Live-in carer - am I expecting too much?

[NetZeroZealot]

Elderly DPs (87 & 90), one recently diagnosed mild Alzheimer's, the other very frail & also prone to confusion / extreme forgetfulness.

They are lucky enough to have savings and a large house with a separate annex and as my sister & I live 1 & 2 hours away respectively & their needs have increased we decided a live-in carer was the best option starting in January. It was a job persuading them but after Mum had a couple of falls & a hospital admission they agreed ...

What the agencies promised and what has been delivered are miles apart!

As continuity is very important, we asked for a long-term carer to work a 5-day week - family can cover the other 2 days. Carer is free to do what they want at weekends and has the privacy of their own self-contained accommodation with TV, kitchen etc. I spoke to a few agencies and settled on a well-known, long-established company who promised (as they all do!) to carefully match the carer to DP's needs and offer us a choice of people, and importantly, came to meet my DP rather than relying on form filling.

In reality we were not offered any choice & had to accept the carers offered as the agency only found someone 2 days before the start dates. Only 3 months in we are now on carer number 3. The first did not drive which was a pre-requisite of the job; the second clearly did not like living far from home / in a semi-rural area and left of her own accord; and we now have number 3 who is OK. But not great.

Although the agency says they have checked references, they do not share the references with clients, but cherry pick quotes from them. DBS checks are a given.

All the carers have been competent and likeable and my DP have adjusted, but they found the unanticipated changeover between them very stressful, as I knew they would.

Meal planning is part of the care plan but the current carer seems to struggle with this - on my visits I still have to throw out bad food, or chuck stuff in the freezer which is on its last day when it should have been frozen the day the food delivery arrived, etc. This was a major problem with my Mum before & I feel the carer should be managing this better.

She also keeps asking me to buy stuff for them / the house which I don't think is needed or she could easily pop out & buy for them. And many other minor niggles - now I write it down it all seems a bit trivial.

They are paying a lot of money for this, and although it is reassuring to know there is someone there to deal with issues when they occur (which they do) I expected more. But perhaps I was being naive?

Sorry this is so long, anyone else got useful insights to share?

Exactly. The agency are getting fat, the carer gets crap pay. If you paid that directly, you could find a better standard of candidate.

I agree.

Thanks everyone, lots of advice here and food for thought.

To answer a few general questions:
Carer works 8-hour day with a 3-hour break in the afternoon, 5 days a week.
No night time cover needed, both sleep well.
Has basic food hygiene training.
Driver is needed as semi-rural area - for trips to medical appointments etc. Although she hasn't been doing much of that. Decent food shops are in walking distance (for carer, not for DP).
Aim is to keep DP at home as long as possible. They have lived in the same house for generations & have a great local support network.
Weekly food shop is done online with occasional top-ups if they run out of something. I have sight of all of it.
We both have financial & health LPA.

Bear in mind if you recruit yourself you become the employer directly. So insurance, managing NI, all aspects of employment responsibilities become yours too. Get some legal advice if considering doing this so nothing missed.

I think it’s tricky as you are doing it differently to most. We had carers who did two weeks on/ off. I think it can be hard starting again on the Monday as parents will prefer family and you have to rebuild the routine.

I also wonder if family are keeping on top of household tasks over the weekend. Rather than leaving the clearing of the fridge to the carer.

I once asked our carers what they got from the agency as a big issue was that one had an ancient car that constantly broke down enroute to the shops with elderly people (their cars had been sold long ago).

I was a bit horrified to find out it was about a pound above minimum wage, hence the car. Everything was a struggle for the carers financially and a large % of the money went to the agency for doing very little. I was glad to move on to the next step of a home as I did feel the carers were a 'weight' on the elderly people... Everyone knew everyone else's problems, one side was worried about the huge weekly bills - and still cognitive enough to understand money - expecting 'more' for the money, yes housework, whilst the carers were increasingly fed up by the increasing work load, loneliness, promises via the 3rd part agency that 'of course carer can do that!' and at the end of it, a very low pay check for the hours worked...

It didn't help that in true stereotypical fashion, when there was a problem and the agency manager drove to the house, it was in a brand new 80,000 pound merc with personal plates and she was maybe 23 yrs old

The first thing I do when I get there is check the fridge!

Fridges are a massive bone of contention for the ww2 'make do and mend' or late 40s, early 1950s rationing generation.

Carers must pick their battles. My experience was toilet needs and bathing needs always trumped an argument about a dodgy yoghurt.. 😂

Good carers know this.

My god, the arguments over fridges...

Interestingly we had issues with fridge items as well. We had a cleaner on top of carer visits and wanted this to be done. It wasn’t.
I don’t know why.
Sometimes things I found were due to Mum, putting cooked ham near to raw bacon etc. And no idea about use by dates herself. She could be a bit tetchy if you explained something had to go in the bin. Her judgement gone.
In the end we stopped buying her much in the way of raw ingredients.
We resorted to food meal deliveries for elderly people. Wiltshire were good and would put directly in the freezer if requested.

1 more fridge related though...

The elderly people often 'stewed' with their thoughts as they had no responsibility left in their lives. Food was hugely important, something they could control a few years ago. Perhaps one of the last things...

For the carer, the fridge, shopping etc, was way down compared to safety, keeping them occupied, clean, clothed, warm and so on. Hours would be spent helping the elderly person to find the remote for the TV they'd hidden the night before, otherwise there was anger, tears, utter breakdowns by them both. Crying, sobbing on floor. All over the TV.

That yoghurt that was a few days old, pah!

We didn't have a live in carer but a carer come twice a day for FIL. The food thing, well, they just didn't care. Didn't give the food in date order, gave out of date food to FIL and never threw rotten food out. We only had a carer to make sure he was eating so it was a really easy job.

I would have a chat directly with the carer. There just might be a miscommunication here. I know carers who have received complaints from families because of chucking out food so they might not know this is ok. Sounds daft when it’s mouldy but it’s an issue.

Also check it’s not your parents stopping the carer. If one (or both) have capacity the carer can’t go against their wishes.
Another thing to check is if the carer can purchase food. How is this set up? Have you agreed what can be spent and how spending is evidenced. I would also check if the carer feels they can’t leave the house to go shopping.
It’s a minefield but unfortunately very common. If they are good in most areas I would give the benefit of the doubt for now and have a direct conversation. I hope it works out for you all.

If family visit every weekend how are there 3 week out of date eggs in the fridge. Would a hot neal food delivery be better, then just top up essentials and only buy small cartons of milk, delivery only for household and tins.

"delivery only" was another problem...

Elderly didn't want 'delivery' because it was unnecessary as carer could get it. 'delivery' was seen like taxis. Frivolous. A waste of money. Expensive. Dare I say 'for lazy people?'.

Sometimes what we considered easy solutions again proved more problematical than the original problem.

We resorted to trickery.the carer was sipped cash regularly and told to replace the old eggs with fresh, but to use the old carton. Same with milk... Empty it down sink, wash bottle out, pour in fresh milk...

It worked.

I don’t think it’s acceptable to not give you full references.

I think potential clients would fixate on any negative comments which nearly all references have. It would be financially disastrous for the agency as no one would be 'good enough'.

In 1:1 care, referees can be very 'personal' and petty towards carers... My elderly person didn't approve of 1 of our carers have a child, now a teen, but 'out of wedlock'... Was a big thing to the elderly person that her carer wasn't an honourable person (in her words). Well, her words were more unpleasant and judgemental from 1932 era.

The problem with care plans and the timing is well known to carers. What the office think and what the reality is are often an hour apart!

in my last job they introduced ‘timed’ visits rather than the ‘however long it takes’ plan. In theory it’s great. You know where you should be and when you should be there.

in reality…. Not so good. A bad morning can stretch personal care from 30 mins to an hour easily. Once your timing is out everything else runs behind and you end up feeling rushed and passing that on to vulnerable clients.

honestly, you’d be better off removing the agency and employing directly.

They are a live in carer

Okay so the person I know who does this kind of care for people on the scale you are talking is paid directly a lot more money. About 10 years ago, they were getting 3k a week. I cant imagine what they'd pay now.

It was very high level housekeeper/carer service live in. They did it a few months a year to maintain a very affluent lifestyle.

With a care plan with timings. They never work.

There isn't much the care agency can do, I suppose, if the carers don't like the work and choose to leave? They can't force their staff to accept the specific situation.

Why not try to employ someone yourselves. You could pay them more with no agency taking a cut, and therefore are likely to attract someone more skilled and experienced, and you would have more control over the decision? You can still check references etc.

We had live in carers to look after both parents: they managed showers, help with dressing, medication, meals etc and still had loads of relaxation time a day. One knitted sweaters on commission for additional income.

We had a rotation of carers of varying skill and experience. However, every woollen sweater was shrunk, cooking very hit and miss. Numerous items that should not have went in the dishwasher, all the non-stick pans wrecked, etc etc

This...
Pop out and by it themselves
When OP has stated its a semi rural community
Hasn't mentioned how these items will be funded
And who will be held responsibility if a fall etc occurs whilst the carer "pops out".
All no doubt when the carer is on around minimum wage and the agency and charging silly money

TBH I’d have thought that with parents in the state you describe, more than one carer on shifts would be needed. It sounds an awful lot for one person to have to manage, especially with dementia in the mix.

Can the carer be guaranteed an unbroken night’s sleep? Because dementia so often involves people up and down in the night, wanting this or that, and completely unaware of the time of day or night. (Speaking from (too much) experience here!

I can honestly say - you will be very lucky to get a good live in carer - we went through 6 in as many months - in my opinion they are not vetted properly - and many not fit for purpose - I would like to wish you good luck in your search