Elder "Au Pair" Plan?

[W2R]

My oldest brother had a series of strokes that left him physically and mentally disabled, with very poor short term memory. When my mother died, we arranged for him to immediately get her place in the continual care facility where she lived, and somehow he was even able to move in a few months before she died without having to go through the waiting list procedure.

It has been great. They make sure he takes his pills when he is supposed to, they provide good nutritious meals, and make sure he is seeing the doctor regularly. Also they are equipped to deal with any further disability that may occur. Taking care of a 6'4" heavy, muscular guy (former high school football player) in his 60's and 70's who needs physical help and more for his usual daily life, is more than any one home assistant could manage. Also due to his mental disabilities, he became surprisingly hostile and hard to get along with and this too is more than a home assistant would be willing to endure. But the facility is used to dealing with difficult residents.

He didn't originally want to move in there, but reluctantly agreed when his son and brother both pointed out to him that he needed to be there.

So, basically I am "voting" for a good facility as opposed to a home health care assistant because that worked out so nicely for Bob.

[Walt34]

When I was working in the Fraud Section as an investigator I saw many instances of elderly people being financially taken advantage of, either by outright theft of things and money, by forgeries, and being swindled by con artists with a sob story. Relatives were the most common culprits but many thieves were also home caregivers. It didn't seem to matter whether they worked for an agency or were independents. I suppose there are honest ones out there but I got to be pretty cynical about home caregivers.

So - if you do have an in-home caregiver make sure to remove anything of value that isn't literally nailed down and remove any financial papers, checkbooks, statements and the like, and of course any cash. And it is best, if possible, to give the any caregivers the impression that the person needing care is deeply in debt and on the verge of bankruptcy.

[45th Birthday]

I think your plan can work, depending upon where you are (access to a good pool of potential help). I think you should be looking for a couple for more stability and also to provide some respite for each other.

I personally know two very wealthy families who have "a couple"-and yes they refer to them as that-who do things like cooking, cleaning, driving, light maintenance, etc. One family has a couple at each of their houses. They provide living quarters, food, and a small stipend.

I don't think the financial fraud/abuse risk is really any higher with this situation if you safeguard access to funds, and keep valuables off premises.

Good luck.

[OldShooter]

Quote:

Originally Posted by 45th Birthday ... I don't think the financial fraud/abuse risk is really any higher with this situation ...

Just out of curiosity, what is your experience that leads you to believe this?

[ivinsfan]

Quote:

Originally Posted by 45th Birthday I think your plan can work, depending upon where you are (access to a good pool of potential help). I think you should be looking for a couple for more stability and also to provide some respite for each other. I personally know two very wealthy families who have "a couple"-and yes they refer to them as that-who do things like cooking, cleaning, driving, light maintenance, etc. One family has a couple at each of their houses. They provide living quarters, food, and a small stipend. I don't think the financial fraud/abuse risk is really any higher with this situation if you safeguard access to funds, and keep valuables off premises. Good luck.

This doesn't sound like someone having health issues, or being dependent on a caregiver and perhaps having cognitive issues as well. The fact of being dependent on someone for daily living can blur the boundaries for the person getting the care.

These people sound independently wealthy with live in help..a different scenario.

[Dash man]

We did this with my mother for the last year of my mother’s battle with cancer. But we were able to find a friend of my mother who had recently divorced and needed some help herself. We gave her her own room for helping my mother and no pay. She did find a job for her own money and was saving up for when she had to move on. We agreed to rent the place to her for a year after my mother passed for the cost of the mortgage, which was quite low. After a year we sold the place and she moved on. It was a win win for both of us. She took good care of my mom and was able to get back on her feet living rent free.
We had no trouble trusting a family friend, but a stranger needs some safeguards.

[marko]

Thanks to all for your insights! Looks like I still have some thinking to do.

Very much appreciated.

As far as fraud and theft, we're very familiar with having in-house help (cooks, housekeepers, au pairs as children etc) over the years and long ago put measures in place.

I wish someone WOULD steal some of the stuff there though! Five generations of no-one moving out and just dying instead leaves a lot of stuff behind!

[marko]

Quote:

Originally Posted by Dash man We did this with my mother for the last year of my mother’s battle with cancer. But we were able to find a friend of my mother who had recently divorced and needed some help herself. We gave her her own room for helping my mother and no pay. She did find a job for her own money and was saving up for when she had to move on. We agreed to rent the place to her for a year after my mother passed for the cost of the mortgage, which was quite low. After a year we sold the place and she moved on. It was a win win for both of us. She took good care of my mom and was able to get back on her feet living rent free. We had no trouble trusting a family friend, but a stranger needs some safeguards.

This is kind of the situation I had in mind for a short to mid-term period of time. Yes, eventually, he'll have to go to assisted living but I'd like to find a similar win-win. He needs help but not a lot of help; more like someone who'll watch TV with him and take him out to lunch.

We have the ability to also pay the going rate if need be.

As noted, we had a woman from the neighborhood who worked for my grand father in this way for over 15 years.

Time will tell.

[Sunset]

Quote:

Originally Posted by OldShooter The risk of caregivers taking financial advantage of their clients is not to be ignored. My wife retired as an SVP in Investments & Trust at a major bank and has many tales of financial abuse. One common one was for the caregiver to have the client's checkbook to buy groceries, then buy his/her groceries at the same time. .....

So true.
I worked for a non profit in their group home, and every week we had to take a client or two and grocery shop for 12 people for the week. In today's dollars it was probably $300-$400 worth of stuff.

I was in an upper room and saw the fellow staff person drive up and have clients unload the trunk, except for 2 bags ?

Sure enough the amount of groceries in the kitchen seemed a little light. I asked her if all the groceries came in and of course the answer was yes. She claimed she did her own grocery shopping at the same time which is why their was 2 bags still in her trunk.

I reported it, but the supervisor couldn't do anything (even if shopping for your own groceries is pretty odd and means you aren't fully working).

There were so many ways to steal from our clients, it was really scary..

[45th Birthday]

Quote:

Originally Posted by OldShooter Just out of curiosity, what is your experience that leads you to believe this?

My wife's parents have 24 hour in home care from a mix of direct and small agency help. No one has access to any accounts, separate accountant keeps the books and is responsible for all disbursements. Wife has access to all spending online and watches it. Small valuable items are in a locked safe or safe deposit trunk at the bank. I suppose they could steal the furniture, which would be a blessing because then we won't have to deal with it.

[45th Birthday]

Quote:

Originally Posted by ivinsfan This doesn't sound like someone having health issues, or being dependent on a caregiver and perhaps having cognitive issues as well. The fact of being dependent on someone for daily living can blur the boundaries for the person getting the care. These people sound independently wealthy with live in help..a different scenario.

The health issues mentioned by the OP do not seem difficult, at least for now. No nursing duties, just daily stuff. The couples I mentioned manage large houses with people coming and going, and frequent entertaining. Probably a more complex situation than taking care of one person with housekeeping staff in place.

[gretah]

If your brother will need to move into a Medicaid-funded assisted living or nursing home facility, the waiting list to get a room could be long.

In my area, the wait is 2.5 - 3+ years.

Just something to factor into your plans.

[marko]

Quote:

Originally Posted by gretah If your brother will need to move into a Medicaid-funded assisted living or nursing home facility, the waiting list to get a room could be long. In my area, the wait is 2.5 - 3+ years. Just something to factor into your plans.

Appreciate the thought, but I don't see Medicaid in his future; he's pretty well resourced.

Having said that, I'm not sure if Medicaid pays for assisted living, only nursing homes; is that so?

[audreyh1]

Quote:

Originally Posted by marko Having said that, I'm not sure if Medicaid pays for assisted living, only nursing homes; is that so?

That seems to depend.

[Katsmeow]

Quote:

Originally Posted by marko Appreciate the thought, but I don't see Medicaid in his future; he's pretty well resourced. Having said that, I'm not sure if Medicaid pays for assisted living, only nursing homes; is that so?

In some cases Medicaid can pay for assisted living (or at least part of it). This may vary so would suggest talking to an elder care attorney in your brother's locale.

Something else I wanted to mention. You referred to this as being similar to an "au pair." When our kids were younger we did use au pairs. It is in no way a simple swap of room and board for someone who is on call 24/7. I realize you indicate the person would not have to work full-time even, but it is unclear whether you would expect them to be on call 24/7. For example, could the person stay out all night or would they be expected to be present in the home at night? If the latter, then that would probably count as working.

Anyway -- when we had an au pair, the au pair was paid minimum wage. The room and board could suffice to cover part of the minimum wage. However, there was a formula for this and it only covered a part of the minimum wage. The rest of it was paid in wages.

Also, this was based upon working 40 hours a week. We were not allowed to ask the au pair to work additional hours. (Note that if we had been allowed to do so then overtime rules would have applied -- we couldn't do that so I don't know the details). For example, if the au pair's day was over at 7 PM, we couldn't just leave the house and go somewhere and expect the au pair to be available if the kids needed anything. That would have been considered her working. Once her day was over she was perfectly free to go anywhere she wanted to until her next shift started.

All of this is to say that this idea may be far more expensive than you anticipate. Also note that the expenses went beyond the minimum wage as we did pay our share of payroll taxes.

Of course if you go through an agency so that you aren't the employer of the person then you don't have to worry about some of this. But, an agency is probably going to want to charge a high hourly rate based upon the hours worked.

[marko]

Quote:

Originally Posted by Katsmeow Something else I wanted to mention. You referred to this as being similar to an "au pair." When our kids were younger we did use au pairs. It is in no way a simple swap of room and board for someone who is on call 24/7. I realize you indicate the person would not have to work full-time even, but it is unclear whether you would expect them to be on call 24/7. For example, could the person stay out all night or would they be expected to be present in the home Also, this was based upon working 40 hours a week. We were not allowed to ask the au pair to work additional hours. (Note that if we had been allowed to do so then overtime rules would have applied -- we couldn't do that so I don't know the details). For example, if the au pair's day was over at 7 PM, we couldn't just leave the house and go somewhere and expect the au pair to be available if the kids needed anything. That would have been considered her working. Once her day was over she was perfectly free to go anywhere she wanted to until her next shift started.

As I noted at the start, I deliberately kept the details sparse for the sake of brevity but I now realize it doesn't paint the entire picture.

I see him myself every single day --he lives a block away--and take him out to the driving range, doctor visits and lunch or dinner. What I'm looking for is someone to fill in some gaps rather than provide full time supervision.

I'm just in the 'thinking phase' but I was envisioning something more casual in the line of "the lady next door who drops in twice a day to see if he needs anything".

Something where the person would set their own time and agenda of help; within certain parameters of course.

As noted, he doesn't need someone all day every day. He needs someone to keep him company and drive him places.

As it is now, mom might have breakfast with him 4-5 days a week, goes on her errands, takes him for a ride and leaves him alone around noon, then comes over to watch TV with him around 5PM, has dinner with him and then leaves for the night. Every day is different but she usually spends about 3 hours a day face to face. He sleeps a lot and is quite happy (as he always had been) watching the ballgame/hockey/golf on TV all day.

Cost is not an issue.

[ivinsfan]

Marko you sound like you come from a great caring family and your brother has the best life possible.

Right now your brother lives in his place albeit attached to Mom's home and it takes 2 people working in tandem to provide him with this life. You aren't going to find one person to have breakfast with your brother and be there on and off till bedtime.

I keep circling back to starting to look for a great assisted living facility where you can put his name on the waiting list. The best ones all have a wait list. What if you or your Mom becomes seriously ill or for some reason can't continue the daily routine. You know it will happen sometime.

Are you willing or able to moved into your Mothers house when she is no longer living there, it would be easier to arrange daily outings or company for your DB then it would be simpler to get reliable/honest help

It's great that money isn't a problem and one thing you haven't mentioned is if you have talked to your DB about what he thinks should happen when your Mom isn't here to give him daily attention and companionship.

[Aerides]

From what you've described Marko, I think you'd need to find someone with some nursing background and strength (there will come a time, when not if, that both of those will be helpful). And while that person would have a flexible schedule, it sounds like one that would preclude their ability to get a full time outside-the-home job, or have their weekends totally their own.

So, perhaps a rent-free+small income plan would be needed for that sort of arrangement. Your mom's current schedule might only add up to 3 hours a day, but if I had her schedule it would be hard to make other plans for any income.

[Amethyst]

+1 Agree with the thoughts of Ms. Cat-tail Orchid.

Quote:

Originally Posted by Aerides From what you've described Marko, I think you'd need to find someone with some nursing background and strength (there will come a time, when not if, that both of those will be helpful). And while that person would have a flexible schedule, it sounds like one that would preclude their ability to get a full time outside-the-home job, or have their weekends totally their own. So, perhaps a rent-free+small income plan would be needed for that sort of arrangement. Your mom's current schedule might only add up to 3 hours a day, but if I had her schedule it would be hard to make other plans for any income.

[tb001]

I think this can work, but it really requires time to find the right person/people and you have to spend some time thinking about the ways it can go wrong. It really can be an ideal situation for someone living on disability or a small pension/ss.

My mother has a small detached apt on her property and has had a caretaker living there for many years. They help out with feeding animals and taking care of the house when my parents are on vacation and generally help maintain the property. The woman they have living there now is great and has been there for several years, but it’s taken a bit of time to find the right person.

A few things to think about. As others have said, having a defined set of responsibilities is key. What happens if they are injured or become ill and can’t do the job anymore? Or worse, are injured in the course of working? How do you intend to deal with someone who isn’t working out? What happens when your DB needs more care?

We have a detached casita and have thought about doing this in exchange for light housekeeping or childcare. Right now the additional $ isn’t worth the hassle, but that may change if I stop working.

FWIW, we’ve had great luck finding people for help like this through a couple of avenues. We used care.com and found an older religious woman in a lower income area who was retired but baby sitting for extra $ during retirement. She has a huge network of friends and family and has been a great resource for help when we need it. We’ve also had great luck with a mainly Hispanic church in the same area. At one point pretty much every person we hired for help around the house came from that church.

I agree with others who suggested a couple—you may find that this will just be easier. Honestly, I think you can find great people for an arrangement like this where it’s a huge help for both parties, but just like when hiring any sort of home help, you really have to find the right person.