General Question

keobooks's avatar

What would be the most fair way to offer care services for relatives?

Asked by keobooks (14301points) June 24th, 2010

I have three living grandparents who are close to being in their 90s. They all live on their own, but are starting to have some trouble managing. I’m considering giving up work and helping them out, BUT I can’t offer this for free, as much as I’d want to. My family can’t really afford for me to work for free, but I could work very cheaply.

Here are the specifics of all 3 families (2 sets of grandparents and me)

My immediate family: Consists of me and my husband. I’m having a baby in September. I wouldn’t start working for my grandparents (if I did so) until December or January. I’m not sure how I’d work out childcare so far. My mother and Mother in law have offered to babysit one day a week. Also, my grandparents are fairly low maintenance so every now and then, I may be able to bring her along to at least one set of grandparents. I would NOT leave the child alone with my grandparents ever. The baby may make this difficult—but I’d like to try to work something out.

Grandmother A—Lives less than 5 minutes away from my house. Unable to drive and showing some early signs of dementia. Currently, I drive her to the grocery store and doctors appointments. It’s been difficult for me to work at my current job, go to my OBGYN appointments and take care of her at the same time, so I haven’t been doing as much as I’d like. Basically, she gets VERY lonely and needs a lot of company and interesting activities. She also needs someone to cook for her. If she doesn’t get enough attention, she calls people several times a day and starts to bother the neighbors.

Grandparents B—Live one hour away. Grandmother in excellent health and normally independant. She is the primary care giver of my grandfather, who is in very frail condition. I would be unable to do a lot of the physical work that my grandmother does for my grandfather, but I think “babysitting” my grandfather so that she could go out and run errands or attend social clubs would help her out.

Anyway, I’m not sure how to broach the subject and not sure how to ask for money for my services or how much to charge. I feel bad for having to ask for money from them, but I’d ask for less than I would a stranger.

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13 Answers

ANef_is_Enuf's avatar

Are you certified? Often times medicare will help to cover the costs for senior care. That might be worth looking into.

WestRiverrat's avatar

Sounds like you should try to get them into an assisted living facility. Assisted living will let them live semi independantly, but still have help and company close at hand.

I would look into the state laws where you are before offering to assist. Often Medicare/medicaid will not pay for care given by a relative, but will pay for either assisted living or a home health nurse to visit.

ANef_is_Enuf's avatar

Many people, regardless of their age, have a hard time asking for.. and accepting help. If neither set of grandparents have actually asked for you to step in, it would actually be pretty bold of you to just dive in. First of all, you have to find out if they want your help. The grandmother caring for grandfather situation may be easiest to approach – you could ask her how she felt about paying for someone to do respite care for her while she runs errands. If she is open to the suggestion (she may already be thinking of it herself), you could suggest to her that it would be much cheaper to hire you. Hiring a private duty caregiver or HHA typically costs half what it would be to hire through a bonded agency. I’m sure your grandparents would understand that you’d require some type of payment for your services (other than cookies and hugs, that is.) and they might view it as a good opportunity. It sure beats paying a stranger even more than a trusted loved one.

As for the other grandmother, is there anyone else in the familial picture? Your parents? Her son/daughter?

keobooks's avatar

@WestRiverrat – I would REALLY like to get Grandmother A into a facility, but her children will not hear of it. I’ve been asking them for years. They have the final say. They keep telling me that she only needs a “little bit” of help. They all live very far away and I am the only nearby relative. Sometimes I feel a bit put out because her children are all single and childless and don’t seem to get that it’s hard to balance a job, family and soon children AND do all of her errands, take her places and help her with stuff as much as she needs it.

Grandparents B—refuse assisted living. Considering that my grandmother could likely bench press me and still does all her own farming, AND manages to do all her own taxes accurately and better than I can, I can’t really argue with her. I just think the stress of doing it all by herself is getting to her.

@TheOnlyNeffie No, I’m not certified. I just want to help. I already help out one grandparent on a weekly basis, but my job and other duties get in the way and I can’t help her as much as she needs it. The other grandparents only need a little help, and I’d like to be able to see them more often.

lillycoyote's avatar

Why are you the one/why would you be the one who would be taking on the care of your grandparents; instead of their own children taking on the responsibility?

WestRiverrat's avatar

@keobooks With Grandmother A, maybe you should start billing her children for the work you do for her. At least tell them if they want you to continue giving the care she needs, they will have to shell out for daycare so you have the time to devote to her.

My parents are like your Grandparents B. We were able to talk them into hiring a maid to come in to clean once a week. But that is only because we convinced them the maid was desperate and needed the money to keep her kids. After they got used to her, they were more willing to allow others to start helping.

jca's avatar

there may be day programs for seniors in your area. In my state, Medicaid pays for the day programs and the programs transport the people. there are programs for people with alzheimer’s, programs for blind people (i live in a wealthy county but check out what’s in your area), and the programs feed people lunch, go on trips, and in addition, offer services like OT, PT and some even shower people. there’s even a night program for seniors that are awake all night and sleep all day.

they’re not going to be eligible for visiting nurse service if they don’t need actual nursing. where i live/work, visiting nurse service is given/paid for by Medicaid/Medicare only if the patient has recently been discharged from hospital. someone who just needs a little help with being served lunch or help bathing or toileting will not qualify for a visiting nurse, as the level of care of a visiting nurse is way above what is necessary to toilet someone or cook them lunch.

do you want to do this more because you need the money or more because you feel obligated? if you feel obligated, then i would want the adult children to take on some responsibility if i were you.

where i live, a Personal Care aide (which is the lowest level of aide – it’s what you would do since you’re not certified in anything – a PC aide does tasks like cleaning and helps with personal care, like toileting or bathing) makes about $10/hour.

YARNLADY's avatar

If they’re anything like my Mother In Law you are walking on quicksand. She has finally accepted the services of the woman the VA paid to help Grandpa. She is paying out of the insurance settlement she got when Grandpa passed away.

Our Daughter-In-Law is out of work and could really use the money to help her, but MIL told me she would never ask a family member to help her with her “personal” needs. She’s too proud to ask someone close to her for help.

keobooks's avatar

@TheOnlyNeffie—With grandparent A, I already do stuff for her. I’d just like it to be a slightly more formal arrangement. I don’t want to diss my dad and his siblings, but to be honest they seem in denial about their own mother. They want to come home for Christmas to their childhood home, stuff like that. With Grandparent B, they refuse help from all family members. I MAY have an in, because my grandmother could slightly fool herself into thinking that she’s doing ME a favor by offering me work—and she’d see me more often. Every time I visit, she tries to “backwards pick my pocket” and stuff money in there. So I think she’d feel like she was doing a good deed by “letting” me work.

@ica—If I quit my job, I would need the money. I don’t know exactly about feeling obligated. Right now, I feel pressured and obligated with grandma A, because I’m trying to juggle her in with all of my work. If I could quit my job and work for her, I’d feel much LESS pressure. And to be honest, she’s low enough physical maintenance that I could likely have my daughter there sometimes and it would be really nice to not have to take my daughter to daycare and work with my family instead. I just think I’d enjoy what I do for her more if I didn’t have to fit it in—it was just part of my life. With grandparents B, I’d like to be able to see them more. And my grandmother was acting really moody and she really needs some time by herself.

@ica My grandfather is a new dialysis patient and needs a great deal of physical care. He most likely qualifies for a nurses aid. It’s just a matter of my grandmother allowing it. I am not qualified to take care of him on a serious basis. Most likely I’d just spend time with him and get food/drink for him and keep him from getting bored and into trouble while my grandmother went out and did some things for herself. She can’t leave the house for a minute anymore she says because he gets bored and starts walking around the house and he falls. I think entertaining him for a few hours would keep him from getting into trouble.

jca's avatar

@keobooks -it’s JCA not ica – i know it looks like ica.

keobooks's avatar

@jca—THANKS sorry about that. I kept wondering why you didn’t show on the @list.

Neizvestnaya's avatar

Go to Social Security and if applicable the VA because there is assistence for caregivers. My mother got tax breaks while she housed and cared for my alzheimer’s suffering grandfather. Prepare yourself emotionally though for them not to be receptive, cooperative or appreciative. Some people accept help very begrudgingly, even from loved ones. It’s A LOT of work and very emotionally draining. It feels good to help but it kicks your butt! The VA has programs for part time visitors, nurses and don’t forget Meals On Wheels.

Andreas's avatar

@keobooks You have certainly set a lofty and fine goal for yourself, and I salute you.

Helping family in these times is never easy and it seems only one or two individuals ever step up to the plate.

On the subject of your grandparents not accepting help: When my grandmother passed away, my mother and aunt organised home care for my grandfather. There was a time when certain electrical work had to be done (and he had been a licenced electrician!), but unfortunately he always refused help. His carer had to say to him, “Remember, Dick, we talked about this the other day, and we agreed that it would be good to have this work done?” At that point my grandfather would say, “Oh! Yes. I do remember that.” The work would get done even though no such conversation ever took place! At that stage he was going into Alzheimers. On another occasion we had to pretend that some necessary work was being done by a personal friend of mine as a favour to me, which was not the case at all.

We had to see this as being a necessary thing more than a confidence trick because of his then mental state, but it didn’t always sit well with me. I tell you this by way of some practical suggestions which you may find useful to adapt to your situation.

When our elderly family members are in these types of situations, no-one else’s situation will ever be the same, but all suggestions can be listened too and hopefully a worthwhile path will open to you.

All the best.

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