Home health care
I am 70, in reasonably good health, with some managed issues. DW is 67 in moderate stages. She has frequent urinary incontinence and needs assistance with dressing and bathing. I cook breakfast every day. We have an adult daughter nearby who really helps out a lot, frequently bringing meal preps and assisting 2-3 days per week. Family is suggesting that we begin to bring in home health care. Although I'm a little tired, I feel like we're managing reasonably well. Beyond some respite care, I'm not sure what the helper would do. For those who have used home health care, what did it look like? How many hours per week did you start with? What kind of a task list did you have for your aide? How did you manage introducing a stranger to your loved one? I guess I'm looking for a little guidance from folks who went this route. Thanks very much.
Comments
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I started with companion care when it reached the point DW could not be left home alone for any length of time. I need an opportunity to leave the house without feeling like I was constantly burdening DW daughter who had her own life and issues to deal with.
I started with 15 hours a week (three 5 hour shifts per week) as that was the minimum hours per week with the payroll service I was using.
The first two visits I stayed with the companion in the house the whole shift. The companion was just quietly observing and picking occasional spots to interact.
On the third visit I left them alone for a couple of short periods. After that I was confident leaving DW alone with the companion for extended periods and it has worked well ever since.
I was not ok with having a stranger show up and immediately leaving DW alone with that person. However, these people are supposed to be professionally trained and I know some people have success with that approach.
My aid is primarily for companionship at this point. She helps a bit with dressing and hygiene but I generally handle most of that. My companion would eagerly do house cleaning, cooking and such, but I don't really need that. Right now I prefer to do that stuff myself.
The idea of bringing a stranger into our household was daunting. I was fortunate in that I found a good fit early. I know it can take time for some people to find the right fit.
Having found the right fit has been a blessing. Our companion is an invaluable member of our support team. We live in a large city where there are lots of agencies and private hire options. Just knowing where to start felt like the hardest part.
I probably waited too long to look for someone. The realization that I could not leave her alone and not having someone in place put me in a bad spot. Looking back, I should have started looking sooner.
Primarily the companion is used so I can leave the house or occasionally do work on the house/yard. Generally I do not spend much time in the house when DW and companion are here.
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I have been coping very well DH 77 me 75, but suggestions from our daughter were to use help if it was available because down the track it was probably going to be necessary. Being extremely independent I found this quite difficult and I’m still new to using help. We now have lawn mowing and garden maintenance every 3 weeks 1 hour, the blokes are really great plus we have domestic help every fortnight 1 1/2 hours she changes the bed sheets, cleans the bathroom and mops and vacuums the house. I can ask for extra help if required eg washing, cooking etc but it’s not necessary. DH and I must remain at home while cleaning is going on so we disappear into the garden with a cup of coffee and I might read out loud while DH has a little snooze. So far it’s been quite pleasant. Good luck I do suggest you take advantage of any help that’s available.
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I have two ladies, both CCA certified who come each week to be companions for my DH. One is retired with 30 years experience in Continuing Care. The other is also very experienced. I'm fortunate that I have a cottage nearby so they take turns doing overnight shifts and I get to recharge my batteries. I have his main meals prepared, and no housework is required. Just feed him at mealtime, walk the dogs with him, feed the dogs and just be his companion. he is still physically fit. He doesn't resist the arrangement as he has not recognized me as his wife for over a year. He thinks I'm his hired primary care worker and they are my assistants. For now it's working.
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We have recently added a companion and it was something I didn't know we much needed. I've told DH that it's his 'old friend' visiting him. We started with 2 half days, and just increased it to 3 half days. So far, I have not left the house, at just a few weeks into this new arrangement. I use the time to take care of activities outside. I feel it's very good for him, getting to mingle with another person, besides me, all the time. I will soon be incorporating leaving the house in small, staying local, increments. There is a bit of guilt, knowing that DH likes getting out for car rides as well, but maybe it's just 'in case'.
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Our aide just left. DH has a great time with him, always filled with smiles.
Today he got DH showered and teeth brushed then hung out with him while I had a chance to get in a shower. It was delightful.
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If you just feel like you need a little respite time, another option is to see if there is a local day care program for dementia patients. I used this for my DW for awhile in late Stage 5 and early Stage 6. It was 4 hours at first 2 days a week, and then 4 days a week. My DW really enjoyed the socializing and failure free activities. The program was limited to 15 PWD and had 5 people running it at a local church. It was good for her and great for me to have time to run errands, go to the dentist, take a bike ride. She was often a bit reluctant to go as she didn’t like leaving me, but always in the end the aides said she really seemed to enjoyed it. Just another possibility for you to consider.
Edit: I should note that my DW was the youngest one there by many years but that didn't matter, it was more about the stage she was in was similar or even greater than most others there.1 -
I worked in in Senior home care for about 7 years after my long Admin career. My role varied a good bit depending on the situation. I worked primarily through agencies. I will list the various things I did for folks: Safety 1st; respite care; meds; meals; snacks; nap time; laundry; kitchen clean-up; light housekeeping; trash; grocery shopping; picking up Rx's; bank, walks & walking assistance, casual car rides, changing sheets, being the "Listener" writing notes for client's family and/or my agency; puzzles, sweeping outside walkways along side with my pt; monitoring pt while in the hospital; going on appts with pt, taking client/pt out to lunch; making phone calls as per pt of family requests; assisting with pets; anticipate-anticipate-anticipate! Generally speaking I worked 2-3 hours per client/pt.
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My advise to you based on prior experience with family members with Alzheimer’s is to look into agencies now so that you have that option in place when you need it. They will come in an assess how many hours are necessary for your needs. You can increase those hours as time goes on. Lock up any valuables. Put Ring cameras inside your home so you can monitor your loved one until you know the person can be trusted and is a good fit. Relatives had jewelry and other items stolen by in home caregivers. The agencies were bonded and insured. Having said this, you will need the help. Do it sooner than later.
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I agree with your thought. My DW is at home and likely in stage 5 + or -. Our daughter helps 1-2 times a week, usually by taking her grocery shopping or for lunch with her. It seems my need (so far) for a break is sporadic and short-lived. I don't know how I would use home care either. I guess I am more fortunate than many.
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Hi ME44- I’m 71 with chronic health issues and my DW with AD is in stage 5. She will not accept help from our friends (she thinks it’s weird that they would want to come hang out with her when I am gone). So, I have been her sole caregiver. I decided I needed help when I realized I could not leave her alone safely almost two years ago. It has been a stressful process to actually get someone in due to DW’s anosognosia and her extreme resistance to having help in the house. Even though I would tell her the help was for me, she wasn’t buying it and would become very angry and agitated. About 7 months ago I started experiencing episodes of vertigo and couldn’t drive and realized the jig was up and getting help was essential. DW could see that I was incapacitated, I think it scared her, so this time finally when I told her help was coming no matter what, she accepted it. Since I have started to feel better she’s started to complain when the caregiver comes, but I know I cannot return to not having help- if I want to keep her at home, which I do. The challenge has been caregiver turnover due to their own health problems or some other issues. Also, it’s been hard to find caregivers in my area that are willing to work under payroll. We are on our 4th one now, hopefully she’s a keeper. They have all helped #1 with safety, companionship, walks, dog care, meal prep, grocery shopping, driving to appointments, laundry and housekeeping, and our current one has successfully redirected my DW away from news shows on tv to hilarious old movies on Netflix. Yay! After the first 15 minutes of the caregiver walking in the door (I never tell her ahead of time that they’re coming) my DW forgets she doesn’t want someone there and I think she enjoys the companionship of someone other than me. I agree it’s important to stay at home in the beginning with a new person in the house. You need to satisfy yourself that they are trustworthy, have experience with dementia, and can establish a connection with your LO. Also, I ask that they stay in touch with me via text when I’m away from the house. I am grateful to be able to afford help, and I encourage anyone who can swing it financially to do it! Keep us posted!
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Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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