I just read an article about a new agency here in Baltimore that provides live-in help to take care of people (including dementia patients). They do the training, bonding, etc., and charge $180 a day, which is about the same as some of the residental dementia facilities. I wondered if anyone here has had experience with live-in help and could discuss the pros and cons. Frankly, I think it would be tough to adjust to having someone else around all the time, but if the care would be much better than in a facility, it may be worth considering when we get to that stage.

I have a CNA for 8 hours a day seven days a week. I hate to look a gift horse in the mouth, but yes it is uncomfortable when I am home on the weekends. we have had to change several times b/c of personality conflicts between him and them but now we have good combo. One for 5 weekdays and another one for weekends. It is a strain also if someone comes to visit him b/c the CNA sits in on the visit (we have a small house) If you consider live in I would make sure that they have their own space and you would have to set their time off and rules for their company(visitors) etc. It seems like a good idea until you start thinking thru all the things that could come up.

There is no income limit because it's private pay, but they do take LTC insurance, which my husband has. The companions aren't from the U.S., but they are trained here and work for several months--then go home for a few weeks--the agency provides a fill-in until they come back. Apparently, they don't get time off until they go home. Our house is large enough to accommodate another person, but I agree that it would be strange having someone here all the time. However, I'm thinking it may be the lesser of two evils. In Calif., for lots of people live-in help has been the norm for years. I just don't know if I could get used to it! I certainly wouldn't want to feel that I always have to be out of the house. Having company for 2 weeks--well, it depends on who they are.

I have had someone in the house during the day since October of 2007. Yes, you do feel uncomfortable having someone else in your home. I finally got used to it just lately because I really like the male caregiver I have now. I didn't like the male that I had the first 11 months. We have LTC insurance that covers up to $3,177 a month for in home care. It's okay as long as I don't use him more than 35 to 37 hours a week.

I posted this under another discussion but I will add it again here as it is very relevant.
I found someone to exchange room & board for 3 days of care (all day) when I work teaching at a college. When I placed the ad on Craig's List I got an overwhelming response from people who were interested. I think it's the economy. I found a wonderful gentleman who helps with shopping, housework, and cooking (he's French!), he's well educated and he is a great companion to DH. I like him too ;-) I did a background check and called all of his references including his boss (he works the days I am at home) and it has turned out to be a perfect arrangement.

I received an amazing amount of responses including some from registered nurses and others with experience caring for the elderly and children. I interviewed a few with DH and the French gentleman just felt right to both of us. It has been two months now and we are both much happier.

We don't have any insurance so that isn't an issue with us and I am not paying him, just providing room, bath and meals. He's a keeper! DH tells him the same story over and over and he is sooo patient. And yes, MarilyninMD - the economy has affected the quality of people available - I was amazed.

My DH was released from the hospital with the condition I hire a live-in, otherwise he would have to go to a facility. His LTC only pays for a certified, license agency live-in. Unfortunately the daily rate theLTC covers for a live-in is $112.00/day - the going rate locally is $195-$215/day, so I have to pay roughly $85-$100/day out of pocket. In NJ, all of the live-ins are from other countries - mostly Africa. We have a male live-in who is a nice person and willing to do non-traditional work (let the dog out, shovel walks when it snows, etc) but it is a major adjustment having someone else live in your home. He speaks English but there are frequently times when we do not understand each other or use different words for things or events. the othe factor that I didn't anticipate, having an other male in the house makes my DH competitive and when he tries to do something for me the DH barges in and says he will do it. another issue is cultural - our live-in is the "head of the family" in native Africa, so he gets cell phone calls day and night and has this sense that he is right and his opinion has more weight than mine. My advice is that if you go this route, outline responsibilities (your/his or hers) expectations, if they are not from an agency conduct background/credit checks, get as many references as you can and Call THEM AND MAKE SURE YOU HAVE ENOUGH HOMEOWNERS INSURANCE IN CASE THE PERSON GETS INJURED ON THE JOB AND SUES YOU. Also set rules on cellphone usage - my live-in says he is obligated to go on casual outings with us, however while we are out, he spends all his time on his cell phone. I finally said to him if he feels it is his obligation to be with us on outings unless we tell him definitely he cannot come, then he cannot use his cellphone while we are out because he is on duty. It's a double edged sword - not sure I would do this if I didn't have to. Oh, one last point - if you expect the live-in to control LO's behaviors be aware they will not do anything which might aggrevate them. My DH came home from psych hospital with a raging case of scabies which he passed to me, live-in AND the dog, when I went to my dr's appt for scabies treatment, DH had picked up and held scabies infected dog for the 2 hrs I was out. When I came home, live-in advised me that DH held dog and he could/wouldn't do anything about it because he didn't want to escalate the situation, so we are noew re-infected again after 6 weeks.

getting respite is so important. and i would encourage anyone to look for good care. but among the other issues consider:
1. health screening-who does tb and drug screening?
2. dementia knowledge base. where did the live-in get trainning? and do they have a certificate? are you willing to teach distraction, relocation, and validation?
3. in maryland, a live-in must be allowed 8 hours of sleep. so that must be built in to their day. that leaves 16 hours (give or take a few breaks) to be on duty. it would be a good idea to have a list of do and don'ts from day one. like no cell phone use while on duty-unless emergency.
4. when are the aide's days off? can friends, family visit at your house?
5. who pays for medical care while the aide is in your employ? if the aide is sick (cold) will you take care of him? meds, liquids, food.
6. do you pay taxes, ss, etc or is all of this under the table?
7. an agency offers some security and redress for days off, sickness, holiday fill-ins, etc. they may be more expensive, but good ones are worth it. think hard before going out on your own-you will need to do police background checks, personal background checks, call your insurance agent., make that list of expectations. due dilligence is worth it.
7.

Checking references may not be enough. A friend of mine hired a lady just for daytime help. She stole a couple of checkbooks and cleaned my friend out. It was a mess to take care of...closing the account and opening a new one, notifying proper authorities, credit agencies and companies paid by bank draft, etc. There is still a problem of her SS check going into the account that is closed. They couldn't get that changed in time.

After the theft of a piece of jewelry last summer by someone painting a room in our house, I moved all my jewelry and other valuables, including blank checks, credit cards we don't use, cash, anything with SSN or financial data, to a locked location. We already had a safe--I had found out you get a discount on your homeowner's policy (if you have jewelry riders) when you have a safe. Another thing I had heard of is cleaning help leaving a window unlocked, then someone else comes back and enters the house through that window and really cleans you out! Short of checking every window every day after someone is there, I don't know how you can deal with that.