Can we contract Mom's caregiver to be Dad's, too?

6 answers | Last updated: Oct 23, 2016
Ozzie asked...

My mother is currently under 24hr care with an agency. My father, who has a leukemia type disease, has recently deteriorated and also needs care. My mother's primary care giver has been a HUGE help and has helped my father with IADLs and more recently with some ADLs (without additional compensation.)

We would like to reimburse or hire her directly for his care while keeping her on contract with the agency, per the original agreement, with my mother.

Can anybody tell me if this will be a problem with the agency and if we are going to be obliged to pay the agency for her services?

PS I am not sure what to do about the days when she needs time off and both my parents require care?

PSS Are there any contracts on line for independent care givers?


Expert Answers

Kay Paggi, GCM, LPC, CGC, MA, is in private practice as a geriatric care manager and is on the advisory board for the Emeritus Program at Richland College. She has worked with seniors for nearly 20 years as a licensed professional counselor, certified gerontological counselor, and certified geriatric care manager.

Hiring a caregiver is a complex issue, particularly so if you want to hire one caregiver for two parents. I am not clear about your question; I think you are asking if you will have to pay the agency for your father's care if it is given by the same caregiver who is assisting your mother. You state that your mother is receiving 24 hour care and imply that her care is coming from one person only. Let me give some general guidelines.

If a single caregiver is expected to stay in the home for 24 hours for several days at a time, you cannot expect the best care after the first day or two. This is especially true when there is more than one person who requires care. This is because 24 hour care is intended to assist the care receiver throughout the night as well as during the day. If the care receiver did not need nighttime care, the agency would have contracted for 18 hour shifts. After the caregiver has been awaken at night for more than a few nights in a row, he/she cannot be as alert and responsive as she was on the first day. The care receiver may be able to nap during the day but this is not usually the case for the caregiver.

One solution is to have 2 caregivers, one for your mother and one for your father. Another suggestion is to have 2 caregivers who alternate, so there is always one there and one resting off duty.

I believe most agencies would require additional payment if the caregiver is expected to provide assistance for more than one care receiver.

The next part of your question has to do with days off. Again, I recommend more than one caregiver alternating days or several-day shifts. Four days on and four days off works well in many situations. This eliminates the need for off days becasue they are built into the arrangement.

You asked about independent caregivers, those who do not work for an agency. I discourage you from hiring independents on a long term basis. Agencies do thorough background checks, and assign caregivers who have training and/or experience to give the type of assistance needed for the particular client. Most private individuals (or families) such as yourself do not have expertise to check the background and references of a stranger applying for the position. This is an area where documented abuses are abundant. Even honest, well-meaning caregivers may not realize that they do no have the skills to provide necessary assistance until it is too late.

Independent caregivers are good for running errands, making social visits, helping the care receiver choose what to wear, and perhaps taking them on outings. These types of activities are very different from helping a care receiver with impaired balance take a bath or get to the toilet.

Another item about hiring a caregiver who has been assigned by an agency is that there is probably a contract with the agency not to accept a job as a private pay caregiver in the same home where the agency placed them. When the agency has gone to the expense of checking the background and references and training the caregiver, it is a violation of the contract between the agency and the caregiver for the caregiver to accept the position and be privately paid. The caregiver would never be employable by an agency again.


Community Answers

Ozzie answered...

thank you Kay. You used the word "hore" in the second sentence, I am hoping that was not the mispelling of the word "whore" as this is clearly not the intent of my question. am aware of much of what you responded with and particularly appreciate the articulation of "Burn-out." Just so you or others understand the original intent of my question. It is the primary caregiver (who is an employee of the agency)who is suggesting that we have the option to hire her (or anyone we choose) as an independent caregiver for my fathers care. she has been wonderful and appreciated, but I also think she would like to maybe get some of the money that agency gets (and I cant blame her)figuring she is there anyway and so muchh of what she does is to the benefit of both. I was really asking the question to see if I might be able to accomodate her wishes and actually put a few more dollars in her pocket. In addition to the comments above about the potential for a slip in the quality of care there is a "non-solicitation clause" in the contrtact we have for our mother and I think we are treading a fine line should we hire her directly for dads care. Therefore I will be be needing to contact the agency directly and work out a schedule that includes care for the both of them and compensates our primary based on their schedule as best we can. Last, and I dont know if this should be a concern or not. OUr primary caregiver has been with my Mom for almost a year and really incerted herself in my parents life (and for the most part, has even won over my difficult father) we are extrememly grateful for all she has done but she has also become more assertive (as I explained above, wanting to worka seven day schedule with only my sister giving her breaks,)my sister has accommodated so far, but she is at a point where this is too much for her and would rather visit strictly as a daughter and not a care-giver.) Also, caregiver (along with others) has advised tht dads condition has deteriated and he may not have long--though we have not heard this form Physcian yet. Is there any reason for me to worry about overzealousness to control the situation at this time. PS between my brother, sister and I one of us is usually there to visit at least once a day. Thanks again, Kay...any other comments are welcome.


Momma-k answered...

My mother had alzheimer's and my dad cared for her at home by himself until he found out he had lung cancer and was going to have to start chemo. He asked me and my daughter to take turns caring for my mom but he didn't trust us(or anyone, for that matter)so he also hired caregivers from an agency. My mom didn't feel comfortable with people she didn't know, so the caregivers sat in a chair in the corner and did crossword puzzles, while my daughter and I looked after my mom. Basically I think my dad wanted us to keep an eye on the caregivers and vice versa. BUT after awhile,I noticed that one woman had gradually become indispensible to my dad. So much so, that towards the end he wouldn't listen to me anymore or even let me into the house! After he died, I Found out he had not only loaned her money, but she had used his credit card AFTER his death to pay her house payment and other bills! So agency or not, if a caregiver is inserting herself into your parents lives then it is time to go! And if she's telling you things that the doc's not, it is REALLY time for her to go, because ONLY the doc can say if your dad was dying or not! Handy to have around or not!


Ozzie answered...

Thank you K Mamma, you got me alittle worried.

Now what do you think....We worked out a deal where we would keep the contract with agency and add my father. good deal really it is only an addtional $20. Bad new is my caretaker would get kinda screwed and probably only gt another $10 bucks for adding my father. So our solution is to increase the contract with the agency to the max that our LTC would cover and also give her additional cash directly from us. So we get all the service and schedling from the agency, and she nets about $60 more per day than she would working through the agency. Total about $170 a day for the two of them and we pay $240 to agency and another $40 to her directly. Not a boat load of money, but a better position and I hope this is fair for considering the agency is taking a $110 haircut off the top. So then she ask about compensation fo rwork she has already done for my father. Saying she has been taking care of him since January and coming up with some pretty inflated numbers (mostly due to bad math.) Well it gets a little tense and I help her with a calculation that shows her net difference for two people vs. one and it is $65. Well we go back to Feb 1 (which is the date the LTC company determines my father would qualify) and she wants roughly $4000.00. I think it is a little over the top. She has been doing alot of IADLs for my father but none of the actual ADLs. She usually makes dinner while making hers and moms. walks his dog on days he cant, goes to store, laundry and a whole host of things, but up until the last 30 days or so my father has done a lot also. He is mobile, makes his own breakfast and lunch, walks dog and even ocaionally goes to store. So my question, Is that $4000 a fair amount for her to request? I am tight but dont want to jeopardize loosing her if I am out of line thinking that is a pretty big request. Ultimately it is up to my mother and father, but I am trying to take care of all this behind the scenes so it is a simless transtion and my father is not in a position to have to negotiate for himself? Any suggestions? PS There was never a dollar amount talked about for any previous work with my father (she had mentioned a couple time thatthis is just what she does, in term of helping dad) there was a rightful expectation that she woul receive some money ftom the time he "qualified" but I did not expect that much. I was thinking maybe half that amount. But she said $4000 was as low as she would go.


Momma-k answered...

Honey! She is screwing you! She did this on purpose! It's a scam!!! She makes you think she is so wonderful and then you think you have to give her what shes asking for or you are gonna lose this person who "takes such good care" of your mom!!! Or shes hoping that you will just WANT to give her the money because of the great care she gives. personally I'd set up a caregiver cam to see what shes really up to. But even if she is doing right, she is stealing from you by going around her agency. Fire her immediately and tell the agency what she is doing! Everyone who ever signs on to an agency knows up front that they cannot EVER take money from the client EVER! or like the other woman said, if someone finds out they will never work for an agency again! It is wrong to pray on people who are desperate for their loved ones.


Momma-k answered...

Honey! She is screwing you! She did this on purpose! It's a scam!!! She makes you think she is so wonderful and then you think you have to give her what shes asking for or you are gonna lose this person who "takes such good care" of your mom!!! Or shes hoping that you will just WANT to give her the money because of the great care she gives. personally I'd set up a caregiver cam to see what shes really up to. But even if she is doing right, she is stealing from you by going around her agency. Fire her immediately and tell the agency what she is doing! Everyone who ever signs on to an agency knows up front that they cannot EVER take money from the client EVER! or like the other woman said, if someone finds out they will never work for an agency again! It is wrong to pray on people who are desperate for their loved ones.