Part-Time Versus Live-In Care
The cost of care can be prohibitive even for minimal levels of care, so you need to evaluate what your parents need and when they need it. For example, a companion who provides supervision, cooking, and some light cleaning but no hands-on care can cost $9–$15 per hour. A certified nurse's aide or home-health aide trained in hands-on care can run about $19 per hour. A licensed practical nurse will cost at least $32 per hour, and an RN in excess of $50 per hour. Expect your parents or in-laws to balk at the idea, so if they don't need live-in care, start with something short term and only as often as necessary.
A friend or neighbor might be willing to stop in daily for a few dollars a week or an exchange of favors. Someone to bring the newspaper and check to see that Mom is up, knows what day it is, and has taken her daily medications may be all you need right now. You may need to add a daily phone call later in the day to make sure she has eaten and fed the dog.
From there, you might have to progress to the wake-up bath or put-to-bed visit from a nursing aide. Or you may have to hire a layperson to come in and help cook and clean and spend a few hours a day with them to make sure they've gotten themselves up, bathed, groomed, and fed. If they need assistance with personal care, you'll need a trained person to assist with this — either a nurse's aide or a layperson you have trained.
Start with a few hours a few days a week if you can, and let them get used to having someone in. If you need to add more time, they will be more comfortable if the process started slowly.
Older people are usually at their best in the morning and fade as the day progresses, so it may be that you need to look into having someone come in later in the day and help them with an evening meal and getting ready for bed. Hiring someone to arrive in the morning would be a waste of money and not solve the problem.
It may be that your parents are just fine during the day but have difficulty during the night. Most falls occur during the night when an older person gets up to go to the bathroom and doesn't turn on a light or use a walker or cane.
Having someone there at night can be a big comfort. And perhaps that's all you need for now, but it may come to a point where someone is needed 24/7. You can choose to staff that situation in several ways. Shift care can sometimes be less costly because a live-in caregiver must have eight hours of sleep. If your parents are up all night and need help during the day, you'll need to hire someone to relieve the live-in so she can sleep.
Shifts are typically eight or twelve hours. For most older people, the fewer the changes the better, so twelve-hour shifts may be the best choice.
Whether you hire privately or go through an agency, always ask for references and check with agencies such as the Better Business Bureau and even your local police department before hiring anyone.
