Elder "Au Pair" Plan?

[marko]

As I've mentioned here a few times, my 62 year old brother suffered a massive stroke almost two years ago. I'll spare the details but if you envision a semi-independent 83 year old man, that's about where he is physically and cognitively today.

He's well enough that our 89 year old mom--who he lives with--can easily handle his needs; mostly companionship, med reminding and driving him to lunch and appointments (yes, she still drives). He's able to do most everything else on his own (bathing, dressing, light meals etc). We have a housekeeper who comes once a week.

Looking further down the line, I know that mom won't be around forever and I have an idea that I'm hoping will allow him to stay at home and avoid heading to an assisted living facility too soon.

So, here's my plan: Mom lives in a big house with an entirely separate four room apartment. Brother is staying in that apartment as it's all on one floor. When mom departs, my thinking is to offer mom's living space for free (or very modest rent) to "the right person" in exchange for providing my brother all the things mom was doing, mostly companionship and driving. Sort of a live-in "au pair" situation.

For brevity, I've left out a lot of details but that is the overall situation and idea. Living with me is not a good option.

But I'm wondering about what could be the downside of this idea:
What if the person --for any one of a dozen reasons-- doesn't work out?
What if things change and the person doesn't want to move out?
What if....? I don't know what I don't know.

As the time were to near, I would certainly run this by our attorney and likely have some sort of contract done, but I'm curious what the wise folk here think before I get too enamored with the idea.

 

[youbet]

I suspect you'll have a real challenge finding a competent, trustworthy person to take this opportunity if you're only offering free rent as compensation. Will the person's time be mostly their own with just a few interruptions for driving your brother around, making sure he takes his meds and providing some companionship/socialization from time to time? Will the person have some regular days off? Or will he/she be largely tied down and involved in several hours of duties each day? If the latter, in the Chicago area you'd have to provide a salary + expenses as well as room and board.

What will you do if your brother begins to require more care than currently but is still at a point where you'd like to spare him from residential assisted living? Perhaps a situation where the caregiver can seldom leave him alone and must perform significant chores? Doing that for only free rent would be asking a lot IMO.

Good luck on finding "the right person." Hopefully you already have someone (a family friend, relative, etc.) in mind. Otherwise, contact an agency and get their input on your idea and if they think they could locate someone who would accept your meager terms, be flexible in terms of future requirements and do a responsible/reliable job.

 

[MissMolly]

I, personally, don't think you will find anyone willing to devote themselves 24/7 to your semi-invalid brother with no pay and expected to pay a "modest" rent. How are they supposed to support themselves and or even earn money to pay the "modest" rent? Being available full-time is a physical and emotional drain. I find this scenario highly unlikely.

 

[ivinsfan]

It's a nice idea but real world realistic.. I assume your brother is on SSI...

I suggest you turn your thinking in the direction of assisted living of some sort for your brother. Look for a facility that has the assisted directly to nursing home living to avoid too much change. Some places even have just apartment type places with more freedom and med supervision and transit available.

If you haven't done it already, and if your brother is agreeable and understands the implications you get his POA . With an 89 YO mother and your DB at a mental/physical age of 80 something I'd talk to an elder care attorney about your options in regards to one or both of them. Their present situation doesn't seem likely to continue long term.

 

[marko]

Thanks for the input so far.

To be a bit more clear, I'm thinking of a sort of PCA (Personal Care Assistant) situation which is quite common. Our neighbors in Florida have a live-in for their mom.
My grandfather had a similar setup 30 years ago with a neighbor woman who'd come in twice a day. It's not a 24/7 requirement.

Just thought a free apartment might be an avenue for a reduced salary and the ability to not have to commute.

Money for salary is not a problem. I was thinking of a retired person looking for free rent as a first pass. We can pay and could go through an agency.

He can be left alone for all day if required, as often happens today; not 24/7. This could also work for someone working a part time job.

Family has attorney on retainer; legal/elder issues fully covered.

 

[eytonxav]

Finding a trustworthy person to buy into that would be tough, but if you do find such a person, keeping that person over an extended period of time might be tougher.

 

[TrvlBug]

The problem is finding someone reliable. DD had a stroke 20 yrs ago leaving him paralyzed on one side. The stroke also brought out his negative personality traits so living with me was out of the question. We hired 24/7 in home caregiving providing free room and prevailing salary for area. Brought in agency hire one day a week as well as for vacation and emergency needs.

The 2 private hires, all vetted and previous employers called, lasted a couple of months. They kept on moving in family members . Then went to full agency hire. These people either stole from him or talked him into giving them substantial loans. Did get a couple of them fired once I found out about this. Some of the loans never got repaid. He ended up in a 6 person highly rated board and care home and this was the best solution.

I agree with poster above who suggested assisted living. Base on my experience, I would never again go the private hire route.

 

[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. Another was for caregivers to be selling valuable objects and jewelry from the house. Outright theft is not uncommon either, like the caregiver intercepting and cashing checks that come in the mail or using the client's checkbook or credit card number to pay for caregiver's purchases. And, of course, there is the ever-popular writing oneself a check from the client's account.

This happens with independent caregivers such as your idea and also with agency-provided caregivers.

DW was also a member of our state's Board on Aging. The estimate there is that 85% of frail elders have been financially abused, often by relatives.

Are we having fun yet? I have no suggestions on how to evaluate this risk in your situation but you do need to be aware of it. Certainly you must plan to monitor your brother's financial activities and assets carefully and frequently. It may make sense, too, to have yourself named guardian.

 

[TrvlBug]

I tried, without success to edit my post to add that I was warned away from private hire by friends and co-workers who had experience. Theft was rampant.

 

[OldShooter]

I agree with the recommendation for assisted living as the best alternative, but that is not a panacea for preventing theft. My mom was in a very high-end assisted living facility and took the precaution of having a locksmith install a very good lock on the jewelry drawer of her chest of drawers. After she died we found a box in that drawer that was empty, formerly having held a valuable gold bracelet. How/when? Who knows?

 

[Bamaman]

We had to have help watching over my parents, and it is just so difficult to find reliable people. We spent substantial time working through our options, but time and situations have a way of changing. Our planning ended up being moot.
We ended up with my mother in a very plush assisted living apartment, and she had a life of her own that was very happy.

 

[Scrapr]

Our neighbor's dad had a major stroke about 10 years ago. She got control (guardianship) and moved him to the West Coast. She found a adult foster care home for him. About 3-6 clients in the home. These are pretty common in our area. She had a good experience with them. He was there about 4-5 years before moving up the care continuum.

Maybe try something like that as an interim step before full on AL

 

[tmm99]

Are you thinking of defining exactly what this person needs to do? For example, this person will only work 5 hours a day 5 days a week from 10AM to 3PM, including the time to take your brother shopping, drive him to his doc, cleaning the house, and being his companion? If the job description is open-ended, like what your mother does, that would probably be more like a 24 x 7 "beck and call" job, and that probably won't fly for anybody, unfortunately.

 

[ivinsfan]

Thanks for the input so far.

To be a bit more clear, I'm thinking of a sort of PCA (Personal Care Assistant) situation which is quite common. Our neighbors in Florida have a live-in for their mom.
My grandfather had a similar setup 30 years ago with a neighbor woman who'd come in twice a day. It's not a 24/7 requirement.

Just thought a free apartment might be an avenue for a reduced salary and the ability to not have to commute.

Money for salary is not a problem. I was thinking of a retired person looking for free rent as a first pass. We can pay and could go through an agency.

He can be left alone for all day if required, as often happens today; not 24/7. This could also work for someone working a part time job.

Family has attorney on retainer; legal/elder issues fully covered.

I understood that at this time he would be fine with a PCA...I think you are looking at full salary and perhaps using the free rent as an inducement to fine someone exceptional. It sounds like a big enough living area for a couple. Perhaps an older couple who need income and lighter duty.

 

[ivinsfan]

Are you thinking of defining exactly what this person needs to do? For example, this person will only work 5 hours a day 5 days a week from 10AM to 3PM, including the time to take your brother shopping, drive him to his doc, cleaning the house, and being his companion? If the job description is open-ended, like what your mother does, that would probably be more like a 24 x 7 "beck and call" job, and that probably won't fly for anybody, unfortunately.

light living assistance and avaibility for emergencies is kind of an in between area. An older couple that wasn't interested in a lot of traveling and could trade off being available might a good answer. But any solution is going to require a huge amount of vetting by the OP.

 

[RAE]

Our neighbor's dad had a major stroke about 10 years ago. She got control (guardianship) and moved him to the West Coast. She found a adult foster care home for him. About 3-6 clients in the home. These are pretty common in our area. She had a good experience with them. He was there about 4-5 years before moving up the care continuum.

Maybe try something like that as an interim step before full on AL

Yes, this is the type of care we arranged for my dad for the last 5 years or so of his life. He could do some things for himself (bath, bathroom, etc), but cooking for himself was not an option. And he just generally needed someone to remind him about things and to keep an eye on him to make sure he didn't get into trouble. So, adult foster care worked out okay in his case. I wouldn't say it was ideal (there were some problems with the owner of the facility not doing some things she was supposed to be doing), but staying with me was not an option, and nursing home care was not really appropriate for his situation.

 

[Huston55]

I suggest you turn your thinking in the direction of assisted living of some sort for your brother. Look for a facility that has the assisted directly to nursing home living to avoid too much change. Some places even have just apartment type places with more freedom and med supervision and transit available.

I agree with poster above who suggested assisted living. Base on my experience, I would never again go the private hire route.

I agree with the recommendation for assisted living as the best alternative, but that is not a panacea for preventing theft. My mom was in a very high-end assisted living facility and took the precaution of having a locksmith install a very good lock on the jewelry drawer of her chest of drawers. After she died we found a box in that drawer that was empty, formerly having held a valuable gold bracelet. How/when? Who knows?

+4

My experience is that “in home care” rarely addresses a person’s needs over the entire spectrum of assistance required & time it’s required. One possible exception is if you’re very, very wealthy and can essentially pay for ‘in home’ assisted living then nursing care.

 

[youbet]

light living assistance and avaibility for emergencies is kind of an in between area. An older couple that wasn't interested in a lot of traveling and could trade off being available might a good answer. But any solution is going to require a huge amount of vetting by the OP.

And there are two sides to the coin.......

What if a caregiver signs up for the apartment, expenses and a modest salary in return for light living assistance and consistent availability and then things change? Will OP be quickly available to grab the reigns if care needs escalate? The client falls ill and needs to be hospitalized. Client falls and will be using a wheel chair or walker for months. Client's health degrades physically or he becomes mean/irritable. Etc. The caregiver needs to ensure there is a quick "out" if things suddenly change beyond what they expected. Or the total compensation package needs to be adequate to make those eventualities part of the deal.

After thinking this over since my original post, I'll now say that I wouldn't go with a direct hire on my own. I'd use an agency that would provide supervision, backup and escalation of resources (if needed) over time and on short notice. Or, I'd sell the house and go with assisted living.

 

[ivinsfan]

You can do vetting through an agency too. It's possible the perfect couple will magically appear in a private hire situation but not likely.

In post number four I suggested assisted living as the best option..but no reason the OP can't spitball other solutions before things become an emergency.

 

[TrvlBug]

After thinking this over since my original post, I'll now say that I wouldn't go with a direct hire on my own. I'd use an agency that would provide supervision, backup and escalation of resources (if needed) over time and on short notice. Or, I'd sell the house and go with assisted living.

We had financial abuse problems using an agency...see my post above. They simply don't monitor their people as that function is left for family members to perform. My favorite though was from one (don't recall if she was removed due to financial issues) who wrote him letters professing her love for him and wanting to get married...somehow she knew he wasn't a poor pensioner .

Just remembered that the second direct hire had his address changed to her family's address. His financial mail stopped coming to my house.

I also discovered several thousand dollars missing from one of his IRAs and we were never able to determine how it went missing...the issues never ended. Overseeing his care (both private hire and through an agency) for the 2 years I did put an incredible strain on me, my work and my marriage. I almost had a nervous breakdown.

 

[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]

... 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]

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.