Any idea about costs for an overnight carer (for elderly person)?

[oneofsuesylvesterscheerios]

My dad has lost most of his mobility in just the past 6 months. He's in hospital at the moment getting it investigated but there is a strong chance he'll be disabled for the rest of his life now, probably wheelchair bound.

He is a widower and there is no possibiity of him living with us (house unsuitable) and his own house is a roomy bungalow and so potentially OK. He would early love to go hme eventually and if his mobility doesn't deteriorate a huge amount more he could manage at home, with help. The big problem would be for overnight care - would it necessitate a carer from an agency or something like that?

Anyone any idea how much this would be? We will be getting advice from social services in due time but it's very frustrating not being able to access them straight away and I want to be able to talk to dad about the possible options. He knows how much a care home would be and we'd like to know it would compare.

any ideas please? I've been trying to access nhs websites but it's a minefield and sooo confusing . thanks

I work with elderly people and a couple of them have au pairs living in their homes. They pay a small amount of the au pair who gets to go out quite a lot but they do stay in overnight (I guess this varies and would have to be agreed beforehand).

You could try phoning au pair agencies to see what they say. Some au pairs might well prefer to look after an elderly person rather than some lively children.

Hope this helps.

Should say "They pay a small amount of money to the au pair...."

thanks pippop. I hadn't considered an au pair; I'd always associated them with children. I don't know whether we'd want anyone 'living in' though, and I guess it would be hard when considering nights off, etc. I kind of thought it would involve agency staff, maybe rotating it between 2 or 3 people whom my dad could get to know well and feel secure with, and then a social worker/ carer(s) at stages in the day.

God I don't know... it's so confusing.
thanks anyway though.

One

Sorry to hear about your dad.

You should start by asking to talk with the ward's occupational therapist as they will be involved with planning your father's discharge from hospital.

They should assess him on the ward,with input from nursing staff and judge whether or not in their view he could be looked after at home with a suitable 'package of care.'

If they think he could return home,and / or he expresses a keen desire to get home,they should at some stage carry out an assessment of his home environment to determine, if with suitable equipment in place,and suitable care package, he could be cared for at home.

For example he may need a hoist to be transferred from his bed into his wheelchair, and also onto a commode.
If this is the case 2 carers would be needed at least in the morning and again in the evening, and again for daytime toilet access.
(A live in carer would need back up in this situation)

If he has savings over around £22500 he may be paying for this care himself,but depending on father's local authority he may get a few weeks of free assessment period.

To find local care agencies and also homes go to www.cqc.org.uk and you can search by postcode for agencies and homes.

If it is felt instead that your father may need palliative care as he is suffering from a rapidly deteriorating illness he may be eligible for 'continuing care'funding, which comes from the NHS and is not means tested

Again the hospital and possibly the local social services team should be helping you through ths very difficult and confusing time.

Finally,depending on where your father lives expect to spend at least £80 to £120/day for live in care. A live in carer should be know how to wash and dress your father safely, and with dignity, together with preparing meals, prompting to take medication and light household tasks.
You also need to factor in additional costs such as the carer's food,but this depends on the agency you choose.

Your dad should get Attendance Allowance - will be back dated to when you apply ,so don't delay .
www.direct.gov.uk/en/disabledpeople/financialsupport/attendanceallowance/index.htm.
Just want to say ,perfectly doable to continue in own home alone if in wheelchair .
I help care for 94 year old with no mobility ,she has excellent package of care via social services ( but don;t be pushed into direct payment and you arranging the carers,which they seem to push these days ) .
Your dad may not need anyone at night - my 94 has no one .
She does have to wear pads tho - but they have all sorts of aids ,and I think its easier for men,especially if he has mobility in upper body ,arms etc .
Can't post more right now ,PC troublesome ,but good luck .

PS - the lady I help with owns own ,very expensive house ,but not much income so 99% of her care is funded thru social services .
Oh and she has a pendant linked to local scheme - she presses it and it activates phone to call centre ,they will alert named people or ambulance if necessary .
Again ,very little cost to her ,tho think fairly reasonable even if you pay full cost .

This is brilliantly helpful - thank you both. I asked at hospital today about dad's assessment but they said nothing could be done until Tuesday because of the bank holiday which I spose is understandable. Less forgivable is the fact that when he arrived on the ward Friday evening he was left in the corridor in a chair by staff who didn't even say hello to him , let alone the 'welcome to the ward and I'm called " or whatever they're sposed to do. And they've put a fucking nappy on him.

It's all so demeaning. It makes me want to cry with anger.

We've already applied for attendance allowance. I think dad would actually be ok at night if he had a bottle, and then just have help getting up and dressed in the morning and then getting to bed. As long as his mobility gets no worse we're thinking about an electric wheelchair for him. I spose we'll know more in a few days when he's been seen by more people.

Does he really have no choice about wearing this nappy thing? He has no history at all of incontinence, and on his previous ward he managed really well on a wheelchair commode which they took him to the loos to use in privacy.

and he does have savings - more than 22K.
I'm thinking he may not need live-in care now though - more like a couple of visits a day as mentioned above.

oneof that is fecking shocking. NO he does not have to have a "nappy", he should be provided with a bottle for urinating and a commode as you say. Its disgraceful for them to have done what they done-speak to someone on the ward and demand that they put these in place and that they dont put continence pads on him in future.

I agree with violet-dont be pushed into direct payments by SS-as great as they are in theory, there are a PITA in reality, they require the person to run books/accounts/timesheets/wageslips/tax/insurance etc etc
The lady that I care for has had them a yr and SS have now withdrawn them-resulting in a whole heap of confusion, upset, anxiety etc etc

As for costs, as an independant carer I would charge £8ph for a sleep in arrangment/ £15ph for a waking night arrangment.
agency wise you would be looking at similar figures.

Do as much research as you can re electric wheelchair to make sure you get the one that your dad needs .
You can get ones that adjust so that you can recline in them with feet up ,back down .
Often people who can only sit all day need to lie down at some point - pressure sores etc .
They can be a very expensive mistake .
My friend is looking for one for her mum and says there are quite a few on ebay at present .

Glastonbury is right - why have the hospital put a nappy on him ? To make their life easier or his ?
With the package of care make sure they write everything down that needs to be done ,and bear in mind that you will need someone outside the agency ( friend ,family ) to pop in ,keep an eye on things to make sure that it is working.
Don't know where your Dad lives but the old lady I help has the most amazing package - 5 visits a day ,2 people each visit .
Though it took an awful lot of letters of complaint etc ,etc ,to set up .
And sadly the amount of help you get varies according to which social services area you are in .
Be prepared to hone your project management skills, keep a record of things ,don't expect profesionals to volunteer info about what is available there are usually all sorts of people whose specific job is to advise on eg incontenience aids ,but they don't volunteer the info and no one tells you which agency does what ,and then they don't talk to eachother.
Ask ,for example ,if he qualifies for a special bed - can't remember name ,but an electric one that goes up and down etc ,like in hospital .We got ours through District Nursing team - though we were so grateful to get one that intially didn't realise we'd got an old model and that there were more suitable ,newer types available if you ask !

Your Dad will be assessed, the hospital social services team will then get involved and sort out a "package" for your father to go home with, by package i mean a care package so he may need 45 mins in the am to help get up washed/dressed etc and then maybe 30 mins lunch to help out and 30 mins at night etc, they will make a decision based on his needs and what he can and can'r do for himself now.

Social services will then contact a care agency and find someone who can take on the package and set up when your father is due for discharge and the carers will then start attending.

Your dad won't have to pay for the first 6 weeks, he will then have a financial assessment where someone will come to his house and run through his finances with him, they will then let him know how much he has to pay towards his care, this will depend on how much he has in savings it is around the 23,000 mark.

Morning ones

Just to chip in, again, local authorities have different processes and contrary to Morning's advise the 'free 6 weeks' may not apply in your dad's area.Instead it may be described as a free period of assessment only and could just last a few weeks.In practice this tends to be around6 weeks.
(Sorry i know this is all semantics,and unnecessarily confusing)

Some areas also offer intermediate care in the transition from hospital to home, and the objective is to get your dad back to his pre admission level if possible, or to rebuild his confidence after being in hospital for so long.

The ward staff should be discussing with you and your dad if they think he is likely to have 'ongoing' needs for a package of care, or if they think is care needs are of a more temporary nature.From what you've said I guess the former is more appropriate in your dad's case.

Your Dad should not have been put into pads especially as he had not needed them before, and this is unacceptable.I am sure you will sort this out this matter!

With regards to getting a hospital (profiling bed) be prepared for a battle between health and social services!As a rule of thumb it goes like this:
If he spends most of his day in bed and needs one to prevent pressure sores health ( (in practice DNs)should supply.
If he needs one to make it safer for the carers to wash your father, in bed, then social services should provide.

Again, discuss with the ward's OT

As your dad has savings above the threshold, you don't need to worry about the pros and cons of direct payments just yet.

Finally,equipment should be supplied free of charge as it will effectively be on loan to your dad.However as always the case in real life, purchasing your own gives you more choice and may be quicker.

Mumsnet was a godsend when I had my dds, and is proving to continue to be during this new era we seem to be experiencing with my dad.

Thank God for MN !!!

The advice and info you've given me here is absolutely worth its weight in gold. I am soooo grateful.

I have already rung the ward and ask why dad was put in pads - the nurse had no idea - so I asked that they be removed and that dad use his bottle and commode unless he specifically asks otherwise.

Dh will be visiting today and then I'm going in tomorrow when I'm told it will be a full compliment of staff and I can actually talk to someone about dad's care.

The info about equipment is interesting. I already looked on a site for electric wheelchairs and realised there were ones that reclined etc. He'd also need one that can go outside as I'm sure he'd love to be able to get to the paper shop again and do a bit on his own. I know we're a long way off him going home yet but it helps me to imagine that we have some control over what happens, as everything else has been like p* ing in the dark these past few months.

One thing a friend of mine mentioned (he is a social worked for elderly folk) is that we might need to apply for extended power of attorney. Dad has already agreed to this regardinh his banking, as he won't be able to get to the bank himself anymore, and is very hard of hearing, so phone banking is not an option. Ideally, we'd like to be able to do it via internet banking then at least dad can oversee it with me on the computer.

once again, thanks loads. any more advice very gratefully received.

Ones

I am still fuming about your dad being put in pads
FYI the only reason pads should be put on somebody is if they lack any sort of cognitive insight into the need to pee or defecate.
Alternatively some people may choose them if they 'dribble' but this would be the patient's decsion and request.

My dad is the only one on his ward doing sudoki puzzles and crosswords; is sharp as a tack and has better waterworks than me (who didn't do her pelvic floor exercises) after he had his prostate op last year!

It's been pretty heart-breaking watching some people talk to him like he's a small child. Yes, to have to speak clearly to him, but he's not stupid. He actually said (quite politely) to a nurse the other night who was telling him to try harder to stand up "I'm in hospital because my legs won't work, not beause my brain doesn't" and she apologised

Oh good for your Dad - and the nurse ,for apologising .

lol at me calling sudoku 'sudoki' like a confused old gimmer myself

Hospital have now rung and said there is no visiting as norovirus has speard to most of the wards. Fair enough.

But then I asked how would dad get his paper now, which we bring everyday. He doesn't use his tv because of his hearing problems, so his paper is the only thing he gets to do every day to pass the time between visits. Apparently, the trolley that brings the papers "won't" come to the outside door of the ward with the papers, even though we would be allowed to do so.

So we've now been told we can drive 6 miles there, drop a paper off outside the ward and drive 6 miles back without seeing dad. I totally understand the need to seal the wards off as much as poss, and I certainly wouldn't like dad to become ill with this horrible virus. But it also seems that there is no-one prepared to go the extra mile for the patients by going to the hopsital shop and buying a paper, which he would be paying for, or the trolley to drop papers off outside wards. I know it seems really petty, but it's little things like this that make a hospital stay go from bearable to unbearable. >sigh< perhaps I'm being unreasonable. I'm losing perpective about what's unreasonable or not.

One

Good to hear you're close enough to sort this out for your dad.
IME the nursing staff will be overwhelmed caring for and clearing up after patients with norovirus, and are likely, as ever, to be too understaffed to be able to do a paper run, as well.
Give them the benefit of the doubt on this one.

What you want is a Lasting Power of Attorney. Hope you are able to visit your Dad soon.

God help all old people without money once the election is over and the cuts kick in.

also 'age concern' are really very helpful with this sort of stuff. they will have info applicable to your area. they have been very useful with things for my gran. things like a handyman service they have, all free too plus they can do a benefits review and help you access other info you may need.

link here

When I've visited people in hospital where noro virus and c.diff has struck ,we've had to follow strict procedures - plastic apron ,handwashing ,gloves ,no sitting on beds or chairs etc .
We were however allowed to visit .
Interesting how the policy varies according to hospital.

Thinking about electric wheelchair - wonder if you need 2 ?
One for indoors and one for shopping ?
Anyway ,my advice would be to get ( if you can afford ) one ,particularly the one that your dad would be in during the day ,that will cater for him in the future if he becomes frailer /less able .

Yes, will give them benefit of doubt. Dh went up to drop paper off and was allowed in for 5 mins. Dad was surprised that dh wasn't stopping and didn't know that there was noro on the ward. But also looks like he's got it himself as he had stomach upset at 5 this morning. Is that usual not to let patients know? Just wondering...

Dh is a nurse (not ward nurse and not at that hopsital) and was fastidious with the hand-washing before and after the ward and also when he came back. But I'm not sure I'd feel happy going onto the ward tomorrow even if I'm allowed, with the dds to consider too .

We've worked with Age Concern, before dad was hospitalised; they were very helpful. We'll pursue the wheelchair stuff when we know more about his needs. The onyl thing I would worry about with 2 whhelchairs is transferring from one to the other, and whether he'd manage this himself.

Can I just chip in, if you have someone out in the morning to wash and get your dad ready for the day- at night when a person calls to help your father get ready for bed...make sure that this perosn isn't calling at 7pm

My gran had someone calling three times a day and the perosn that came to put her to bed came somtimes at 7pm - my gran got cross cause she didn't sleep much any way and would lay in bed from 1am awake after being put to bed at 7pm

So make sure form the offset that they are told your dad can't go to bed early.

Forewarned is forarmed

Good luck with his care and i hope you get him home soon.

yes we had that with my grandad. he had someone who first and last thing and a couple of times in the day, plus one was supposed to come half way through the night to turn him and check dressings etc. only that one would turn up usually at 5am, rather than 2am ish. but they have to fit everyone on their round so often can't keep to a schedule.

my gran has a lady come help her shower each morning, sometimes she's there at 8am, sometimes 11am

The issue of timing is a really tricky one as carers are spread about looking after several people and obviously can't 'do everyone' at say 9.30pm, so somebody will have to be an early call and somebeody the last call of the evening iyswim.

Again depending on your LA they may contract out to agencies initially and you may have a little more say in preferred timings.
If the care is 'in house' timings may be, shall we say, flexible, until ongoing care needs are established and an agency takes over.

Sadly again it may come down to the ability to pay for care yourself, as your father would retain much more say in the deal/arrangements as he is effectively the customer

It is brilliant that he has a committed advocate in you to help him navigate the way, and support his best interests.