Caregivers: How to Convince Someone to Hire Them, How to Find Them & How to Keep Them

Apr 8

Before my father entered the hospital last July, my mother took complete care of my dad.

He had mild dementia but fortunately did not need “much” — she handled the cooking, cleaning, household management, investing, taxes, etc.

My father could still walk, talk, read, eat, bathe himself, dress and go to the bathroom.

Then in July 2021 my father stopped getting out of bed.

He mostly slept for about 4 days, without eating and drinking.

His primary care doctor told my mom to “let him be” and not wake him.

On day 4 my father went to the bathroom — and collapsed afterwards.

My mother could not pick him up so she called 911 to take him to the ER.

My father was in the hospital for about 5 weeks and after he was finished lying in bed the whole time, he lost the ability to walk. (Hospitals don’t offer physical therapy and they did not have the manpower to have my father get out of bed, not even to go to the bathroom, so he lost a lot of strength and muscle tone.)

At discharge, the hospital recommended my father go to a skilled nursing facility (SNF) where he could regain his strength and get physical therapy and occupational therapy before coming home.

After some ups and downs, my father did surprisingly well at the SNF and came home after 5 weeks.

It was at that point that my mother agreed to hire a caregiver.

The Decision to Hire a Caregiver

Prior to my father’s collapse, I don’t think my mother would’ve ever hired a caregiver.

She didn’t want a stranger in the house, especially with Covid. And we could not force her to hire anyone into her home.

Caregivers are also expensive - at $25 / hr and 9 hours a day, my mother is paying roughly $7000 / month.

When my father left the nursing home he was stable but not back to baseline. The risk of my father falling and injuring himself — and my mother who’d be assisting him — was just too great.

Also, he had been in a diaper for 10 weeks so he’d need assistance with toileting as well, not to mention bathing and getting in and out of bed.

Finding Caregivers

My mother has found her caregivers through an assortment of agencies and referrals. She tried out about a dozen caregivers before ending up with some really good ones.

My mom wanted the caregivers to have experience and good attitudes. She also wanted them to show up for their shifts, and be willing to help with a bit of light housekeeping (dishes, etc.) while my father napped 2 to 4 hours a day.

Some of her best caregivers have been referrals from other excellent caregivers.

My mom is home about 90% of the time so she can observe and support the caregiver.

Keeping the Caregivers

Initially my mom cycled through a lot of caregivers before being able to develop a more stable team.

I kept encouraging her to lower her standards, give the caregivers steady hours (i.e. don’t adjust hours if my dad happens to be sleeping in one morning - let them still come at the regular time even though there’s nothing to do), and surprise them with cash gifts. I’ve also suggested offering a contract with a bonus if the caregiver stays for a certain period of time.

When my father would go back to the hospital (about once a month for UTIs from his catheter) initially my mom would not pay the caregiver during those days, since there was nothing for them to do.

The caregivers would quit.

Then I told her to start paying a retainer during hospital time, asking the caregivers how much they wanted.

One caregiver agreed to $50 / day.

But he still ended up finding another job when my dad was in the hospital.

This latest stint when my father is in the hospital currently, I’m encouraging my mom to pay the caregivers their entire rate and have them go to the hospital to accompany my father.

My father is not really verbal anymore and doesn’t know how to operate a call button.

He also needs assistance with eating since he doesn’t swallow well, so he basically needs someone with him for 3 meals a day.

Benefits of Caregivers

While it’s stressful and expensive to keep an ill person at home (caregivers 24 hours a day would cost about $18,500 / month), we are convinced my dad has gotten the best care possible.

Hospitals and nursing facilities just don’t have the manpower to closely monitor / care for someone who needs a lot of help.

My father has been a lot happier, lucid and mentally stimulated at home.

It’s been a different story for my mother.

She’s had to deal with all the logistics of hiring and working with caregivers, and she also witnesses the minute-by-minute roller coaster of my dad’s health issues. She’s been under immense stress.

At times we’ve recommended my father be placed in a SNF or Board and Care to alleviate my mothers’ stress but she’ll have it no other way.

My mother feels like putting my father in a nursing home or board and care would hasten his death.

How about you — what has your experience been with caregivers, nursing homes and hospitals? What caused you or your parent to hire a caregiver? How did you find and keep caregivers?