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Remember, when you are an "employer", where you directly pay the caregiver, you need to contact your homeowner's insurance carrier. It is important to have a "workman's comp policy" in case the caregiver should get hurt while on the job.
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Before I hired a service for my father, I drafted a list of all potential activities, then discussed them with the nurse who handled the intake process.    I was surprised how many they would not be willing to handle, but to be fair, most of the "rejected" tasks arose from my father's dysphagia.  They felt it was too much of a liability for them to address.

Since that was a primary concern, I had to hire a different service, which was more flexible, but not as professional.   Out of 3 people who saw Dad, only one was worthwhile.  

You might want to consider something like that - making a list and discussing it with your new caregiver to ensure you're both "on the same page" as to what's expected.

And I want to emphasize FreqFlyer's advice on liability issues.    At one point we considered hiring someone from his church, a young woman who allegedly had CNA experience.   I was in for a rude awakening when I contacted my father's  homeowner's insurance carrier.   

I was advised that any potential injury of the caregiver wasn't covered under HO insurance; we would have to purchase a business type liability policy, at about $700 a year (at that time, some few years ago.)  I was also warned that the premium would escalate annually.

I discussed the issue with a friend who owns his own business; his position was DON'T take this route.    Liability coverage could raise the cost so high that the services weren't worth it.   Better to let a company provide someone and cover any potential liabilities.
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Mom (91) lives with us.

I found out last month (after 18 months of Homehealth providing an aide for "custodial care " that Mom's insurance doesn't cover that. So, I called an aide to see if she would moonlight. She's not with our current agency because of contract negotiations going south at the top of the food chain. BTW, we use a physicians group agency that manages EVERYTHING except Mom's appts with her regular drs. It's great.

Back to the aide biz. from experience, different aides do different things. So, ask what the will do. We had one that was supposed to be able to make a small meal or snack, but said flat out that she doesn't do that - she also had an attitude towards the males in the house, was routinely late and would rush doing things with Mom instead of adhering to the rehab plan setup by the agency for Mom to relearn how to become more independent. Needless to say, I had her replaced asap. We've had some great aides. One thing our agency aides can't do is handle wound care or dispense meds, even though they know how to. But private ones can do a lot more. I'd assess your needs in the home.

Since insurance won't pay for custodial care, the private aide comes for two hours in the morning M-F so I can go to my PT job, then my almost 20 son who has a singing gig Wednesdays and Sundays takes over when she leaves. Then I take over when I get home. Everybody pitches in (hubby and 25 yo who both work fulltime).

I hired a cleaning crew once a week - at first to scour and disinfect Mom's quarters, then decided to double that pay to include the community areas, bathrooms and our bedroom. I wash the laundry, and they fold it and put it away (I hate laundry). So our aide doesn't clean; she picks up and straightens Mom's room daily, including trash take out. Our aide provides custodial care (bathing, grooming, dressing, bed change, toileting (currently diaper changing) and helps Mom with her morning ADLs. She also takes vitals, makes sure Mom takes her prebreakfast meds and gives Mom her breathing treatment. She checks equipment and lets me know if something is wonky. She and my son cook breakfast. This week, she will start getting Mom out of bed into her chair in the mornings. She also provides joyful companionship since Mom is depressed and has anxiety. She inspects Mom's body for skin breaks and attends to bed sores and whatnot, leaving me notes on what she sees so I can tell the nurse who currently comes bi-weekly. She'll find things on the TV or computer that Mom likes. She may do light nail care if Mom asks her (agency aides would not do that).

I'd assess your household needs - what you can't do, don't like doing, or just don't have time to do - and ask the aide you're screening if they will provide custodial care, including A, B, C and X, Y, Z.

Also find an aide that lives close to you. Define the hours you need them and days of the week.
I've found that they are more expensive by the hour the less time you need them (per visit).

IMO, everything is negotiable.
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babziellia May 2021
BTW, she charge $25 if only 1 hour per trip, but $20/hr for 2-hour duty. If Mom could afford 3 hrs, it would be less than $20/hr, but probably not much less. Yes, Mom is paying for it. (learned that lesson finally.)
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