks

My DPs recently had temporary live in care.

I made a little booklet up of routine and how they like things for each bit of the day, which the agency said was very helpful.
Including what to lay for breakfast and where to find things etc.
Photos would have helped too.

Also a cupboard in kitchen for carers own items, and hanging/drawer space in bedroom.

The carer will have a separate annexe with bathroom & kitchen so no issues with having space for their stuff.

Fabulous set up for a carer.

We went through a few, but my DM was quite "challenging". She didn't like the way some if them cooked. She argued with the Greek (DM is Italian), she drove the Czech lady to tears (who was so lovely), the Russian only lasted a week because she couldn't to cook and was fat (DM insulted her).

Mum didn't want any black women, so that was limiting.

The British lady had the measure of DM and actually was very good with her. She did walk off with some jewellery and paintings.... Not great, but she saved my sanity, so I let it go.

Did you get them through an agency Hosta?

My DP are fairly easy going, but my Dad has said he doesn't want anyone who is fat! (I'm not exactly skinny myself).

Shocked about the theft ...

The deal was 3 hours (?) off every afternoon.

Do you want carer to be in room with them during the day? Or if not how to call her if needed?

Car driver needed?

yes, car driver will be essential. And one of the agencies I spoke to suggested a call button or something between the annex and the kitchen.
Time off in the afternoon is fine as they usually nap then anyway.

You can get plug in door chimers. My parents have these all over the house and my DM has a caller round her neck so wherever she is she can call Dad, and wherever he is he can hear the call. A second doorbell is at the front door which makes a different ring tone.

Yes a local small agency in the village. They were pretty good actually, very understanding, thank goodness.

Not theft exactly. She kind of manipulated DM a bit, by saying ooooh I like that, I like this, and DM would just give her stuff. So DM essentially gifted stuff, but really she shouldn't have accepted it when she knew DM was vulnerable.

I'm just a bit spicy about it, because they happened to be things DM had left me in her will..... C'est la vie.

Your first decision is private carer v agency carer.

Agency carers are vetted (to an extent) have some training and can be replaced if not a good fit, sick, family emergency, annual leave. Agency also sorts out all the employment issues - contracts, tax, NI, insurance etc. They will also ensure you do not inadvertently create a tenancy in the annexe. Expensive but worth it.

Private carers are often cheaper. But unless you have personal recommendations, vetting can be an issue. You also need to think about sickness and holiday cover. You will need to be on top of all the payroll, insurance and tenancy issues.

I see the appeal of a live in carer over a care home. But be aware that there are no safeguarding guarantees when an individual works alone. And looking after elderly people with dementia would drive a saint crazy. I I know care homes also have issues, but at least there are other staff to whistle blow and cameras.

Cost of a live in carer v high end care home about the same for one person. But you will be looking at a minimum of £ 70,000 plus pa. Obviously lower than two people in a care home.

Go into it with your eyes as wide open as possible to the realities.

Some examples:

1. It’s not 24/7 care. Several hours off a day and not routinely woken at night is usual.
2. Costs - generally expected to cover living costs.
3. Influence on the clients life. Someone there all day every day can really start to influence the clients way of thinking. Whether that’s pro / anti care home, exercise, family members, choice of to program, politics, spending habits, gifting etc.
4. Not easy to replace overnight (whereas visiting carers through an agency are usually consistently available as the agency arranges cross cover).
5. How long they do before a break. What the cover arrangements are. Whether they’ll come back.
6. smoking and drinking habits.

An elderly neighbour of ours used this agency a few years ago and was very satisfied:

Nationwide Live-in Care Providers | Country Cousins

Yes, the booklet is a really good idea. I also made up a folder of photos - family members, favourite holidays, pictures of favourite hobbies etc (eg lots of the late queen) and labelled the pictures so that they could look through them together and the carer had enough clues there to ask questions/prompt memories.

We struck gold with the carer who looked after Mum and Dad - found through myhometouch.com She had 2 hours off in the afternoon and was ok being woken once if needed overnight - same for an aunt, who needed care.

Thanks a for the advice. Responding to a few points:
Currently have 2 carers coming in for 1-2 hours a day 6 days a week.
But DP now need support in the evenings as that’s when most things go wrong, eg Mum had a fall a week ago. Not too serious but next time it could be.
Care home ruled out. Their needs are not great enough, they have lived in the same house for 40 years with lots of lovely neighbours & have the space to accommodate a carer. They don’t need it yet & would never agree to it.
Dementia not yet diagnosed but I’ll be amazed if it isn’t. No irrational behaviour (yet) but extremely forgetful, repeats self a lot.
I think we will probably go the agency route for reasons many have mentioned. It feels like an extra safety net.
Thanks for all comments so far.

Also no night time care needed currently. Both sleep well.

I would recommend looking at a few agencies rather than one person. The agency should have their employees trained in manual handling, safeguarding etc. also arrangements for rest breaks, annual leave etc.

I’ve seen it work really well. Good luck.

I had one for my late Dad.
She has worked for various agencies and came with full references, but I was lucky enough to be recommended her privately.

It was extremely important that they got on, esp just the two of them. She stayed until he died, and in the last few weeks said he needed night care too so we found one through an agency who was awful, not at all suited to caring. She too had amazing references. The agent was very good at helping us, and sent someone else.

But his main carer was my absolute lifesaver. She was so good with him. We got on well. I’m still in touch with her several years after he died, sadly she’s not working in this country any more or I’d recommend her, and she’s now an honorary auntie to me.

Start with an agency.
Meet several carers both with and without your parents. And trust your feelings. You may have to pay for their time, and sometimes travel too, for an initial meeting. But it worth it to find the right one who is a good fit.

If there’s dementia, which is sadly only ever going to get worse, do be prepared for eventual night time wandering, and possibly banging on the carer’s door at 3 am.
Sorry, but I have far too much experience of this horrible disease, both FiL and DM.

We tried this, through an agency, and the quality of carer was awful, plus once any form of evening / night issue occurred, and it soon does with dementia, we were told we needed two carers, so covering the shifts and they defaulted to ringing ambulances rather than step up It was also more expensive than the wonderful home we then found, where the standard of care / hoists/ medically trained staff was way beyond the 'carers'. Depends on the person, but we did try 6 staff to give it a good go.

Yes. I accept that the situation is likely to get worse over time & we will need to be adaptable in future.

We had good experiences with the country cousins agency. Their structure was particularly helpful when we were getting started, things like each ‘carer’ stays a fortnight and ideally the agency time three different people who rotate. This means that however the ‘irritations’ of any one carer, they are gone again in a week or so before the irritant has really got under their skin.

They had fixed time off in the day and were all pretty flexible about reacting to what DM needed them to do, even those she was very reluctant to ask.

All worked very well until double incontinence and needing overnight care meant that DM was actually safer and more comfortable in a home.

Hope you find what works for you.

https://care.country-cousins.co.uk/live-in-care/?gclid=CjwKCAiAlrXJBhBAEiwA-5pgwo2eZ6fXs5pZQXoSL37-qfYzTV09gUJnRSQ0LmbQzzDiWa2Quu_d1xoC8IQQAvD_BwE&utm_term=country%20cousins&utm_campaign=&utm_source=google&utm_medium=cpc&campaignid=12366001618&adgroupid=178473321509&creative=749611810689&matchtype=e&network=g&device=m&gad_source=1&gad_campaignid=12366001618&gbraid=0AAAAADt-BGFn1n8w1-lJyYkAl8gmqe98z

Thanks for everyone's suggestions. I've been speaking to some agencies and they seem a bit inflexible - especially since my DPs care needs aren't that great at the moment (but obviously may change in the future.

One has just told me I must pay for a 12-hour day, when in reality they won't need nearly that much help.

Country Cousins has been acquired by Trinity Homecare.

Feeling a bit overwhelmed!

The thing is is the carer is needed on and off throughout the day then they need to be there all the time and thus paid.
Because of travel time allowance/costs there is a spot where live in becomes cheaper than multiple visits even if you don't need the full 12 hours.
We hit this with my DPs, they had live in for 3 weeks - didn't need full care but needed small bits across the day.

I actually know the CEO of Trinity Homecare. He is passionate about his job and what they do: he has direct personal experience of the challenges of caring for elderly people in their homes so I would think that he would expect the same standards to be maintained or bettered now that Country Cousins is part of Trinity.

I was a fan of country cousins when I worked in this sector about 8 years ago

They talk a lot about how flexible they are on the website, but when I said I wanted a live-in carer to work 8-10 hours, 5 days a week I was told their live-in care package is a 12-hour day, 7 days a week, swapping carers every fortnight. We just don't need that level of support at the moment.