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?

Yup. My last employer paid the agency I came from over £3000 to release my contract

And yes. I loved the job and I’m proud to say I was damned good at it :)

It's 120 hours from they go to work until they can go home and have a day off. It's this difference in perspective between the families and staff that tends to make it really hard to put realistic work schedules/wages in that allow staff to stick.

Noone is at fault of course. The system as it is, is unworkable rather than the people in it.

I think the numbers in terms of thousands of pounds a month just flummox relatives. When the salaries of a secondary school headmaster and a solicitor combined aren't close to paying for live at home care to 2 elderly people with dementia, and that's now, God knows the situation in another 10 years.

I can see a time soon when there's just no way the government will be able to afford supporting so many elderly people, without assets left, unless other areas change dramatically: outstanding student loans not cancelled at 65, rather taken from someone's estate... Or state pensions means tested as well. Surely, it's only a matter of time with such massive costs of care, fewer people in the future owning their own homes, and people living to 100yrs becoming far more common...

I would consider advertising the role on local social media pages, for example. As you may find someone who doesn't currently work as a carer, but has personal experience of caring for an elderly relative and feels drawn to the work.

My mother, my brother and I shared caring responsibility for my father (now deceased) who had dementia. They both really struggled with it, understandably, but it gave me a real sense of fulfilment (and not to sound arrogant, but I feel I was good at it!) and that made me think that if for any reason I could no longer work in my current career, I do feel a certain sense of vocation towards caring.

I have spoken to others who have had a similar experience, and some who have switched careers later in life to become full time carers....

I would say for this role your ideal candidate would be someone who enjoys caring for the elderly, gets personal satisfaction from it, and would almost become part of the family in a way....

You could also consider whether you would be willing to pay for any additional training someone may need (first aid course for example?). As again this would make the role more attractive, to a younger person especially.

From what you say about the location etc, it does sound like an attractive proposition!

Do everything you can to make it appealing - be as flexible as you can in terms of hours they need to be "on duty", perks, holiday allowance etc etc.

Think about things like, are they allowed guests to stay over? (How separate is their accommodation?). Is there anything you can do to improve the accommodation you offer them? And so on.

And hopefully you will attract somebody genuinely kind and caring, who enjoys the work and takes pride in doing a good job.

Yes it's incredibly difficult to square up not actively doing anything for huge quantities of time and just being a supervisong presence but also not being able to leave a premises for days on end and people needing to be compensated for the time that is their employers
The support OP describes would be charged in at £3100 per week for one person at the agency I recently left. Technically 1 care worker could be there for both people but very little people would be willing to look after 2 people when they'd get paid the same money for 1.
It's a hard mind shift for people but the future is going to be digital solutions where family are not able to do it. Night care isn't really awarded by the state anymore, certainly not for anything but the rarest of cases and instead the offering would be residential bases care or motion detectors in the form of incontinence and epilepsy bed mats, fall detectors and door and window alarms that go through to central hubs.

Interesting how costs vary.
A reasonable self funded CH per person is £2200 per week, hence why many people employ livein carers and accommodate them
in annexes.

The food is one thing but I’d be more concerned about other aspects.

For two parents, with dementia, £1400 is very low. What breaks is the person getting? None by the sounds of things. Who is dealing overnight? What if someone needs the loo and falls overnight - how is that situation to be dealt with by one person.

Two or even one/two occasionally would still be hugely cheaper than two carehome places.

You said family were going in at weekends - so they didn’t notice for 3 weeks that the eggs were out of date?

Did you post about your situation before? Not this exact topic, but the general situation? If it wasn’t you, apologies, but I think I advised you, as did others, that caring for two people with Alzheimer’s was a lot to expect of one person.
Yes in the kindest possible way I think you are expecting too much. A home carer will not necessarily be used to cooking and meal planning much. And if your parents have dementia can they just safely ‘pop out’ for shopping? You may well need someone else to take care of household management type tasks.

It's probably just me missing something but I feel like there's a logical disconnect somewhere. £1400 a week gross is £35ph for a 40 hour week, plus accommodation and food. There surely aren't that many care jobs where people can earn that much day in, day out.

But why are you offering accommodation in the package? Is it because no one will do it as a live out role? Or is it because you need/want the live in aspect and it's tacitly more than 40 hours a week? Why can't the 40 hours be delivered by a small group of directly employed carers on a timetable? I see roles like this advertised locally and they never pay more than £20ph.

Even just having 2 people working in shifts, with one or both of them living out, just seems to me so much more realistic and robust. Perhaps this is just me showing my ignorance - these figures are scary - but I am genuinely interested. (I'm not trying to minimise the work at all, I think being a solo carer like this week in, week out sounds very challenging indeed. But it has literally never crosses my mind that the high care costs that are needed for some late in life would ever be all paid to one single person working alone, rather than a team.

They need someone sleeping in the house overnight. Mother has already had a couple of falls, falls are really common at night. Sleeping night time care alone is £200 a night.

For £1400 a week can’t you quit your job and do it yourself

Thanks @Aluna - but @NetZeroZealot you're adamant it's a 40 hour a week job so how does that work? Either you're paying them to be on duty overnight or you're not.

@Gleanzer

What you are missing is that £1400pw is what the agency gets.

Not what the carer gets. They may be on minimum wage or not much more

Caring is a very hard job. It takes a special person to be able to do it. You need to make the job as attractive as possible. As op have stated if they were
both in a home it would be costing you anything up to £5k per week and possibly more,

@Allthesnowallthetime a 200% mark up just for agency overheads really? wow. I was assuming a few £ per hour for that, not £20+ straight to the agency

Have you had a sit down chat with the carer? Agreed expectations? Been honest about what you expect and listened to what they tell you is the reality of living with your parents?

don’t forget, the carer effectively has 5 bosses - the agency, your parents, you, your sibling.

and the 3 hour break during the day - I suspect that effectively means they are restricted during the day, during their break and during the evening.

im not saying that you’re asking too much of them. It’s what the agency agreed they could provide.

But the reality is that it’s a very hard job for extremely poor reward. A full on responsibility with many different priorities. a lonely role with little support, no one to vent to when you’ve had a difficult shift.

A change of lifestyle, a new job, a ‘hit the ground running’ expectation. It’s a lot for anyone to adjust to.

you’re doing your best for your parents. I’m sure it’s heartbreaking to realise the carer isn’t giving the same level of care that you do when you take over at weekends.

I hope you either manage to come to an agreement about how the carer performs going forward or else find an alternative provision that suits your parents better.

OP get The Lady magazine and employ your carers directly.

If you or your sister are there every weekend, why are there eggs 3 weeks out of date & mouldy food?

8 hours. 3 hour break in the afternoon. So something like 9-1 (4 hours) 4-8 (4 hours) so they get ready for bed & go to bed without any assistance?

you'd be fine if the carer went out at 8pm & returned at 8am?

Why don't you express your concern to the agency specifically about the food situation mouldy food ect and meal planning is part of the care plan and not being done. If it doesn't improve I would look for something else. Do they really need live in care at the moment? what about trying a respectable home care company - they do exist ! The one I work for tend to provide continuity by having the same carer. Have you had there needs assessed by a social worker? They can be really knowledgeable and helpful in organising support and do work with privately funded people. I feel for you it's a difficult situation when you live away and can't just pop over.

For my friend who earned 3k a week doing this privately over 10 years ago, it was because the expectations of the client were realistic and appropriate. They understood that while they normally sleep through and all is well, they do need someone to be "on call" at night and that person needs to be paid for that time. So even though the person didnt actually need 24hr care, every day, someone has to be in "work mode" 24hrs a day for him, even when they are asleep.

They also expected the house to be safe, clean and tidy. Some admin and errands had to be completed as well as meal planning and cooking. They wanted home cooked decent meals every day and so the carer has to meal plan in a way that meets their medical needs as well as being interesting, varied and nice food. It isnt like dishing up canteen food to a set menu. They knew that needs paying for if you want the right person.

Unfortunately it's just not possible to outsource the sort of care & thought about family member puts into elderly care.

You want someone to do what you'd do - get the shopping in, look through it, think about which meals will be made each day, and pop the chicken in the freezer.

An agency hired paid carer will not "do the thinking", they'll follow instructions. They are paid very little, they don't have the emotional attachment you have.

This is why care homes exist - its cost efficient to have managers and administrators doing the thinking and planning for a large group, its less so for 2 people.

You'd be better going outside of an agency but be aware - you will need to pay essentially a full time salary for the sort of the thing you want. You are probably thinking the fact that it offers accomodation is appealing/reduces what needs to be paid but it doesn't really, live in just means you are "on" 24 hours a day and there are relatively few people who want to live away from their own family to do this.

What you pay the agency sadly won't be what the carer receives.

The replies are polarised because some people like me have taken your 8 hours a day/40 hours a week at face value, others see a full time live in carer not even receiving minimum wage for all their hours at work.

I think mostly everyone is confused if it is 8 hours a day/40 a week why they have to live in so assuming they are on duty (but unpaid) at night.

Some replies have said they need constant care but you have not said that. Any person and any elderly person can fall in the night. Would the carer in an annexe even know if your parent fell using the bathroom in the night? If they wouldn't the live in aspect is adding nothing and a carer arriving in the morning would do the same as a carer getting up in the morning. Someone shouldn't be on duty but unpaid. If they are not on duty at night why can't they go home?

I think this is a good approach. One of the later carers we had to supplement the full-time ones had no professional caring qualifications or experience, but had cared for her mother during a terminal illness. We arranged for her to go on courses that were free from the council, but paid her for her time to do them. I think if you feel that someone would take care of your elderly parent like you would, even if they aren't a professional carer, you're pretty lucky.