Who determines when 24-hour supervision is necessary?

Lynne D

This may be a double-edged sword. My husband sleeps much of the day and does not get into trouble. When he is awake, he does not attempt to cook, does not wander, basically does not get into trouble. But he does leave the front door wide open, let pets out, leaves the tap running, leaves the fridge open, etc. I get away for trips to the grocery and such and leave him alone, figuring that I can mitigate any damage he does.

I would like to get away for a friend's wedding out of town in early October, should I be able to find respite care, overnight for a few days. Our local agency on aging indicates that a person must need 24-hour supervision to qualify. How does that happen?

ladyzetta

Lynne,

I was told by my DH Doctor as well as his caregiver that my DH needed 24/7 care. I took this as a warning that I was not to leave him alone for any reason. I had a caregiver from Home Instead that was at my house 3 times a week  and he told me that so I checked with my DH Doctor and he agreed.  It was something that I did not want to hear because I did not feel it was that bad. I hope this helps. Hugs Zetta 

star26

My Dad's PCP had to fill out paperwork for him to stay in a respite facility. Like your husband, he didn't get into any trouble during the day, and I could leave him for errands etc., but no one ever questioned that he should not be left for an extended period of time. Plus, he didn't cook for himself or manage his own meds, etc. He was totally dependent on me. Our facility had a 10-day minimum stay.  Nothing gave me so much peace of mind as using this facility when I was out of town (better than caregivers in the home) and also just knowing they existed in case of emergency.

Stuck in the middle

Haven't been there yet, but I would think the decision would be based on the opinion of his doctor.  That opinion would be based on what you tell him about your husband's function.  You might keep a diary of his miscues and present it to the doctor.  

If the house catches fire, will he know what to do?  If not, he needs 24/7 care.

Rescue mom

Most people IME decide, or see, for themselves when 24/7 supervision is needed at home.  Wandering is a big reason, leaving stoves on, messing with faucets, etc. are others. Things that can cause damage or safety hazards. And being able to recognize a problem/threat (often the PWDs don’t even know it’s a threat) AND be able to call for help, which many cannot do. But agencies  IME don’t require doctors OK.

That said, many agencies are short-staffed now, and want clients to take long hours. Or there could be legal issues/liability for the agency.

For example, if you got a caregiver for a few hours, and the caregivers arrives and the person is gone—or the pet is out, or the kitchen has flooded, or fridge left open and spoiled—what would the caregiver do then? Would they have to clean up, repair, find missing person? The complications are potentially catastrophic, they may well think better for them to have somebody there 24/7 and prevent such things.

Staying in a facility short-term could be totally different, depending on facility. Also can be different if nursing care is needed but you did not mention that.

Cynbar

Are you looking for funding to cover respite? If so, and they require that the patient needs 24/7 care, that would be determined by his PCP. But if you are planning to pay out of pocket, there should be no such requirement. You can call a local home care agency that does private pay and they would send out an aide for the agreed upon shifts, there is almost always a minimum of 3-4 hours, sometimes more. Call around, some agencies are more open to one time contracts than others. If you are thinking of a facility, most assisted livings and memory cares in my area are open to short term stays, although they often have a minimum as well (2 weeks is common but the can vary.) You would choose the facility that best meets his needs, they have his PCP fill out any paperwork, and you pay the fee. I chose a memory care when my DH needed coverage but some people do arrange for in home care.

In a broader sense, I think each family makes their own determination for when a person needs 24/7 care. I know in my case that my DH can be left alone early in the day, through roughly mid-afternoon, with no problem. It's only for a short time, also. I wouldn't attempt it in the evenings when he is sundowning. Occasionally families have to be told by their MD or a social worker, but I don't think that's the norm, Most families really do want to do the right thing.

yaya-me

Hi - Im new here and have found myself in a similar situation.  My DH has advanced PD and Dementia.  Ive been caring for him for 9 years now - 24/7.  I was recently diagnosed with Colon Cancer and have to be in hospital for a few days then a 4 week recovery.. If I could find a facility to care for him for 10 days that would be great.  Im also looking into an at home live in for this time period.  Im afraid of the financial cost.  Can you please tell me the name of the facility or how you found it?  I have not called Aging and Diability yet but he definitely needs 24 hour care.  Any info any body can give me will be helpful and appreciated.  Thank you

Rescue mom

Yaya-me, first, you will get many more replies if you start your own thread with your own question. Right now you are kind of hidden at the bottom of an older thread about mostly different things,. If you look at the top of the thread list, you will see a green box that says “add topic.” Click on that, and create your own thread with your specific questions.

Sounds like you do need a respite facility and/or 24/7 help,for a while. You can call ALFs or MCs in your area and ask if they allow short-term residents. Many do. Many also have minimum stay  or cost requirements, and it’s not cheap IME and what I’ve seen here. Maybe $1500 to $2500 for 2 weeks (or less, but still minimum cost) but this can vary place to place.

With the PD, does he need a skilled nursing facility? Or actual nursing care at home, rather than a regular “babysitter” type caregiver? Those can be easier to get in for short term stays. But skilled nursing care at home is usually more expensive than basic caregivers, again, in my experience.

There are home care agencies that can provide someone in your home 24/7, they usually cost around $35-45 per hour, in my experience.

You can also call your local Alzheimer’s Association for lists of facilities and services in your area. I’d call any senior health agency that offers some kind of help or advice, at least to start.

Others will probably have other ideas, if they see your question.

yaya-me

Thank you Rescue Mom that was very helpful.   We dont need skilled, my family can give him his meds.  Problem seems to be here there is a shortage of Personal Care aides.  I appreciate the info on estimated cost of facilities.  Its the hardest thing, to get cost info.  I thought about starting a new post and will do that.  I am new to this group and will take some time and sharing to used to the ropes. Thank you again, your reply sparked some ideas with me.  thank you again.

Lynne D

Ya-Ya-me, I am at the Sam point. Our county agency affiliated with the Alzheimer’s Association says it assists with respite care if the individual requires 24-hour supervision. My question is, says who?