Anyone employed a live in carer?

[DrBlackbird]

Has anyone had experience of hiring a live in carer for themselves or an elderly relative?

We are wondering about hiring a live in carer to look after my MiL with dementia i.e. paying an annual salary of £xx. We understand this includes being responsible for NI, pension contributions, holiday pay etc.

It’s difficult, however, to understand the legal ramifications of employing a live in carer. For example, my DH thinks you’d have to hire two people to accommodate their need for time off each day/night ie paying £xx to two people. Surely this puts live in care beyond the grasp of any ordinary family?

From what I’ve read, it seems that a live in carer would be classified as a domestic servant and therefore not subject to working hour directive, but it’s hard to find complete information.

Can anyone direct me to further resources on hiring a live in carer or have personal experience of doing so themselves?

Yes you’re right. It may well come to a home but she’s lived in her current home for 50 years. So far, she knows where everything is by operating on autopilot. She has some hygiene needs but not much as yet. That will change but not sure how fast/slow. I think she’d like her own carer if they the right person.

@Mischance sorry to hear about what sounds a horrendous experience for you and your DH. Care in this country is woeful with families bearing the brunt.

You need to check because a few years ago my dad (now deceased) had dementia and his social worker stated That with dementia they don’t do care in the community. Also in Wales people with dementia come under a ‘dol’ officer, deprivation of liberties officer and yes they go through everything. I’d contact social services and get their advice. If you have them assessed you may find that they are fully funded from nhs due to dementia and she won’t lose her property.

She was in a care home post op recently and went considerably down hill because of so little meaningful interaction with either staff or residents.

Often respite care, if provided free of charge to you, is in places that you don't get to choose. Not sure if that was true in your case. I have several friends with parents in care homes / were in care homes and i believe the quality of activities & cater interaction varies a lot.

It's important that any carer has reasonable hours and plenty of time off.

@kafkascastle thats why we’re thinking we would continue with the day care at least two/three times a week that runs 9am-330pm. The carer would have this time off.

I’m struggling to see how this is a hard job other than granted repeating yourself constantly is wearing. But my MiL would be happy doing puzzles, being in the garden, watching tv with someone. She just wants company and to do things. Even with her dementia she wants to still feel useful and busy. It’s so sad.

Consider using a self employed carer if you need a carer for mainly companionship. They will do personal care morning and evening, medication, 3 meals a day plus drinks and snacks obviously and companionship, and the clients laundry

A good self employed carer will charge £1000 a week plus £40-£50 for food (they don't pay tax on food allowance). Some people give the carers cash for food and some carers just take over the food shop for the carer and the client. This usually works well. If they start to go a bit beserk with champagne and lobster you might have to reign them in a bit.

They need a 2 hour break every day - sometimes the client can be left alone during the break but if not, you'll have to cover it with another carer.

There are a few facebook pages and an umbrella company called CuramCare who all use self employed carers. Many of them double up with a colleage and do 2 weeks on and 2 weeks off. There's also The Lady vacancies (Yes, thats still going and still a good place to find jobs and staff).

They are also expected to get up during the night if the client needs them - BUT ONLY ONCE. If they are getting up twice or more during the night then you need to employ a separate carer for the night time.

There's no working time directive for self employed people. Plus you won't have the worry about PAYE etc etc.

I used a platform called Curam so you can advertise a job yourself and look through the applications etc. Though obviously more work for you to do than if you went through an agency. The carers are still classed as self-employed iirc. The platform take less of a % of the total fee (an agency I used before this took a good chunk of the fee charged which I agree felt unfair).

In one post you say you find it wearing looking after her a few evenings a week, yet in another you say you struggle to see why it would be a hard job. Just be careful there. Caring for somebody, especially someone with dementia, is 'wearing'. The hours you want are also unusual that won't suit many people. Carers will typically be expected to be paid more for early morning, evening, night and weekend work. Then what happens if your carer is sick, wants to go on holiday etc? What if your MIL got worse? Do you pay more? What if she got admitted to hospital? Do you pay less? Carers are worth their weight in gold. To get a decent one however you have to pay very well, and yes, this often does involved paying more than the cost of a care home. I guess it's just looking at the bigger picture regarding the costs.

I’m struggling to see how this is a hard job other than granted repeating yourself constantly is wearing.

Well maybe you should offer to do it 24/7 then!!!

thats why we’re thinking we would continue with the day care at least two/three times a week that runs 9am-330pm. The carer would have this time off.

So when would the carer clean, strip beds, do laundry, cook the evening meal etc- or would you hire a cleaner and cook separately?

Have you spoken to adult social services in her area and had her assessed? They might be able to signpost you to companies that provide care. Plus, your MIL might be able to get x amount of care, then you could top up with a live-in etc.

There was a MN poster that had 2 part time live in carers for her parents. They lived their full time - more like an au pair arrangement but with better pay. Meant they could study, have another part time job plus cover for each other and provide overnight care.

With accommodation costs being so high it may be an attractive option to some people. The vetting and safeguarding issues remain and I can only see it working of you were local enough to keep an eye on things.

would you hire a cleaner

The agency we used to provide carers insisted on there already being a cleaner for 'the rough' that delightfully period expression.

Carers were expected to be clean and tidy but not do actual cleaning.

@Wasywasydoodah

Do you actually have ANY on the ground experience of this issue? If not, your comment is completely pointless.

A person who has early dementia will find adapting to someone living in very hard.

Not necessarily. My relative who is mostly cared for by a family member they live with adapts well to having a live-in carer for a week. They have mild dementia as a complication of another condition but are still able to articulate whether they like the carer etc. and have ways to contact others if they feel unsafe. We are careful with which agency we use, there is a handover training day, and we keep pretty close tabs unless we know the carer already from a previous visit and have asked them to come back.

It is very expensive though - my relative only pays for it for a few weeks a year at £1500 a week. We do use an agency at the moment to be simple and because it's only for a week at a time and they can send a replacement and take care of any issues and also arrange some care within 24 hours if needed for us, which we need to keep on the backburner. If it was for more than 2 weeks at a time they would swap in different carers. The agency we use, and a couple of others that we have preselected as alternatives make sure the training and checks are up to date and take care of selecting the most appropriate person they have, sending someone else if there is a problem such as sickness, etc.

If it was all year around we'd go the direct route and get an accountant to deal with the payroll NI, pension etc. (I've found one easily to do this when we need it) but then we'd probably still need to use an agency to cover when they needed to be on holiday or off sick, realistically. In fact we are thinking of getting one or two PA/carers directly for regular part time daytime/evenings during the week; but not to take over sole care including overnights, getting up in the morning, taking oversight of the whole day's medication and nutrition, etc. With training provided by the client and their main carer, who would be around and about but having some time to themselves, which is different again.

OP - PM me if you like.

I don't think it's pointless, 2 eyes are always better than 1 in terms of safeguarding and general care. In this case if 2 carers did say a 2 week on 2 weeks off rota between them, if one isn't correctly documenting and treating pressure sores, weight loss, mouth care etc, hopefully the other one will pick up on it.

so w us the carer gets 3 hours per day, and 8 hours off 1 day in 7. Should not be called on overnight (8 hours). It’s expensive… but you are paying for your own peace of mind, and their comfort/contentment, as well as care

Our experience is that carers do any necessary cleaning that is part of the care, such as washing up after preparing food for themselves or the client, mopping the floor, changing the sheets, etc. but not deeper cleaning. It does depend partly on the agency and the carer and contract made, and partly with how much attention the client needs - is it very full on or whether there are quieter times, remembering that the carer needs some times mentally for themselves even if still in the same room or the house. This is not dissimilar to a discussion about nannies on a different thread. If you employ someone directly then you can negotiate what they do and don't do.

Although one carer who was coming for a few weeks full days live out for part of the week on a rota (as the agency and both carers were local - different year, lower level needs) was clearly quite bored in the periods where her role was just to supervise gently between bursts of caring activity. She was desperate to clean anything and everything to keep busy, so we gave her a list of what and by what method/materials starting with the most important, and said "please feel free, but we don't expect it". That particular period, it was helpful as things had been quite chaotic (for good reason) the preceding weeks.

Mostly though, the care needs are now higher, and we'd like the carer to take a bit of time for themselves in periods of relative down time, and make sure they spend plenty of time engaging the client in activities and conversation, between food, personal care and medication episodes. And take the client into the garden, and out once a week. That's a lot if you also aren't getting a full night's unbroken sleep every time or it's a bit short. So don't ask too much of the carer (or, too little).

We had a live in carer when mum was EOL.
NOT RFTF but remember a live in carer beds to sleep at night and have breaks in the day. They don’t work 24hrs. We had a waking night cover and I covered day time breaks. I didn’t realise this but it’s obvious when you think about it.

We reached a point when we would have needed two live in carers because OH's needs were day and night. We did not have the space nor the money for this.

@DrBlackbird
They don't get days off . They work 7 days a week for a few weeks on . Many of the carers employed by the agency I used for my parents came from Europe and went home on their weeks off . This is the same for my friend who does this work.

I don't really know what you mean about being classed as a domestic servant. Their role involved personal care and needed experience of clients with dementia.

When we originally employed the carer, they were for my mum who had dementia . Initially my dad had carried on doing all the tasks at home with my help and he kept saying they were 'fine'. They weren't . We started off with day care popping in a. couple of times per day to do mum's personal care and medication and to prepare them a meal on the days I worked full time . My dad then had to be admitted to hospital on several occasions following infection . The carer was meant to be for my mum but after a couple of months it became apparent my dad needed care too, and we had to have in respite for the carer's breaks and overnight . Eventually it became impossible and my father had to move into a care home, followed by my mum when a space became available at the same home .

I would recommend that you start having a look around at care homes earlier rather than later so that you are aware of what is available in your area - there is a big difference in quality and you don't want to be in a position where they are moved in an emergency to the only home that has a vacancy .

As another poster has said, homes that offer respite which is NHS funded are often homes where there are vacancies as people who are able to chose where to move to wouldn't go there, mostly they don't have good QCA scores . My dad was moved to one such place for 'respite' and I think this was a big factor in his decline .

The home where both of my parents ended their days was really good, I think they could have both benefitted from moving there at an earlier stage but it was a big enough battle getting them to accept a carer into their home.

Many thanks to @BlockbusterVideoCard and @ShinyAppleDreamingOfTheSea for the useful advice and explanations of your experiences. Now I understand about why they need time off every x weeks if they’re working 7 days a week.

I was envisioning this like a regular job so to speak ie at least one day off a week (with us covering at the weekends) but the carer living in the house. The bit about the job being classified as a domestic servant has to do with the UK working hour directive as I realise they need breaks/days off etc. Just trying to work out how much.

We too would get an accountant to deal with the payroll etc. and at the moment wouldn’t need another carer but yes realistically need to also research care homes now. If possible, however, it’d be better for MiL to remain in her house of 50 years as it provides her with a sense of self as it were. She’ll be so lost if/when she has to move somewhere new.

If it was all year around we'd go the direct route and get an accountant to deal with the payroll NI, pension etc. (I've found one easily to do this when we need it) but then we'd probably still need to use an agency to cover when they needed to be on holiday or off sick, realistically